Rheumatoid Arthritis Flashcards
Definition of Rheumatoid Arthritis
chronic auto immune systemic illness characterised by a symmetrical peripheral arthritis and other systemic features
Rheumatoid Arthritis Features
- Morning Stiffness lasting at least 1 hour before max improve
- Arthritis of 3 or More Joint Areas
- Arthritis of Hand joints
- Symmetric Arthritis
- Rheumatoid Nodules
- Serum Rheumatoid Factor
- Radiographic Changes
Where can rheumatoid nodules be found
Over bony prominences or extensor surfaces
What kind of radiographic changes can be found in rheumatoid arthritis
erosions or unequivocal bonny decalcification
Which gender most likely affected by rheumatoid arthritis
Females
Rheumatoid arthritis may occur any age from
16 years old
Overall incidence of RA rises to what in monozygotic twins
12-15%
Genetic contribution to RA estimated to be
50-60%
Where is the closest association with specific amino acid sequences in RA
70-74 DRB1 (shared epitope)
What environmental factors can lead to RA
Smoking
Chronic Infection eg Periodontal Disease
which immunoglobulins involved in rheumatoid arthritis
IgG, IgM
Which major cell types involved in RA
Fibroplasts
Plasma Cells
Neutrophils
What happens to cartilage in RA
thinned and destroyed
Which Anti Cyclic Citrullinated Antibodies looking for in Rheumatoid Arthritis
Anti CCP, Acpa
Investigation for RA
X-Ray
Ultrasound
Clinical Signs of arthritis
Swelling Tenderness Limitation of Movement Redness Heat
What can RA lead to long term
Malignancy
CVS
What systemic features can RA present with
Fatigue
Lassitude
Weight Loss
Anaemia
Rheumatoid Arthritis Assessment:
Clinical Remission
What DAS in Rheumatoid Arthritis represents clinical remission
<2.4
What DAS in Rheumatoid Arthritis represents eligibility for biologics
> 5.1
Possible Treatments for Rheumatoid Arthritis
NSAIDS
DMARDS
Biologics
Corticosteroid
Name 4 DMARDS used in Rheumatoid Arthritis
Methotrexate
Sulfasalazine
Hydroxycholoquine
Leflunomide
What kind of biologics can be used in Rheumatoid Arthritis
TNFa Inhibitors Il-1 Inhibitors (Anakinra) Anti B cell Therapies (rituximab) Anti T cell Therapies (Abatacept) IL6 Inhibitors (Tocilizumab)
Biologics in RA have a enhanced response when co prescribed with
Methotrexate
What makes up synovial fluid (2)
Hydaluronan
Lubrican
The Rheumatoid Synovitis (Pannus) is characterised by (3)
inflammatory cell infiltration, synoviocyte proliferation and neoangiogenesis
Synovial Fluid in Joint cavity contains
Neutrophils
Which two autoantibodies commonly associated with RA
RFs and anti-citrullinated protein antibodies
Which autoantibodies occur in RA that recognise joint antigens
type II collagen
which autoantibodies occur in RA that recognise systemic antigens
glucose phosphate isomerase
