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

Define rheumatoid arthritis

A

A chronic auto immune systemic illness characterised by a polyarthritis and other systemic features

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

What is polyarthritis

A

When at least 5 joints are affected by arthritis

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

What joints are most affected by rheumatoid arthritis

A

Small joints of hands, feet and wrist are most affected - metacarpal-pharyngeal joint, proximal inter-pharyngeal joint

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

What joint in the hands doesn’t get affected by rheumatoid arthritis

A

Distal inter-pharyngeal

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

What is ACR criteria used for

A

Lupus and rheumatoid arthritis

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

What score in the ACR criteria is diagnostic of rheumatoid arthritis

A

6 or more

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

Which gender is rheumatoid arthritis most common in

A

Females 3 : 1 Males

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

What age does rheumatoid occur at

A

4th and 5th decade but can occur at any age after 16 years old

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

Which gene is associated with rheumatoid arthritis

A

HLA-DRbeta1

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

What environmental triggers can cause rheumatoid arthritis

A

Cigarette smoking
Chronic infection e.g epstein barr virus

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

What hormonal factors can cause rheumatoid arthritis

A

Early age menopause

Low testosterone in men

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

Describe how rheumatoid arthritis is caused

A

Arginine changes into citrulline - the body recognises the protein as a foreign pathogen and activated dendritic cells which produce B and T lymphocytes to defend - the protein is commonly found in the synovium which is the common site of infection of rheumatoid arthritis

Osteoclasts then become activated and start eroding bone

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

how does rheumatoid arthritis present

A

Pain
Morning stiffness which lasts longer than 30 minute - characteristic of inflammatory joint conditions
Poor function
Systemic symptoms

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

What is morning stiffness longer than 30 minutes characteristic of

A

Inflammatory joint conditions

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

What is expected to see on examination of a patient with rheumatoid arthritis

A

swelling
tenderness
the joints will feel warm and appear red
There will be restricted movement in the joints

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

What joints is rheumatoid arthritis normally not present in

A

the joints in the central line e.g spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is ulnar deviation

A

All the fingers drift to the ulnar side - seen in hand deformity caused by untreated rheumatoid arthritis

18
Q

What are the systemic symptoms of rheumatoid arthritis

A

Fatigue, weight loss, anaemia

19
Q

What are the extra-articular manifestations of rheumatoid arthritis

A

Eyes, lungs, nerves, skin and kidneys

20
Q

What is the long term complication which can occur due to rheumatoid arthritis

A

In any untreated inflammatory condition, there is increased cardiovascular risk
malignancy can occur as well

21
Q

What are the haematological manifestations of rheumatoid arthritis

A

Anaemia
Thrombocytosis - high platelets
Fetty’s syndrome

22
Q

What is Fetty’s syndrome

A

Triad of low neutrophils (neutropenia) , splenomegaly and rheumatoid arthritis

23
Q

What bloods are checked in rheumatoid arthritis

A

FBC, kidney function, liver function, CRP and ESR

24
Q

What investigations are done for rheumatoid arthritis

A

Baseline bloods
Immunology
X rays
Ultrasound

25
Q

What is checked in the immunology for rheumatoid arthritis

A

Rheumatoid factor
Anti cyclic citrullinated antibodies (Anti-CCP)

26
Q

What is used to assess rheumatoid arthritis

A

Disease activity score (DAS score)

27
Q

What DAS numbers suggest remission

A

less than 2.6

28
Q

What DAS numbers suggest need for biologic therapy

A

more than 5.1

29
Q

What is the tactic for management of rheumatoid arthritis

A

early and aggressive intervention

30
Q

What is the first line of management of rheumatoid arthritis

A

Methotrexate

31
Q

What is used to treat symptoms when patient comes for the first time or during a flare up

A

NSAIDS - naproxen and ibuprofen

Glucocorticoids - prednisone, hydrocortisone, prednisolone

32
Q

What kind of drug is methotrexate

A

conventional systemic DMARDs - disease modifying anti-rheumatic drugs

33
Q

When is methotrexate not indicated as first line for rheumatic arthritis

A

Pregnant women - causes foetal abnormalities

Bad lung disease - can lower immune system and cause fibrosis

34
Q

What are other examples of conventional synthetic DMARDs

A

Leflunomide
Hydroxychloroquine
sulfasalazine

35
Q

What is the order of drugs given in treatment if no remission

A

Methotrexate (unless pregnancy or severe lung disease) - sulfasalazine - biologic DMARDs e.g infliximab, golimumab)

36
Q

What is the function of conventional DMARDs

A

They are slow acting and have a slow onset effect

They don’t stop the process but they modulate the immune system to make the process slower

Has the risk of toxicity

37
Q

What is the difference between biologic DMARDs therapy compared to non biologic

A

Biologic DMARDs are large complex proteins that work rapidly but can increase the risk of infection

38
Q

What is TNFalpha inhibitor

A

Tumour necrosis factor alpha inhibitor - a biologic

39
Q

What are the issues with biologics

A

Injection site reactions
Infection risk increase
Malignancy
Cost - they are very expensive

40
Q
A

MSK (36 decks)

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