rheumatoid arthritis Flashcards
what is inflammatory arthritis
group of conditions where there is joint pr tendon inflammation
is rheumatoid arthritis symmetrical or asymmetrical
symmetrical
how many joints for rheumatoid arthritis
5 or more
rheumatoid arthritis presentation
- pain and stiffness in small joints, usually hands and feet
- morning stiffness
- long lasting stiffness
- rapid onset
- swelling of affected joints
what structure is mainly involved in RA
the synovium
risk factors for RA
smoking
viral infection
genetics
what is the criteria for symptom duration
must be 6 or more weeks
how long does the morning stiffness need to last
more than 30 mins
anti-CCP
- can be present several years prior to symptoms
- correlates with disease activity
- associated with erosive damage and smoking history
which auto-antibody is most specific for RA
anti-CCP antibody
complications of RA
- increased cardiovascular risk
- osteopenia/osteoporosis
examples of disease modifying anti-rheumatic drugs
- methotrexate
- sulfasalazine
- leflunomide
- hydroxychloroquine
- combination therapy
- steroids
side effects of DMARDS
- bone marrow suppression
- infection
- liver function derangement
- pneumonitis
- nausea
does rheumatoid arthritis cause pulmonary fibrosis
yes
what is the first choice DMARD in most patients
methotrexate
methotrexate and contraception
methotrexate must be stopped 3 months before contraception
what drug blocks T cell receptor
abatacept
what drug is a B cell depletor
rituximab
which drugs are anti TNF agents
infliximab, etanercept, adalimumab, certolizumab, golimumab
which drug is an IL-6 blocker
tocilizumab
which drugs are JAK inhibitors
tofacitinib
baricitinib
who gets biologics in the UK
tried 2 DMARDS
DAS 28 score > 5.1
adverse effects of biologics
risk of infection
risk of malignancy?
examples of when biologics are contraindicated
pulmonary fibrosis
heart failure
