Rheumatoid Arthritis

Question 1

LESS of RA

Answer 1

loss of bone space

erosion

see through bone (osteopenia)

soft tissue swelling

Question 2

what is RA?

Answer 2

chronic symmetrical polyarticular inflammatory joint disease - mostly affecting the joints of the hands and feet

Question 3

Autoimmunity is commonly seen in people that develop…..

Answer 3

RA

environmental factor can attribute to it (bacterial infection, smoking and bronchial stress)

Question 4

seropositive rheumatoid arthritis produces:

Answer 4

rheumatoid factor

anti-citrullinated protein antibody

diagnostic anti CCP

Question 5

synovitis

Answer 5

inflammation of the synovium

infiltration of t cells, b cells and macrophages and plasma cells

production of cytokines

Question 6

genes involved in susceptibility to RA

Answer 6

class II major histocompatibility complex genes and PTPN22

Question 7

drugs that treat RA

Answer 7

NSAIDs

DMARD (disease modifying anti rheumatic drugs)

Biologics (TNF alpha inhibitors, IL-1 inhibitors)

corticosteroids

Question 8

example of DMARD

Answer 8

methotrexate

Question 9

examples of biologics used in RA

Answer 9

TNF alpha inhibitors

IL1 inhibitors

anti b cell therapies

anti t cell therapies

Question 10

examples of inflammatory indicators to look for when running bloods q

Answer 10

ESR

CRP

Question 11

what is the determining test for RA?

Answer 11

A positive anti-CCP (cyclic citrullinated peptide) antibody

Question 12

DMARD

Answer 12

disease modifying anti rheumatic drugs

Question 13

Anti CCP antibody test in RA

Answer 13

anti cyclic citrullinated peptide antibody

diagnostic of RA

Question 14

Physiology of RA

Answer 14

autoimmune disease

IgG forms against cartilage and Rheumatoid factor (an IgM antibody) forms against IgG - causing synovitis

Synovitis can lead to synovial pannus and joint destruction

Question 15

what is synovial pannus?

Answer 15

deposits in the synovial membrane

Question 16

examples of DMARDs:

Answer 16

methotrexate

sulfasalazine

Question 17

how do you treat RA?

Answer 17

Analgesia: NSAIDs

DMARDs (methotrexate, sulfasalazine)

Biologics (TNF alpha inhibitors, IL-1 inhibitors)

Corticosteroids

Question 18

what scoring system measures severity of RA?

Answer 18

DAS-28 score

Question 19

what joints does RA usually effect?

Answer 19

small joints in hands and feet

MCP (metacarpopharyngeal)

PIP (proximal Interpharyngeal)

MTP (metatarsopharyngeal)

wrist

Question 20

how do you investigate RA?

Answer 20

Rheumatoid Factor (70%)

ACC antibodies (anti cyclic citrullinated peptide) antibody

high ESR

high CRP

X-Ray (if there is synovitis)