Rheumatoid Arthritis

Question 1

rheumatoid arthritis

Answer 1

inflammatory condition that affects small joints

Question 2

causes

Answer 2

family history
females
smoking

Question 3

signs

Answer 3

joint swelling of small joints in the hands and feet
symmetrical form
morning stiffness >30 mins
pain better on activity 
distal joints not commonly affected 
cervical back mainly affected
\+ve squeeze test

Question 4

what other conditions can be seen

Answer 4

carpal tunnel syndrome
bursitis 
uveitis 
anaemia 
osteoporosis

Question 5

investigations

Answer 5

bloods - raised inflammatory markers
rheumatoid factor +ve
x-ray
anti-CCP postive

Question 6

what can be seen on an x-ray

Answer 6

narrowing of joint space

soft tissue swelling

Question 7

management

Answer 7

DMARDs
anti-TNFs (once 2 DMARDs have failed)
biologics

Question 8

what is used to assess the disease activity

Answer 8

DAS 28

Question 9

how do you know treatment is not being effective

Answer 9

if the change is less than 0.7

Question 10

what is a complication of hydroxychloroquine

Answer 10

eye problems

Question 11

how would you manage RA in pregnancy

Answer 11

hydroxychloroquine, sulfalazine and folic acid

Question 12

what is involved in felly’s syndrome

Answer 12

RA
neutropenia
splenomegaly

Question 13

how are flares managed

Answer 13

steroids

Question 14

what is prognostic factor

Answer 14

anti-CCP

Question 15

what is used for a mild disease

Answer 15

hydroxychloroquine

Question 16

findings of joint aspiration of flare up

Answer 16

increased WBC
yellow
cloudy
absence of crystals