Rheumatoid Arthritis Flashcards
LESS of RA
loss of bone space
erosion
see through bone (osteopenia)
soft tissue swelling
what is RA?
chronic symmetrical polyarticular inflammatory joint disease - mostly affecting the joints of the hands and feet
Autoimmunity is commonly seen in people that develop…..
RA
environmental factor can attribute to it (bacterial infection, smoking and bronchial stress)
seropositive rheumatoid arthritis produces:
rheumatoid factor
anti-citrullinated protein antibody
diagnostic anti CCP
synovitis
inflammation of the synovium
infiltration of t cells, b cells and macrophages and plasma cells
production of cytokines
genes involved in susceptibility to RA
class II major histocompatibility complex genes and PTPN22
drugs that treat RA
NSAIDs
DMARD (disease modifying anti rheumatic drugs)
Biologics (TNF alpha inhibitors, IL-1 inhibitors)
corticosteroids
example of DMARD
methotrexate
examples of biologics used in RA
TNF alpha inhibitors
IL1 inhibitors
anti b cell therapies
anti t cell therapies
examples of inflammatory indicators to look for when running bloods q
ESR
CRP
what is the determining test for RA?
A positive anti-CCP (cyclic citrullinated peptide) antibody
DMARD
disease modifying anti rheumatic drugs
Anti CCP antibody test in RA
anti cyclic citrullinated peptide antibody
diagnostic of RA
Physiology of RA
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
what is synovial pannus?
deposits in the synovial membrane
examples of DMARDs:
methotrexate
sulfasalazine
how do you treat RA?
Analgesia: NSAIDs
DMARDs (methotrexate, sulfasalazine)
Biologics (TNF alpha inhibitors, IL-1 inhibitors)
Corticosteroids
what scoring system measures severity of RA?
DAS-28 score
what joints does RA usually effect?
small joints in hands and feet
MCP (metacarpopharyngeal)
PIP (proximal Interpharyngeal)
MTP (metatarsopharyngeal)
wrist
how do you investigate RA?
Rheumatoid Factor (70%)
ACC antibodies (anti cyclic citrullinated peptide) antibody
high ESR
high CRP
X-Ray (if there is synovitis)
