Rheumatoid Arthritis Flashcards
Predominant source of proinflammatory cytokines; major drive for RA
Macrophages
Frequent hallmark of RA
Flexor Tendon Synovitis
Major genetic risk factor for RA
HLA DRB1
Predicts worse outcomes in RA
Presence of anti-CCP antibodies
DMARD of choice
Methotrexate
avoided in crea >2mg/dL
MCC of death among RA
Cardiovascular disease
Pattern of RA
symmetric peripheral polyarthritis (initially monoarthritic)
MC form of chronic inflammatory arthritis
RA
Valuable biomarker of diagnostic and prognostic significance
Anti-CCP (Higly specific)
Presenting symptom of RA
Early morning joint stiffness at least for 1 hour, improves with physical activity
May indicate coexistence with OA
DIP joint involvement
Subluxation of MCP joints + subluxation of proximal phalanx to volar side if the hand
Ulnar deviation
Hyperextension of the PIP joint + Flexion of DIP joint
Swan neck deformity
Flexion of the PIP + Hyperextension of the DIP
Buttonniere deformity
Subluxation of the first MCP joint + Hyperextension of the first IP joint
Z-line deformity
Inflammation if the ulnar styloid + Tenosynovitis of the extensor carpi ulnaris causing subluxation of the distal ulna
Piano key movement
Most common pulmonary manifestation
Pleural disease
Pulmo finding portends a poor prognosis
ILD but responss to immunosuppressive therapy
Diagnosis: HRCT, PFT: restrictive
Most frequent site of caridac involvement
Pericardium
Most common hematologic abnormality
Normochromic, normocytic anemia
Neutropenia + splenomegaly + RA
Felty’s syndrome
MCC of death in RA
Cardiovascular disease
Pathologic hallmarks of RA
Synovial inflammation and proliferation, focal bone erosions, articular cartilage thinning
Most sensitive diagnostic to detect synovitis
MRI
DMARD which decreases the radiographic progression of disease
Sulfasalazine
Safest DMARDs in pregnancy
Hydroxychloroquine
Sulfasalazine
Flares: Prednisone
Likelihood of extraarticular manifestations in RA
smoking
(+) RF
early onset of physical disability
Primary treatment of RA
DMARDS
Methotrexate-1st line
Hydroxychloroquine
Sulfasalazine
MCC of death in RA
IHD
