Rheum - RA

Question 1

Sx of RA?

Answer 1

Very rare to be DIP joints, usually PIP, MTP joints.
3+ joints
Present fo 6wk+
Usually slow onset
At least 1 hour of joint stiffness in the morning

Question 2

Felty syndrome?

Answer 2

Rare complication in severe long standing RA.

• Neutropenia, splenomegaly
• Often has fevers, thrombocytopenia, and vasculitis –> can lead to recurrent bacterial infxn

Question 3

Initial tx for RA?

For how long?

Answer 3

MTX

Indefinitely

Question 4

What two meds can be added to MTX before trying biologic therapies for RA?

Answer 4

Hydroxychloroquine and Sulfasalazine

Question 5

Benefits of TNF-a inhibitors and other biologic agents in RA?

Answer 5

• can achieve remission in new or established disease
• reduce risk of radiographic progression
• normalize acute phase reactants
• reduce cardiovascular risk