Rheumatoid Arthritis

Question 1

Determinants of RA (6)

Answer 1

• increasing age
• females
• Maori and European
• Disability
• Genetics
• Smoking

Question 2

Pathophysiology of RA

Answer 2

Synoviocytes can be divided into fibroblast-like and macrophage-like synoviocytes (cells in synovium that produce fluid, lubricating the joint)

Fibroblast-like synoviocytes –> destruction of cartilage

Macrophage-like synoviocytes –> immune complexes bind to receptors of macrophage-like synoviocytes –> overproduction of pro-inflammatory cytokines

Question 3

Clinical Features (5)

Answer 3

• warm, swollen joints in hands and feet
• pain is bilateral
• morning stiffness > 30 minutes
• Swan neck deformity
• Boutonniere deformity

Question 4

Progression of RA (4)

Answer 4

Joint damage
Disability
Decreased quality of life

Disease modifying Anti-rheumatic drugs (most common) - reduces synovitis and systematic inflammation, improving function