rheumatoid arthritis Flashcards

1
Q

what is inflammatory arthritis

A

group of conditions where there is joint pr tendon inflammation

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2
Q

is rheumatoid arthritis symmetrical or asymmetrical

A

symmetrical

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3
Q

how many joints for rheumatoid arthritis

A

5 or more

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4
Q

rheumatoid arthritis presentation

A
  • pain and stiffness in small joints, usually hands and feet
  • morning stiffness
  • long lasting stiffness
  • rapid onset
  • swelling of affected joints
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5
Q

what structure is mainly involved in RA

A

the synovium

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6
Q

risk factors for RA

A

smoking
viral infection
genetics

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7
Q

what is the criteria for symptom duration

A

must be 6 or more weeks

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8
Q

how long does the morning stiffness need to last

A

more than 30 mins

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9
Q

anti-CCP

A
  • can be present several years prior to symptoms
  • correlates with disease activity
  • associated with erosive damage and smoking history
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10
Q

which auto-antibody is most specific for RA

A

anti-CCP antibody

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11
Q

complications of RA

A
  • increased cardiovascular risk

- osteopenia/osteoporosis

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12
Q

examples of disease modifying anti-rheumatic drugs

A
  • methotrexate
  • sulfasalazine
  • leflunomide
  • hydroxychloroquine
  • combination therapy
  • steroids
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13
Q

side effects of DMARDS

A
  • bone marrow suppression
  • infection
  • liver function derangement
  • pneumonitis
  • nausea
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14
Q

does rheumatoid arthritis cause pulmonary fibrosis

A

yes

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15
Q

what is the first choice DMARD in most patients

A

methotrexate

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16
Q

methotrexate and contraception

A

methotrexate must be stopped 3 months before contraception

17
Q

what drug blocks T cell receptor

A

abatacept

18
Q

what drug is a B cell depletor

A

rituximab

19
Q

which drugs are anti TNF agents

A

infliximab, etanercept, adalimumab, certolizumab, golimumab

20
Q

which drug is an IL-6 blocker

A

tocilizumab

21
Q

which drugs are JAK inhibitors

A

tofacitinib

baricitinib

22
Q

who gets biologics in the UK

A

tried 2 DMARDS

DAS 28 score > 5.1

23
Q

adverse effects of biologics

A

risk of infection

risk of malignancy?

24
Q

examples of when biologics are contraindicated

A

pulmonary fibrosis

heart failure