RA overview

Question 1

What happens in autoimmune diseases?

Answer 1

Autoimmune diseases occur when the immune system is dysregulated, leading to a loss of self-tolerance and attacking the body’s own tissues.

Question 2

What are autoimmune disorders associated with?

Answer 2

Autoimmune disorders are associated with a broad range of diseases affecting different organs and systems in the body.

Question 3

What factors contribute to the development of autoimmune diseases?

Answer 3

Autoimmune diseases may result from multiple interactions between genetic predisposition and environmental factors.

Question 4

Name an autoimmune disease that affects multiple organs.

Answer 4

Systemic lupus erythematosus (SLE) affects multiple organs.

Question 5

Which autoimmune disease affects the blood?

Answer 5

Autoimmune haemolytic anaemia affects the blood.

Question 6

What autoimmune disease affects the endocrine system?

Answer 6

Type 1 diabetes affects the endocrine system.

Question 7

What autoimmune disease affects the nervous system?

Answer 7

Multiple sclerosis affects the nervous system.

Question 8

Which autoimmune disease affects the bones and joints?

Answer 8

Rheumatoid arthritis (RA) affects the bones and joints.

Question 9

What are common clinical features of autoimmune rheumatic diseases?

Answer 9

Common features include malaise, fatigue, weight loss, myalgia, arthritis, and anemia of chronic disease.

Question 10

What is the 2010 ACR/EULAR criterion for diagnosing Rheumatoid Arthritis (RA)?

Answer 10

RA is based on synovitis in at least one joint, no better alternative diagnosis, and a score of at least 6 from factors like involved joints, serological tests, and symptom duration.

Question 11

What is the British Society for Rheumatology (BSR) diagnostic criteria for RA?

Answer 11

RA diagnosis is based on persistent joint inflammation in at least three joints, including the metacarpophalangeal or metatarsophalangeal joints, and morning stiffness lasting at least 30 minutes.

Question 12

What is the prevalence of Rheumatoid Arthritis (RA) in the UK?

Answer 12

The prevalence of RA is 0.81% in the UK, with 1.16% for women and 0.44% for men.

Question 13

What are some predisposing factors for RA?

Answer 13

Hormonal deficiencies, environmental triggers (e.g., smoking, infections), and genetic factors (e.g., HLA-DRB1) are associated with the development of RA.

Question 14

How does RA evolve from genetic predisposition to chronic inflammation?

Answer 14

RA evolves from genetic/environmental predisposition, early immune activation, synovitis, synovial hyperplasia, joint destruction, to chronic inflammation.

Question 15

What is the role of autoantibodies in RA?

Answer 15

Autoantibodies like rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs) may be detectable long before symptoms and contribute to synovial inflammation.

Question 16

What are some extra-articular manifestations of RA?

Answer 16

Extra-articular manifestations may include symptoms affecting the skin, lungs, eyes, and heart.

Question 17

What are some common clinical manifestations of advanced RA?

Answer 17

Advanced RA causes chronic joint pain, stiffness, deformities (e.g., swan neck deformity), and loss of joint mobility.

Question 18

What is the role of DMARDs in treating RA?

Answer 18

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate slow disease progression, control inflammation, and prevent joint damage in RA.

Question 19

How is RA disease activity measured?

Answer 19

RA activity is measured using DAS28, which calculates disease activity based on joint tenderness, swelling, and inflammatory markers.

Question 20

What is the prognosis for untreated RA?

Answer 20

Untreated RA leads to rapid decline in quality of life, increased morbidity, and reduced life expectancy by 3–18 years.