Rheumatoid Arthritis Flashcards
RA is a ___ poly arthritis
Symmetrical
RA is 3 times as common in ___
Women
What are the autoantibodies used to test for RA? (2)
Rheumatoid factor (first)
Anti-CCP (second)
RA pain gets better with ___ and is worse in the ___
Activity
Morning
What are the common affected joints in RA? (Any 3)
PIP joints MCP joints Wrist Ankle MTP joints Cervical spine Knees Hip Shoulders
What is a compilation of RA in the cervical spine?
Atlantoaxial subluxation leading to spinal cord compression
What are signs of RA in the hands? (4)
Z shaped thumb
Swan neck deformity
Boutonnieres deformity
Ulnar deviation of the fingers
What are extrarticullar manifestations of RA (any 3)
Caplan’s syndrome (pulmonary fibrosis)
Bronchiolitis obliterans
Felty’s syndrome (RA, neutropenia, splenomegaly)
Anaemia of chronic disease
CVD
Carpel tunnel
Amyloidosis
What are the investigations for RA? (4)
RF
Anti CCP
CRP and ESR
X ray of hands and feet
X ray changes in RA (4)
Joint destruction and deformity
Soft tissue swelling
Periarticular osteopenia
Boney erosions
What score is used to monitor RA that assesses 28 joints?
DAS28/ disease activity score
What factors in RA lead to a worse prognosis? (Any 3)
Young
Male
More joints and organs affected
RF and anti-CCP positive
Erosions on x ray
What is the first, second, third and fourth line anti rheumatoid drugs used to treat RA? (1, ,1, 2, 2)
1st: methotrexate or sulfasalazine or leflunomide
2nd: 2 of the above
3rd: methotrexate plus biologic e.g infliximab
4th: Methotrexate plus rituximab
What is the MOA of methotrexate and what is a complication?
Immunosuppressant
Pulmonary fibrosis
What is the MOA of leflunomide and what are 2 complications of it?
Immunosuppressant
Hypertension
Peripheral neuropathy
