Rheumatoid Arthritis Flashcards
Most common form of chronic inflammatory arthritis
Symmetric polyarthritis
In RA, Anti-CCPs serve as the ff except A. Diagnostic evaluation B. Prognostication C. Monitor relapse D. None of the above
C.
Most common valvular abnormality in RA
A. Mitral regurgitation
B. Mitral stenosis
C. Tricuspid stenosis
D. Aortic regurgitation
A
Most common hematologic abnormality in RA
Normochromic, normocytic anemia
Most common pulmonary manifestation of RA
Pleuritis
Most common cause of death in RA
Cardiovascular disease
overwhelming cell type in the synovial fluid of RA
neutrophil,
DMARD of first choice for the initial treatment of moderate to severe RA A. Methotrexate B. Hydroxychloroquine C. Sulfasalazine D. Leflunomide
methotrexate
Onset of action of conventional DMARDs
~6-12 weeks
hydroxychloroquine, sulfasalazine, methotrexate, and leflunomide
Methotrexate’s action at dosages used for the treatment of RA
methotrexate has been shown to stimulate adenosine release from cells, producing an anti-inflammatory effect.
Anti-TNF agents (5)
Infliximab adalimumab golimumab Certolizumab etanercept
Which is a chimeric monoclonal antibody? A. Certolizumab B. Infliximab C. Adalimumab D. Golimumab
B. Infliximab
pegylated Fc-free fragment of a humanized monoclonal antibody with binding specificity for TNF-α
Certolizumab pegol
A soluble fusion protein comprising the TNF receptor 2 in covalent linkage with the Fc portion of IgG1
Etanercept
Anti-TNF agents pproved for use as monotherapy, except A. Etanercept B. Adalimumab C. certolizumab pegol D. Infliximab
D.
Monotherapy: Etanercept, adalimumab, certolizumab pegol, and golimumab
Major concern in Anti-TNF agents use
Increased risk of infection
Serious bacterial infections, opportunistic fungal infection, and reactivation of latent tuberculosis
IL-1 receptor antagonist A. Rituximab B. Tocilizumab C. Abatecept D. Anakinra
D. Anakinra
A. Rituximab-anti CD20
B. Tocilizumab-anti IL-6
C. Abatecept-fusion protein linked to the modified por- tion of human IgG
Should not be combined with an anti-TNF drug due to the high rate of serious infections observed with this regimen A. Anakinra B. Tocilizumab C. Abatecept D. Rituximab
A. Anakinra
Small-molecule inhibitor that primarily inhibits JAK1 and JAK3, which mediate signaling of the receptors for the common γ-chain-related cytokines IL-2, 4, 7, 9, 15, and 21 as well as IFN-γ and IL-6 A. Anakinra B. Tofacitinib C. Abatecept D. Rituximab
B. Tofacitinib
Used for treatment of RA-ILD with high dose corticosteroids, except A. azathioprine B. tofacitinib C. mycophenolate mofetil D. rituximab
Adjunctive immu- nosuppressive agents, such as azathioprine, mycophenolate mofetil, and rituximab
How is Simplified Disease Activity Index score (SDAI) calculated?
Sum of a tender joint and swollen joint count (using 28 joints), patient global assessment (0–10 scale), phy- sician global assessment (0–10 scale), and CRP (in mg/dL)
ACR/EULAR Provisional Definition of Remission in Rheumatoid Arthritis
Simplified Disease Activity Index score of ≤3.3
OR
Tender joint count ≤1
Swollen joint count ≤1
C-reactive protein ≤1 mg/dL
Patient global assessment ≤1 (on a 0–10 scale)
Most common prosthetic for MCP arthroplasty
Silicone implants
Most common form of lymphoma in RA
Diffuse large B-cell lymphoma
