Rheumatoid Arthritis

Question 1

general mech of RA

Answer 1

autoimmune attacking the synovium of the joints

Question 2

main group of onset

Answer 2

women in the 20-40 range

Question 3

what is joint pattern

Answer 3

symmetrical polyarthritis that can involve every joint but the DIPS

Question 4

most common joints involved

Answer 4

hands (PIPs and MCPs) and wrist

knees, ankles, hips, elbows shoulders

Question 5

3 typical deformitiies

Answer 5

1. ulnar deviation of MCPs
2. boutonierres deformities
3. swan neck contractures

Question 6

4 patterns of time

Answer 6

1. acute and never again (10%)
2. undulating (20%)
3. relapsing remitting (65%)
4. severe progressive

Question 7

3 signs it is unlikely RA

Answer 7

1. not symotric
2. PIPs
3. no contritutional SX in AM

Question 8

dignositic crit for RA (4/7)

Answer 8

1. morning stiff x 6 weeeks
2. arth of 3 or more joints
3. symettric arth
4. arth of hand joints
5. rehumatoid nodules
6. serum RF
7. radiographic changes

Question 9

what is common spine involvement

Answer 9

C1,C2

Question 10

cardiac Sx

Answer 10

1. rheumnodules in heart
2. pericarditis - 40%
3. percadial effusion

Question 11

what is pulm Sx

Answer 11

1. pleural effusions - common
   - low glucose and complement in fluid
2. pulm fibrosis
3. infiltrates
4. nodules on lungs

Question 12

2 ocular Sx

Answer 12

1. scleritis

2. episcleritis

Question 13

mucous Sx

Answer 13

drying due to sjorgens

Question 14

skin Sx

Answer 14

nodules

Question 15

3 lab findings

Answer 15

1. high RF predicts worse outcomes
2. ESR and CRP up
3. normocytic anemia

Question 16

findings on plain films

Answer 16

1. loss of bone mass
2. norrowing of joint space
3. bony erosions at the margins of joints

Question 17

non-pharma Tx

Answer 17

exercise to help maintin ROM and strenght

Question 18

Sx Tx

Answer 18

1. NSAIDS for pain
2. low dose steroids
   - may help modify disease
   - avoid long term high dose

Question 19

DMARDS

Answer 19

1st line
- methotrexate
- hydroxychloroquine
2nd line
-