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BDS3 Diseases of Human Systems > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

1
Q

what is rheumatoid arthritis

A

disease of the synovium with gradual inflammatory joint destruction

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2
Q

what are the two different patterns of joint involvement in rheumatoid arthritis

A

sero-positive RA
sero-negative RA

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3
Q

what does sero-positive RA mean

A

the rheumatoid factor is present

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4
Q

what does sero-negative RA mean

A

rheumatoid factor not present

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5
Q

what cells are present in an inflammatory synovium compared to a healthy one

A

t cells
macrophages
fibroblasts
B cells
pannus
inflammatory cytokines

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6
Q

what are symptoms of RA

A

fatigue
morning stiffness
joint stiffness
joint pain
fever
numbness and tingling
decrease in range of motion

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7
Q

what are early signs of RA

A

symmetrical synovitis of MCP joints
symmetrical synovitis of PIP joints
symmetrical synovitis of wrist joints

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8
Q

what are late signs of RA

A

ulnar deviation of fingers at MCP joints
hyperextension of PIP joints
Z deformity of thumb
subluxation of wrists
loss of abduction and external rotation of shoulders
deformity of feet and ankles

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9
Q

what are extra-articular features of RA

A

inflammation of blood vessels due to systemic vasculitis
psoriasis
eye involvement - dry eyes and Sjogrens syndrome
amyoidosis
normocytic anaemia

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10
Q

what are some options to treat RA

A

physiotherapy
occupational therapy
drug therapy
surgery

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11
Q

what are the purpose of the active and passive exercises in physiotherapy for a RA patient

A

maintain muscle activity
improve joint stability
maintain joint position

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12
Q

what are the drug therapies for RA

A

analgesics
NSAIDS
disease modifying drugs
steroids

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13
Q

what analgesics are used to treat RA

A

paracetamol and cocodamol

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14
Q

what disease modifying drugs can be used to treat RA

A

hydroxychloroquine, methotrexate, sulphasalzine

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15
Q

what class of drugs are azathioprine, mycophenolate

A

immune modulators

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16
Q

what are examples of biologic immune modulators

A

TNF inhibitors - infliximab, adalimumab

17
Q

what are some dental aspects of rheumatoid arthritis

A

reduced dexterity
sjogrens syndorme
drug effects

18
Q

how can sjogrens syndrome impact dental treatment

A

association of disease with dry eyes/ mouth

19
Q

what drug effects do dentists need to be careful with when treating patients with RA

A

bleeding - NSAIDs and sulphasalazine
infection risks - steroids

20
Q

what medication associated with RA can increase risk of oral ulceration

A

methotrexate

21
Q

what medication associated with RA can cause oral pigmentation

A

hydroxychloroquine

22
Q

what issue with the atlanto-occipital joints can be found in RA

A

it can be damaged - this joint allows pivoting and turning of the head and the ligaments that allow this can become diseased - sudden trauma can cause ligaments ripping

23
Q

when might the ligaments protecting the spinal cord be put at risk

A

when there is no muscle tone - eg under general anaesthesia and the head is moved inappropriately

24
Q

when might the ligaments protecting the spinal cord be put at risk

A

when there is no muscle tone - eg under general anaesthesia and the head is moved inappropriately

25
Q

what is the difference between seronegative spondyloarthritides

A

primary focus is on axial skeleton (vertebrae) - whereas in RA it happens in the peripheral

26
Q

what are the three seronegative diseases

A

ankylosing spondylitis
reiter’s disease
arthritis of IBD

27
Q

what is the precipitant of ankylosing spondylitis

A

infection

28
Q

what genetic trait is assocciated with ankylosing spondylitis

A

HLA-B27

29
Q

what are effects of ankylosing spondylitis

A

they cannot turn their spine
low back pain
limited back and neck movement
breathing constricted

30
Q

treatment of ankylosing spondylitis

A

analgesia and NSAIDs
physio
occupational therapy
DMDs
immune modulators
surgery

31
Q

what are the dental aspects of ankylosing spondylitis

A

GA hazardous
limited mouth opening
limited neck movement

BDS3 Diseases of Human Systems (13 decks)

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