Rheumatoid Arthritis Flashcards
What is Rheumatoid Arthritis?
A chronic autoimmune inflammatory condition that mainly effects the joints.
Stiff, painful and swollen.
What are the most common joints affected in Rheumatoid Arthritis? (3)
- Wrists
- Hands
- Feet
What are some characterisations of Rheumatoid Arthritis? (3)
- Symmetrical* Systemic Features
- Periods of exacerbation of symptoms (i.e. flare ups)
What is the peak age of Rheumatoid Arthritis?
Between ages of 30 - 50 Years.
(Although can theoretically occur any time after 16)
Which gender is Rheumatoid arthritis most common in?
Females.
3:1 Ratio
What is the main contributing aetiology to the occurrence of Rheumatoid Arthritis? [2]
- GENETICS (Contributes to 50-60% of cases)
- Environmental factors such as smoking can contribute to it.
What are some complications associated with Rheumatoid Arthritis? (4)
1) Carpal Tunnel Syndrome
2) Cardiovascular Diseases (MI / Stroke)
3) Inflammation of Organs
4) Pulmonary Fibrosis
What are the typical presenting symptoms of Rheumatoid Arthritis? (4)
- Symmetrical* Swelling
- Painful stiff small joints of hands and feet.
- Worst in the Morning
- Poor function of affected limbs
What are some SPECIFIC systemic symptoms of Rheumatoid arthritis?
- Specific:
- Affecting Eyes
- Lungs
- Heart
- Skin
- Kidneys
What are some NON-Specific systemic symptoms of Rheumatoid Arthritis? (3)
- Non-Specific:
- Fatigue
- Weight Loss
- Anaemia
What are some LONG TERM systemic symptoms of Rheumatoid Arthritis? (2)
- Long Term:
- CVS system affected
- Symptoms of malignancy
What are the early inflammatory signs of Rheumatoid Arthritis? (4)
Inflammatory Signs:
- Tender
- Hot
- Red
- Swollen
What are the later signs of Rheumatoid Arthritis? (3)
- Dorsal Wrist Sublaxation
- Ulnar Deviation of Fingers
- Swan Neck finger deformity
What investigations do we conduct when we suspect Rheumatoid Arthritis? (4)
- Bloods
- MRI
- Ultrasound
- X-Rays
What blood tests are relevant for Rheumatoid Arthritis?
- Rheumatoid Factor
- ACPA
- Raised
- ESR
- CRP
- Platelets.
What is the efficacy of diagnosis using Rheumatoid Factors (IgG and IgM) in rheumatoid arthritis?
70% of people with RA show positive results to this test
What is the efficacy of diagnosis using ACPA or Anti-CCP in rheumatoid arthritis?
HIGHLY SPECIFIC
98% of patients with RA show positive results of these tests
What do we look for in the X-Ray of the hand for a patient with Rheumatoid Arthritis?
- Decreased Bone Density
- Narrowing of Joint space
- Bony Erosions
- Cartilage Destruction
- Soft tissue swelling
What Disease Activity scores makes a patient eligible for biologic therapy?
- DAS > 5.1 = Eligible for Biological Therapy
- DAS < 2.4 Represents clinical remission
What Treatments are available for patients suffering from Rheumatoid Arthritis? (6)
- DMARD (hydroxychloroquine)
- Biologics
- Corticosteroids
- NSAIDs
- Surgery
- Supportive Treatment
List the main biologics used for Rheumatoid Arthritis? (5)
- TNFa Inhibitors (x5)
- IL-1 Inhibitors (Anakinra)
- IL-6 (Tocilizumab)
- Anti B-Cell Therapies (CD20 / Rituximab)
- Anti T-Cell Therapies (Abtacepts)
What methods of Corticosteroids are available for patients with Rheumatoid Arthritis? (4)
- Oral
- IM Injections
- IA Injections
- IV Infusion
What Disease Modifying drugs (DMARDs) can be used for people with Rheumatoid Arthritis?
- METHOTREXATE
- Sulfasalazine
- Hydroxycholorquine
- Leflunomide
What supportive services are available for patients with Rheumatoids Arthritis? (4)
- Physiotherapy
- Occupational Therapy
- Podiatry
- Psychiatry (for depression)
