Rheumatoid Arthritis Flashcards

1
Q

What gene is associated with RA?

A

HLA-DR4

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2
Q

What cells are involved in the pathology in RA?

A

T cells

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3
Q

What can trigger RA?

A

Infection

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4
Q

What is the pathophysiology of RA?

A

Inflammed synovium from autoimmune attack

  • Increased angiogenesis leading to hyperplasia
  • Immune cell infiltration
  • Increased cell surface adhesion molecules
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5
Q

What cytokines are involved in the inflammatory process of RA?

A

IL-1
IL-6

TNF-a

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6
Q

What is the ARA criteria for RA?

A
  1. Morning stiffness that improves
  2. Polyarthritis - 3 + joints. Swelling of 14 possible areas
  3. Symmetrical
  4. Rheumatoid nodules
  5. Rheumatoid factor
  6. Radiological changes
  7. Hand arthritis (at least 1 hand)
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7
Q

What are the radiological findings on RA?

A

Periarticular erosions

Subluxation

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8
Q

What are the general symptoms of RA?

A

Fatigue
Wt loss
Anaemia
Rash

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9
Q

What score can be used to measure disease activity?

A

DAS-28

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10
Q

What specific deformities may be present o/e in RA?

A

Nodules

Boutainnaire’s deformity

Swan neck deformity

Ulnar deviation of fingers

Radial deviation of wrist

Z - shaped thumb

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11
Q

What inflammatory signs are seen o/e

A

Increased temp

Redness

Tenderness on movement

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12
Q

What are the signs of tenosynovitis?

A

Stiffness
Pain
Swelling

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13
Q

What are the cardiac complication of RA?

A

IHD
VHD
Pericarditis

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14
Q

What are the respiratory complications of RA?

A

Nodules in the lung
Increased risk of fibrosis
Bronchiolitis obliterans

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15
Q

What may be seen in the eye in RA?

A

Episcleritis

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16
Q

What is felty’s syndrome?

A

RA with HSM and thrombocytopenia

17
Q

What MSK finding may be present with RA?

A

Carpal tunnel

18
Q

What may be seen on neck X ray in RA?

A

Atlanto-axial subluxation

19
Q

Serological tests RA

A

RF

Anti-cyclic citrullinated ab if RF -ve

20
Q

What is ACCab an indicator of

A

Poor prognosis

21
Q

Other bloods

A

ESR

CRP

22
Q

Symptomatic treatment of RA?

A

Analgesia

NSAIDs

23
Q

What is the main treatment of RA?

A

DMARDs

24
Q

What is first line DMARD regimen?

A

1st - methotrexate

+ sulfasalazine

25
Q

What should be tried if DMARDs fail twice?

A

Biologics

26
Q

What biologics can be used in RA?

A

Anti-TNF = infliximab
Anti-IL-1
Anti-IL-6