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Conditions - MSK > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

1
Q

What is Rheumatoid Arthritis?

A

A chronic autoimmune inflammatory condition that mainly effects the joints.

Stiff, painful and swollen.

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2
Q

What are the most common joints affected in Rheumatoid Arthritis? (3)

A
  • Wrists
  • Hands
  • Feet
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3
Q

What are some characterisations of Rheumatoid Arthritis? (3)

A
  • Symmetrical* Systemic Features
  • Periods of exacerbation of symptoms (i.e. flare ups)
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4
Q

What is the peak age of Rheumatoid Arthritis?

A

Between ages of 30 - 50 Years.

(Although can theoretically occur any time after 16)

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5
Q

Which gender is Rheumatoid arthritis most common in?

A

Females.

3:1 Ratio

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6
Q

What is the main contributing aetiology to the occurrence of Rheumatoid Arthritis? [2]

A
  • GENETICS (Contributes to 50-60% of cases)
  • Environmental factors such as smoking can contribute to it.
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7
Q

What are some complications associated with Rheumatoid Arthritis? (4)

A

1) Carpal Tunnel Syndrome
2) Cardiovascular Diseases (MI / Stroke)
3) Inflammation of Organs
4) Pulmonary Fibrosis

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8
Q

What are the typical presenting symptoms of Rheumatoid Arthritis? (4)

A
  • Symmetrical* Swelling
  • Painful stiff small joints of hands and feet.
  • Worst in the Morning
  • Poor function of affected limbs
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9
Q

What are some SPECIFIC systemic symptoms of Rheumatoid arthritis?

A
  • Specific:
    • Affecting Eyes
    • Lungs
    • Heart
    • Skin
    • Kidneys
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10
Q

What are some NON-Specific systemic symptoms of Rheumatoid Arthritis? (3)

A
  • Non-Specific:
    • Fatigue
    • Weight Loss
    • Anaemia
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11
Q

What are some LONG TERM systemic symptoms of Rheumatoid Arthritis? (2)

A
  • Long Term:
    • CVS system affected
    • Symptoms of malignancy
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12
Q

What are the early inflammatory signs of Rheumatoid Arthritis? (4)

A

Inflammatory Signs:

  • Tender
  • Hot
  • Red
  • Swollen
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13
Q

What are the later signs of Rheumatoid Arthritis? (3)

A
  • Dorsal Wrist Sublaxation
  • Ulnar Deviation of Fingers
  • Swan Neck finger deformity
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14
Q

What investigations do we conduct when we suspect Rheumatoid Arthritis? (4)

A
  • Bloods
  • MRI
  • Ultrasound
  • X-Rays
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15
Q

What blood tests are relevant for Rheumatoid Arthritis?

A
  • Rheumatoid Factor
  • ACPA
  • Raised
    • ESR
    • CRP
    • Platelets.
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16
Q

What is the efficacy of diagnosis using Rheumatoid Factors (IgG and IgM) in rheumatoid arthritis?

A

70% of people with RA show positive results to this test

17
Q

What is the efficacy of diagnosis using ACPA or Anti-CCP in rheumatoid arthritis?

A

HIGHLY SPECIFIC

98% of patients with RA show positive results of these tests

18
Q

What do we look for in the X-Ray of the hand for a patient with Rheumatoid Arthritis?

A
  • Decreased Bone Density
  • Narrowing of Joint space
  • Bony Erosions
  • Cartilage Destruction
  • Soft tissue swelling
19
Q

What Disease Activity scores makes a patient eligible for biologic therapy?

A
  • DAS > 5.1 = Eligible for Biological Therapy
  • DAS < 2.4 Represents clinical remission
20
Q

What Treatments are available for patients suffering from Rheumatoid Arthritis? (6)

A
  • DMARD (hydroxychloroquine)
  • Biologics
  • Corticosteroids
  • NSAIDs
  • Surgery
  • Supportive Treatment
21
Q

List the main biologics used for Rheumatoid Arthritis? (5)

A
  • TNFa Inhibitors (x5)
  • IL-1 Inhibitors (Anakinra)
  • IL-6 (Tocilizumab)
  • Anti B-Cell Therapies (CD20 / Rituximab)
  • Anti T-Cell Therapies (Abtacepts)
22
Q

What methods of Corticosteroids are available for patients with Rheumatoid Arthritis? (4)

A
  • Oral
  • IM Injections
  • IA Injections
  • IV Infusion
23
Q

What Disease Modifying drugs (DMARDs) can be used for people with Rheumatoid Arthritis?

A
  • METHOTREXATE
  • Sulfasalazine
  • Hydroxycholorquine
  • Leflunomide
24
Q

What supportive services are available for patients with Rheumatoids Arthritis? (4)

A
  • Physiotherapy
  • Occupational Therapy
  • Podiatry
  • Psychiatry (for depression)
25
Q

What percentage of patients with Rheumatoid arthritis are diagnosed during their working lives?

A

75%

26
Q

What percentage of patients with Rheumatoid Arthritis will stop working withing two years of diagnosis?

A

33%

27
Q

What is the pathogenesis of Rheumatoid Arthritis?

A
  1. Synovial Membrane Inflamed
  2. Pannus T-Lymphocytes & Macrophages present in Synovial Fluid
  3. Neutrophils present in Cartilage = Thinning

Conditions - MSK (37 decks)

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