Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

1
Q

What type of arthritis is RA?

A

inflammatory, seropositive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is inflammatory arthritis?

A

a group of conditions with joint of tendon inflammation, associated with abnormal bloods and imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is inflammatory arthritis common? bigger or smaller joints?

A

smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does it commonly present?

A

pain and stiffness (common in the morning) in small joints, weaker grip, quick onset, swelling of affected joints, symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who gets inflammatory arthritis?

A

any age group, women:men=3:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are triggers for inflammatory arthritis?

A

cigarettes, infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What affects the severity and course of inflammatory arthritis?

A

genetics and presence of autoantibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the main structure involved in inflammatory arthritis?

A

synovium (lines joint capsules and tendon sheaths) makes direct contact with synovial fluid which acts as a lubricant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name some synovial joints?

A

hand joints, wrist, elbows, shoulders, knees, hips, ankles, feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do susceptibility genes lead to?

A

conversion of amino acid arginine to amino acid citrulline this results in protein unfolding due to loss of positive charges the unfolded protein acts as an antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is involved in the diagnosis?

A

history and clinical exam, inflammatory markers (CRP, ESR/Plasma Viscosity), autoantibodies, imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some main clinical features?

A

prolonged morning stiffness (>30 mins), involvement of small joints of hands and feet, symmetrical, positive compression tests of MCP and MTP joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 2 autoantibodies?

A

rheumatoid factor, antibodies to cyclic citrullinated peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How sensitive and specific is rheumatoid factor?

A

sensitivity: 50-80%
specificity: 70-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How sensitive and specific is antibody to cyclic citrullinated peptide?

A

sensitivity: 60-70%
specificity: 90-99%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What autoantibody associated with disease activity, erosive damage and smoking?

A

Anti-CCP

17
Q

Which autoantibody stays positive despite treatment?

A

Anti-CCP

18
Q

When can X-rays detect disease?

A

usually later disease

19
Q

What is ultrasound good for?

A

inc. sensitivity for synovitis in early disease. superior to clinical exam, detects MCP erosions more in early disease to X-rays, making treatment changes

20
Q

When use MRI?

A

When diagnostic doubt as expensive

21
Q

Treatment?

A

prompt diagnosis, early treatment with DMARDS, tight control to achieve remission or low disease activity, patient activity, MDT involvement

22
Q

Advancements of treatment?

A

recognition of regular review, biologic agents

23
Q

Examples of DMARDS

A

methotrexate, sulfasalazine, leflunomide, hydroxychloroquine, combination therapy of 1,2 and 4, steroids (not long term)

24
Q

Side effects of DMARDS?

A

bone marrow suppression, infection, liver function derangement, pneumonitis (common with methotrexate), nausea

25
Q

What is the first choice of DMARDS?

A

methotrexate

26
Q

How can methotrexate be given?

A

orally or subcutaneously, often used in combination

27
Q

What is a strong negative of methotrexate?

A

teratogenic

28
Q

How long should methotrexate be stopped before conception?

A

3 months at least

29
Q

Does methotrexate require regular monitoring?

A

yes, blood monitoring

30
Q

What score is used to assess disease activity?

A

DAS28

31
Q

Name some biologics?

A 
Anti TNF agents- Infliximab, Etanercept, Adalimumab,
Certolizumab, Golimumab
T cell receptor blocker-Abatacept.
B cell depletor-Rituximab
IL-6 blocker-Tocilizumab.
JAK inhibitors-Tofacitinib, Baricitinib
32
Q

When are biologics given in the UK?

A

2 failed attempts at DMARDS, DAS28 score>5.1

33
Q

What are side effects of biologics?

A

risk of infection (latent TB reactivation), risk of malignancy (skin cancer), contraindicated in certain conditions (pulmonary fibrosis, heart failure

MSK (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions