Rheumatoid Arthritis

Question 1

A person with rheumatoid arthritis get a CXR after complaining of dyspnoea. What is the most likely cause?

Answer 1

Methotrexate-induced pneumonitis or fibrosis
Note that this can occur at any time during the course of treatment even after years. Also note that it is not dose-dependent so it can occur both at low and high doses

Question 2

Define Rheumatoid arthritis.

Answer 2

Question 3

What is the gender distribution of RA?

Answer 3

F:M 3:1

Question 4

List the RFs for RA.

Answer 4

Question 5

Describe the pathophysiology of RA.

Answer 5

Question 6

Compare OA and RA in terms of:
1. onset
2. age
3. symmetry
4. morning stiffness
5. joints
5. localization
6. sparing
7. inflammatory markers

Answer 6

Question 7

What are the joint symptoms of RA?

Answer 7

Question 8

What are the extra articular features of RA?

Answer 8

Question 9

You have been asked to do a hand exam on a RA patient. What are you looking for?

Answer 9

Question 10

What would you expect to see on examination of the feet of an RA patient?

Answer 10

Question 11

You have been asked to examine a patient with RA for extra articular manifestations. What are you looking for?

Answer 11

Question 12

Label the image

Answer 12

Question 13

Label the image

Answer 13

Question 14

What are the diagnostic investigations for RA? What are your expected results?

Answer 14

Question 15

Why do RA patients show anemic on FBC?

Answer 15

Question 16

Why do RA patients get CKD?

Answer 16

Question 17

What are your expected CXR findings in a RA patients?

Answer 17

Question 18

What are your expected MRI findings in a RA patients?

Answer 18

Question 19

Why is a DEXA performed for an RA patient?

Answer 19

Question 20

What are the x ray findings of RA?

Answer 20

Question 21

What are the supportive investigations for RA? What are your expected results?

Answer 21

Question 22

Describe this image.

Answer 22

subchondral sclerosis
joint space narrowing

Question 23

What are all your investigations for RA?

Answer 23

Question 24

How would you grade the severity of RA? How often is it done?

Answer 24

Question 25

Outline the conservative management of RA.

Answer 25

Question 26

What is the max number of steroid injections can a patient with RA receive in 1 yr?

Answer 26

Question 27

What is the acute management of RA?

Answer 27

Question 28

Outline the chronic pharmacological management of RA.

Answer 28

DMARDS:
MTX
Leflunomide
Sulfasalazine

Biologics:
Anti-TNF
Anti-IL
B-cell
Jak

Question 29

What is the surgical management of RA?

Answer 29

Question 30

A 30 year old woman with a background of RA comes into the clinic for check up. She is currently on methotrexate. She explains that she wants to get pregnant and asks for conception advice. Would you consider changing her DMARD? If yes.. what would you next best option be?

Answer 30

Stop MTX, start sulphasalazine.

Question 31

How would you monitor a patient on methotrexate?

Answer 31

Question 32

What is the MOA, dosage, route of administration and SE of the following:
1. Methotrexate

Answer 32

Question 33

What is the MOA and SEs of the following:
1. Methotrexate

Answer 33

Question 34

How would you monitor a patient on biologics?

Answer 34

Question 35

What is the pre-tx investigation for biologics?

Answer 35

Question 36

List examples of the following:
Anti-TNF α

Answer 36

Question 37

List examples of the following:
Anti-IL

Answer 37

Question 38

List examples of the following:
Anti CD20

Answer 38

Question 39

List examples of the following:
JAK inhibitor

Answer 39

Question 40

What are the complications of RA?

Answer 40

Question 41

What are the poor prognostic factors of RA?

Answer 41