Rheumatoid Arthritis

Question 1

Definition of Rheumatoid Arthritis

Answer 1

chronic auto immune systemic illness characterised by a symmetrical peripheral arthritis and other systemic features

Question 2

Rheumatoid Arthritis Features

Answer 2

1. Morning Stiffness lasting at least 1 hour before max improve
2. Arthritis of 3 or More Joint Areas
3. Arthritis of Hand joints
4. Symmetric Arthritis
5. Rheumatoid Nodules
6. Serum Rheumatoid Factor
7. Radiographic Changes

Question 3

Where can rheumatoid nodules be found

Answer 3

Over bony prominences or extensor surfaces

Question 4

What kind of radiographic changes can be found in rheumatoid arthritis

Answer 4

erosions or unequivocal bonny decalcification

Question 5

Which gender most likely affected by rheumatoid arthritis

Answer 5

Females

Question 6

Rheumatoid arthritis may occur any age from

Answer 6

16 years old

Question 7

Overall incidence of RA rises to what in monozygotic twins

Answer 7

12-15%

Question 8

Genetic contribution to RA estimated to be

Answer 8

50-60%

Question 9

Where is the closest association with specific amino acid sequences in RA

Answer 9

70-74 DRB1 (shared epitope)

Question 10

What environmental factors can lead to RA

Answer 10

Smoking

Chronic Infection eg Periodontal Disease

Question 11

which immunoglobulins involved in rheumatoid arthritis

Answer 11

IgG, IgM

Question 12

Which major cell types involved in RA

Answer 12

Fibroplasts
Plasma Cells
Neutrophils

Question 13

What happens to cartilage in RA

Answer 13

thinned and destroyed

Question 14

Which Anti Cyclic Citrullinated Antibodies looking for in Rheumatoid Arthritis

Answer 14

Anti CCP, Acpa

Question 15

Investigation for RA

Answer 15

X-Ray

Ultrasound

Question 16

Clinical Signs of arthritis

Answer 16

Swelling
Tenderness
Limitation of Movement
Redness
Heat

Question 17

What can RA lead to long term

Answer 17

Malignancy

CVS

Question 18

What systemic features can RA present with

Answer 18

Fatigue
Lassitude
Weight Loss
Anaemia

Question 19

Rheumatoid Arthritis Assessment:

Answer 19

Clinical Remission

Question 20

What DAS in Rheumatoid Arthritis represents clinical remission

Answer 20

<2.4

Question 21

What DAS in Rheumatoid Arthritis represents eligibility for biologics

Answer 21

> 5.1

Question 22

Possible Treatments for Rheumatoid Arthritis

Answer 22

NSAIDS
DMARDS
Biologics
Corticosteroid

Question 23

Name 4 DMARDS used in Rheumatoid Arthritis

Answer 23

Methotrexate
Sulfasalazine
Hydroxycholoquine
Leflunomide

Question 24

What kind of biologics can be used in Rheumatoid Arthritis

Answer 24

TNFa Inhibitors
Il-1 Inhibitors (Anakinra)
Anti B cell Therapies (rituximab)
Anti T cell Therapies (Abatacept)
IL6 Inhibitors (Tocilizumab)

Question 25

Biologics in RA have a enhanced response when co prescribed with

Answer 25

Methotrexate

Question 26

What makes up synovial fluid (2)

Answer 26

Hydaluronan

Lubrican

Question 27

The Rheumatoid Synovitis (Pannus) is characterised by (3)

Answer 27

inflammatory cell infiltration, synoviocyte proliferation and neoangiogenesis

Question 28

Synovial Fluid in Joint cavity contains

Answer 28

Neutrophils

Question 29

Which two autoantibodies commonly associated with RA

Answer 29

RFs and anti-citrullinated protein antibodies

Question 30

Which autoantibodies occur in RA that recognise joint antigens

Answer 30

type II collagen

Question 31

which autoantibodies occur in RA that recognise systemic antigens

Answer 31

glucose phosphate isomerase