RA Flashcards
In the treatment of rheumatoid arthritis
a. methotrexate inhibits DNA synthesis in immune cells
A. False. This is leflunomide, Methotrexate MOA in RA unclear but:
- Increases extracellular adenosine increase adenosine A2A receptor signalling decrease inflammation
- Increases ROS in T-cells apoptosis
- Reduces expression of adhesion molecules VCam- 1, I-Cam, E-selection
- Decreases pro-inflammatory cytokines
- Suppresses early T- and B-cell proliferation
- Decrease antibody formation to TNF-α McABs
In the treatment of rheumatoid arthritis
b. leflunomide is safe to use during pregnancy
B. False. CI in pregnancy. Requires 2-year washout period
In the treatment of rheumatoid arthritis
c. infliximab binds to TNF-α
C. True. Infliximab has a high-affinity for TNF-α
In the treatment of rheumatoid arthritis
d. folic acid supplementation aggravates methotrexate-induced hepatotoxicity
D. False. Folic acid reduces methotrexate associated adverse effects
In the treatment of rheumatoid arthritis
e. sulfasalazine is hepatotoxic
E. True. Sulfasalazine is
- Hepatotoxic
- Myelotoxic
- Hypersensitivity
- Megaloblastic anaemia
Disease modifying agents in rheumatoid arthritis
a. methotrexate causes mucosal ulceration
A. True, Methotrexate causes:
- Hepatotoxic
- Mucosal ulceration & bleeding (Mouth ulcers common)
- Nephropathy
Disease modifying agents in rheumatoid arthritis
b. leflunomide inhibits T-cell proliferation
B. True, inhibits mononuclear and Tcell proliferation Active metabolite Inhibits dihydroorotate dehydrogenase No pyrimidine (uridine) synthesis Decrease synthesis of DNA/RNA in immune cells
Disease modifying agents in rheumatoid arthritis
c. sulfasalazine increases TNF-α levels in arthritic joints
C. False. Sulfasalazine
- Decrease RF
- Inhibits T cell response
- Decrease B cell antibody production
- Decrease IL-1, IL6, IL12, TNF-α
- MOA ≠ Cox inhibition
Disease modifying agents in rheumatoid arthritis
d. infliximab is safe to use in patients with latent tuberculosis
D. False. Infliximab increases infection risk
Disease modifying agents in rheumatoid arthritis
e. hydroxychloroquine is a folic acid antagonist
E. False. MOA unknown. Methotrexate is a folic acid antagonist n cancer
The following is/are true regarding rheumatoid arthritis:
a. NSAIDS prevent the formation of bone lesions
A. False. IL-6 receptor prevents osteoclastic activity
The following is/are true regarding rheumatoid arthritis:
b. Methotrexate is hepatotoxic
B. True, Methotrexate causes:
- Hepatotoxic
- Mucosal ulceration & bleeding (Mouth ulcers common)
- Nephropathy
The following is/are true regarding rheumatoid arthritis:
c. Hydroxychloroquine increases the risk of ocular damage
C. True
The following is/are true regarding rheumatoid arthritis:
d. Leflunomide is safe to use during pregnancy
D. False.
The following is/are true regarding rheumatoid arthritis:
e. Infliximab increases circulating TNF-α levels
E. False, decreases by binding to both circulating and membrane bound