Week 224 - Rheumatoid arthritis Flashcards
Week 224
What is systemic lupus erythematosus?
Systemic autoimmune disease caused by type 3 hypersentivity reaction.
i.e. soluble antigens & antibodies expressed in equal amounts, resulting
in extensive cross linking & formation of large immune complexes
Week 224
What is sclerodactyly?
This is tightening and hardening of skin over the fingers and hands, seen in SLE.
Week 224
What is telangiectasia?
Telangiectasias (also known as spider veins) are small dilated blood vessels near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter.
Week 224
What is polymyositis?
T Cytotoxic cells invade and destroy healthy muscle fibres.
Only occurs in adults.
Autoimmune disease - invasion of muscle by white cells.
Week 224
What is dermatomyositis?
This is an automimmune disease affecting muscle tissue. It occurs in children and adults. Produces characteristic skin lesions, heliotrope eyelids, and gottrons papules (plaques on knuckles). It affects both muscles and skin.
Week 224
Look at this image. What condition is suspected?
Dermatomyositis
Week 224
Raised creatine kinase indicates that what type of tissue has been damaged?
Muscle tissue.
Week 224
What drug type is used in the treatment of conditions such as dermatomyositis and polymyositis? Give specific examples.
Immunosuppressants, I.E Azathioprine or Methotrexate
Can usually be withdrawn after 1-2 years.
Week 224
What is Sjorgren syndrome?
Chronic autoimmune inflammatory disorder, with lympohcytic infiltration of exocrine organs. Mainly affects lacrimal glands. Salivary/parotid glands +/- nasal, vaginal, skin glands.
This is often secondary to RA/SLE, Mainly affects middle aged females.
Week 224
What is Sicca syndrome? *CLUE*: It’s often associated with Sjorgen syndrome.
Dry eyes, mouth, vagina, oral cavity (basically mucous membranes are all dry).
Week 224
What is the Schirmer test?
Filter paper folded over lower eyelid. Should wet >15mm in 5 mins
+ve test = <5mm in 5mins
Week 224
Which antibodies are often present in Sjorgen syndrome?
Anti - Ro/Anti LA antibodies
Week 224
What is rheumatoid arthritis?
Chronic, Systemic Inflammatory Disorder caused by an Autoimmune aetiology.
Week 224
In three words, which group is most likely to suffer from rheumatoid arthritis?
40’s Female smoker.
Week 224
What is rheumatoid vasculitis?
Inflammation of small vessels causing occlusion/ischaemia
Week 224
What is mononeuritis multiplex?
Mononeuritis multiplex is a painful, asymmetrical, asynchronous sensory and motor peripheral neuropathy involving isolated damage to at least 2 separate nerve areas.
Multiple nerves in random areas of the body can be affected. As the condition worsens, it becomes less multifocal and more symmetrical. Mononeuropathy multiplex syndromes can be distributed bilaterally, distally, and proximally throughout the body.
Week 224
What is Caplans syndrome?
RA + Pneumoconiosis (Occupational lung dis. from dust inhalation)
Week 224
What is Felty’s syndrome?
RA + Splenomegaly + Leukopenia
Week 224
Anti CCP (Cyclic Citrillunated Peptide) is specific for which autoimmmune condition?
Rheumatoid arthritis
Week 224
What are the treatments for R. Arthritis?
- NSAIDS
- STEROIDS
- DMARDS
Week 224
What must be given in conjunction with methotrexate in patients with RA?
Folate. Folate antagonism is not a desired effect in treatment of RA.
Week 224
What is Sulfasalazine, and how does it work?
Sulfasalazine is an immunosuppressive medicine. It helps to suppress overactivity of the immune system in rheumatoid arthritis. It can help to reduce pain and swelling by limiting inflammation.
This suppresses IL-1, TNF and other immune cells.
Side effects include oligospermia, and rashes.
Week 224
What is Leflunomide, and how does it work?
This is an immunosuppressive DMARD. It is a pyrimidine synthesis inhibitor.
Liver damage, lung damage and immunosuppression are all dose-limiting side effects.
Do NOT USE WITH METHOTREXATE - OR ELSE IT IS GOODBYE LIVER