Rheumatic disease 1

Question 1

What is meant by degenerative

Answer 1

occurs in age
- osteoarthritis

Question 2

what is meant by articular

Answer 2

affects joints

Question 3

what are the 2 categories of articular disease

Answer 3

inflammatory or degenerative

Question 4

give examples of inflammatory disease

Answer 4

RA, SLE

Question 5

give examples of degenerative disease

Answer 5

osteoarthritis
-hand, large joints, spine

Question 6

what are the characteristics of articular inflammatory disease

Answer 6

1. often symmetrical involvement
2. small joints always affected, sometimes large joints
3. EMS> 30 mins, pain with activity
4. soft tissue swelling

Question 7

describe how the ACR/EULAR criteria is used to diagnose RA

Answer 7

point system divided in sections
1. joint distribution
2. serology
3. symptom duration
4. acute phase reactants
- score above 5 indicates RA

Question 8

Describe the onset of RA

Answer 8

Usually a slow, insidious onset over weeks to months
- about 15% of individuals have rapid onset
- about 8% have acute symptoms that develop over days

Question 9

give examples of RA non joint features

Answer 9

1. nodules
2. sicca
3. dry eyes
4. others (uncommon)- inflammation in blood vessels

Question 10

what is the causation of RA

Answer 10

1. genetic and environmental factors (smoking)
2. complex and poorly understood
3. HLA determines severity and involves different gene systems
4. trigger could be injury/virus or infection

Question 11

what could RA lead to if left untreated

Answer 11

1. disability
2. damage
3. deformity
4. death

Question 12

outline the treatment and prognosis of RA

Answer 12

1. NSAIDS
2. steroids
3. conventional synthetic disease modifying antirheumatic drugs (csDMARDS)
4. targeted synthetic disease modifying antirheumatic drugs (tsDMARDS)
5. biologic disease modifying antirheumatic drugs (bDMARDS)

Question 13

describe the surgical intervention methods that can be used for RA

Answer 13

1. removal of inflamed synovium
2. arthroplasty
3. reconstruction/fusion
   - high risk procedure
   - questionable outcomes

Question 14

what is meant by scleroderma

Answer 14

hardening of the skin

Question 15

what is meant by myositis

Answer 15

inflammation of the muscles

Question 16

what is meant by vasculitis

Answer 16

inflammation of blood vessel walls

Question 17

what does lupus commonly affect

Answer 17

commonly affects kidneys
- can also affect the heart even if not feeling any heart symptoms
- most common problem is bumps and swelling of the endocardium

Question 18

where can the inflammation of lupus be seen

Answer 18

in the lining, covering and muscles of the heart

Question 19

describe the rash effects caused with SLE

Answer 19

• people will SLE are very sensitive to sunlight
• rashes are red, itchy and painful
• most typical is butterfly rash which appears on face

Question 20

describe the joint pain caused with SLE

Answer 20

• most commonly hands, wrists and knees
• usually the same joints on both sides of the body are affected
• pain can come and go or it can be long lasting
• soft tissue around the joints are often swollen, but there is usually no excess fluid in the joint

Question 21

how does SLE affect pregnancy

Answer 21

the chances of miscarriage, premature birth and death of baby in the uterus are high

Question 22

a patient scores 7 on the ACR/EULAR classification. Describe the components of this classification system and why this score is important in diagnosis

Answer 22

1. components of classification system:
   - joint distribution
   - serology
   - symptom duration
   - acute phase reactants
2. this score is important in diagnosis as it allows the patient to be treated, and as the treatment for RA should commence within 12 weeks of diagnosis, it means that appropriate treatment can commence for the patient