Rheumatoid Arthritis Flashcards
Who mainly gets RA
Can affect any age group, women affected 3 times as commonly
What are some potential triggers of RA
infections and cigarette smoking
What is a key to the early developement of RA
Citrullination of proteins and developement of autoantibodies
How is RA diagnosed
Clinically, inflammatory markers and autoantibodies (also imaging)
What are the clinical features of RA
Prolonged morning stiffness, symmetrical, synovitis, positive compression tests
What joints are involved in positive compression tests
MCP and MTP joints
How often is Rheumatoid factor seen in RA patients
70%
How specific are anti-CCP antibodies
99%`
Can Anti-CCP reflect disease activity
No, remains positive despite treatment
What is the most specific antibody for RA
Anti-CCP
What shows up in late stage RA Xrays
Erosions and subluxation
What shows up in early RA stage Xrays
Can be normal! Soft tissue swelling, periarticular osteopenia
When is an MRI used for RA diagnosis
If there is diagnostic doubt
What is key in RA managemetn
Early and aggressive treatment with DMARDs
What is used for the assessment of disease activity
DAS28 score
When do RA patients get biologic drugs
Failure of 2 DMARDs and DAS28 score >5.1
What are the adverse effects of biologic drugs
Risk of infection (esp TB)
Question over risk of malignancy (esp skin cancer)
Contraindicated in certain situations e.g. pulmonary fibrosis, heart failure
What are patients screened for in RA
Cardiovascular disease and osteoporosis
When are steroids used in RA management
in bridging therapy before DMARDs take full effect and for flares only
