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MSK > Rheumatoid arthritis clinical features > Flashcards

Rheumatoid arthritis clinical features Flashcards

1
Q

What are the 7 criteria of rheumatoid arthritis?

A
  1. Morning stiffness
  2. Arthritis of 3 or more joints
  3. Arthritis of hand joints
  4. Symmetric arthritis
  5. Rheumatoid nodules
  6. Serum rheumatoid factor
  7. Radiographic changes
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2
Q

What is morning stiffness (lel)

A

Morning stiffness in and around joints lasting at least an hour

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3
Q

What are rheumatoid nodules?

A

Subcutaneous nodules over bony prominences, extensor surfaces, or in juxtaarticular regions

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4
Q

What radiographic changes may occur in rheumatoid arthritis?

A

Erosions

Unequivocal bony decalcifications

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5
Q

What is the prevalence of rheumatoid arthritis?

A

Around 1% of the population

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6
Q

What is the incidence of rheumatoid arthritis?

A

Approximately 200 new cases per year

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7
Q

What is the male:female ratio of incidence?

A

1:3

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8
Q

What is the peak age of onset?

A

4th/5th decade

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9
Q

What investigations can be done into rheumatoid arthritis?

A

Immunology - rheumatoid factor, Anti Cyclic Citrullinated Antibodies
X-Rays

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10
Q

What are symptoms of rheumatoid arthritis?

A 
Pain
Stiffness
Immobility
Poor function
Systemic symptoms
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11
Q

What are clinical signs of arthritis?

A 
Swelling
Tenderness
Limitation of movement
Redness
Heat
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12
Q

What are non-specific systemic features of rheumatoid arthritis?

A

Fatigue
Weight loss
Anaemia

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13
Q

What are specific systemic features of rheumatoid arthritis?

A 
Eyes
Lungs
Nerves
Skin
Kidneys
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14
Q

What are long term systemic features of rheumatoid arthritis?

A

CVS

Malignancy

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15
Q

How is rheumatoid arthritis assessed?

A

Disease activity score 28 (DAS 28)
DAS 28<2.4 = clinical remission
DAS 28>5.1 = Eligibility for biologic therapy

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16
Q

What is the general outcome for rheumatoid arthritis?

A

75% of cases diagnosed during working life
Around 1/3 will stop work within 2 years
Around half will be unable to work within 10 years

17
Q

What are the 4 main categories of treatment for rheumatoid arthritis?

A

Medicines
Injections
Therapies
Surgery

18
Q

What are the categories of therapeutics for rheumatoid arthritis?

A

NSAIDs
Disease Modifying Anti-Rheumatic Drugs
Biologics
Corticosteroids

19
Q

What Disease Modifying Anti Rheumatic Drugs are currently used?

A

METHOTREXATE
Sulfasalazine
Hydroxychloroquine
Leflunomide

20
Q

What is the general approach to management of rheumatoid arthritis?

A

Early and aggressive intervention

Suppression of inflammation will prevent joint damage and disability

21
Q

What are biologics?

A

Large complex proteins which target key aspects of inflammatory cascade

22
Q

How are biologics delivered to the patient?

A

Parenterally

MSK (30 decks)

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