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REPOSITORY - Medicine and Physiology 2 > Rhematoid Arthritis > Flashcards

Rhematoid Arthritis Flashcards

1
Q

what is rheumatoid arthritis?

A

initially a disease of the synovium with gradual inflammatory joint destruction

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2
Q

what are the different patterns of joint involvement in rheumatoid arthritis?

A
  • sero-positive RA
  • sero-negative RA
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3
Q

what is the difference between sero-positive and sero-negative RA?

A

sero positive = rheumatoid factor present
sero negative = rheumatoid factor not present

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4
Q

who is more likely to develop rheumatoid arthritis?

A

females > males
(incidence increased after menopause)

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5
Q

what are the symptoms of rheumatoid arthritis?

A

Slow onset of symptoms =
- fatigue
- morning stiffness
- joint stiffness/pain
- minor joint swelling
- fever
- numbness & tingling
- symmetrical polyarthritis

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6
Q

what are the early signs of RA?

A
  • symmetrical synovitis of metacarpophalangeal joints
  • symmetrical synovitis of PIP joints
  • symmetrical synovitis of write joints
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7
Q

what are the late signs of RA?

A
  • ulnar deviation of fingers at MCP joints
  • hyperextension of PIP joints
  • “Z” deforming of thumb
  • subluxation of wrist
  • loss of abduction & rotations of shoulders
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8
Q

what are the extra-articular features of RA?

A
  • psoriasis
  • eye involvement (dry eyes)
  • subcutaneous nodules
  • amyloidosis
  • pulmonary inflammation
  • neurological
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9
Q

what investigations are carries out to diagnosis RA?

A
  • radiographs
  • blood tests to check for normochromic/normocytic anaemia
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10
Q

how is RA treated?

A

combination of
- physiotherapy
- occupational therapy
- drug therapy
- surgery

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11
Q

how is physiotherapy used to treat RA?

A

Active and passive exercises that
- maintain muscle activity
- improve joint stability
- maintain joint position

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12
Q

how is occupational therapy used to treat RA?

A
  • maximise residual function
  • providing aids to independent living
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13
Q

how is drug therapy used to treat RA?

A
  • analgesics (paracetamol, cocodamol)
  • NSAIDs
  • disease modifying drugs (methotrexate, hydroxychloroquine)
  • intra auricular steroids
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14
Q

how is drug therapy in moderate to severe cases of RA used?

A

Immune modulators used
- azathioprine
- mycophenolate
- TNF inhibitors
- Rituximab

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15
Q

how is surgery used to treat RA?

A
  • excision of inflamed tissue
  • joint replacement
  • joint fusion
  • osteotomy
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16
Q

what are the dental aspects of RA?

A
  • disability from disease (poor dexterity & access to care)
  • Sjögren’s syndrome causes dry mouth
  • joint replacements make it difficult to access care
  • drug side effects
  • chronic anaemia
17
Q

what RA drug treatments cause bleeding?

A
  • NSAIDs
  • sulphasalizine
18
Q

what RA drug treatments cause infection risk?

A
  • steroids
  • azathioprine
19
Q

what RA drug treatments cause oral lichenoid reactions?

A
  • gold
  • sulphasalizine
  • hydroxychloroquine
20
Q

what RA drug treatments cause oral ulceration?

A

methotrexate

21
Q

what RA drug treatments cause oral pigmentation?

A

hydroxychloroquine

22
Q

What are examples of seronegative spondyloarthritides?

A
  • ankylosing spondylitis
  • reiter’s disease
  • arthritis of IBD
23
Q

What are the features of seronegative spondyloarthritides?

A
  • association with HLA-B27
  • infection likely as a precipitant
  • often symmetrical peripheral arthritis
  • ocular & mucocutaneous manifestations
24
Q

Who is more likely to develop ankylosing spondylitis?

A

Male predominance (8:1)

25
Q

When is the typical onset of ankylosing spondylitis?

A

Around 20 y/o (rare after 45 y/o)

26
Q

What are the effects of ankylosing spondylitis?

A
  • disabling progressive lack of axial movement
  • symmetrical other joint involvement
27
Q

What are the symptoms of ankylosing spondylitis?

A
  • low back pain
  • limited back & neck movement
  • limited chest expansion
  • cervical spine tipped forward
28
Q

What is the treatment for ankylosing spondylitis?

A
  • analgesia & NSAIDs
  • physiotherapy
  • occupational therapy
  • DMDs
  • immune modulators
29
Q

What are the dental aspects of Ankylosing Spondylitis?

A
  • GA hazardous due to limited mouth opening & limited neck flexion
  • difficult dental access

REPOSITORY - Medicine and Physiology 2 (13 decks)

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