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MSRA MSK RHUEMATOLOGY > Rheumatoid arthritis > Flashcards

Rheumatoid arthritis Flashcards

1
Q

what criteria is used to diagnose RA?

A

2010 American College of Rheumatology criteria

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2
Q

1st antibody test in RA

A

Rheumatoid factor

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3
Q

when to use Anti-cyclic citrullinated peptide antibody (Anti-CCP)

A

suspected RA

early detection

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4
Q

imaging

A

X-ray

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5
Q

Initial Mx

A

DMARD monotherapy +/- short course of bridging prednisolone

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6
Q

flares

A

corticosteroids - oral or intramuscular

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7
Q

DMARDs

A

methotrexate is the most widely used DMARD.
sulfasalazine
leflunomide
hydroxychloroquine

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8
Q

what needs to be monitored whilst on methotrexate

A

Monitoring of FBC & LFTs is essential due to the risk of myelosuppression and liver cirrhosis

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9
Q

side effect of methotrexate

A

risk of myelosuppression

liver cirrhosis

pneumonitis.

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10
Q

TNF inhibitors

A

etanercept

infliximab

adalimumab

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11
Q

risk of infliximab

A

reactivate TB

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12
Q

other medications

A

rituximab

abtacept

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13
Q

presentation

A

swollen, painful joints in hands and feet

stiffness worse in the morning

gradually gets worse with larger joints becoming involved

presentation usually insidiously develops over a few months

positive ‘squeeze test’ - discomfort on squeezing across the metacarpal or metatarsal joints

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14
Q

late features of RA

A

Swan neck and boutonnière deformities

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15
Q

what is palindromic rheumatism

A

relapsing/remitting monoarthritis of different large joints

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16
Q

poor prognosis features

A

rheumatoid factor positive
anti-CCP antibodies
poor functional status at presentation
X-ray: early erosions (e.g. after < 2 years)
extra articular features e.g. nodules
HLA DR4
insidious onset
female gender

17
Q

Early Xray features

A

loss of joint space
juxta-articular osteoporosis
soft-tissue swelling

18
Q

late xray findings

A

periarticular erosions
subluxation

MSRA MSK RHUEMATOLOGY (43 decks)

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