Rheumatoid Arthritis

Question 1

When activated by macrophage-induced cytokines, what impact do T cells have

Answer 1

• synovial cells proliferate

- bone breakdown

Question 2

When activated by cytokines, B cells release what 2 Abs

Answer 2

• RF

- anti-CCP

Question 3

Most common type of RF

Answer 3

IgM

Question 4

RF targets what Fc portion of the body’s own antibodies

Answer 4

IgG

Question 5

Why is anti-CPP preferred to RF

Answer 5

• > sensitive

- >common

Question 6

Common epi for RA

Answer 6

• x3 F

- middle age

Question 7

Common gene in RA

Answer 7

HLADR4

Question 8

Less common gene in RA

Answer 8

HLADR1

Question 9

Limited short episodes of inflammatory arthritis that lasts 1-2 days

Answer 9

Palindromic arthritis

Question 10

Joints that are almost never affected by RA

Answer 10

DIPJs

Question 11

Baker’s cysts in RA are found

Answer 11

Behind knees

Question 12

Atlantoaxial subluxation can lead to further complication of

Answer 12

SC compression

Question 13

What letter shape is made at the thumb

Answer 13

Z

Question 14

Hyperextended PIP + flexed DIP

Answer 14

Swan neck deformity

Question 15

Hyperextended DIP + flexed PIP

Answer 15

Boutonnières deformity (unopposed flexion due to central slip in extensor compartments)

Question 16

Ulnar deviation happens in what joints

Answer 16

MCPJs

Question 17

Palpating synovial is characterised by

Answer 17

‘Boggy’ inflammatory swelling

Question 18

Minimum score required to diagnose RA

Answer 18

6

Question 19

DAS28 score is used to

Answer 19

Monitor disease activity

Question 20

Factors worsening prognosis (think age, gender, etc)

Answer 20

• young onset
• male
• ++ joints & organs affected
• RF + anti CCP present
• visible erosions

Question 21

Meds used to induce remission

Answer 21

NSAIDs/COX-2 inhibitors

Question 22

1st line meds for DMARDs (only one needed at this step)

Answer 22

• methotrexate
• lefluomide
• sulfasalazine
• hydroxychloroquine (mildest)

Question 23

2nd line meds

Answer 23

2 of 1st line options

Question 24

3rd line meds

Answer 24

Methotrexate + biological agent (TNFi)

Question 25

4th line meds

Answer 25

Methotrexate + rituximab

Question 26

Meds to consider in preggo

Answer 26

- sulfasalazine | - hydrochloroquine

Question 27

Common SEs to biological agents

Answer 27

- immunosuppression —> prone to infection (TB/HepB reactivation) - neuropathy - BM suppression

Question 28

Name 3 TNFi

Answer 28

- adalimumab (mono anti) - infliximab (mono anti) - etancercept

Question 29

Name anti-CD20 biological agent

Answer 29

Rituximab (mono anti)

Question 30

Pulm fibrosis is common SE of

Answer 30

Methotrexate

Question 31

Hptn and p oedema are common SEs of

Answer 31

Leflunomide

Question 32

Male infertility (— sperm count) is common SE of

Answer 32

Sulfasalazine

Question 33

Nightmare and reduced visual activity are common SEs of

Answer 33

Hydroxychloroquine

Question 34

Night sweats and thrombocytopenia are common SEs of

Answer 34

Rituximab

Question 35

what is caplan's syndrome (extra-articular manifestation)

Answer 35

pulmonary fibrosis w/ pulmonary nodules

Question 36

inflammation that causes small airway obstruction (extra-articular manifestation)

Answer 36

bronchiolitis obliterans

Question 37

felty's syndrome

Answer 37

- RA - neutropenia - splenomegaly

Question 38

extra-articular autoimmune condition that affects secreting ducts

Answer 38

Sjogren's syndrome

Question 39

Med used in RA that can induce retinopathy

Answer 39

Hydroxychloroquine