Flashcards in Rheum Deck (96)
What is monoarthritis
1 joint involved
What is oligoarthritis
<= 5 joints affected
What is polyarthritis
>5 joints affected
Give examples of monoarthritis
Give examples of oligoarthritis
Give examples of polyarthritis
What conditions is Raynaud's present in
State some signs in the hands that are typical of RA
Z deformity of thumb
swan neck deformity
nail fold vasculitis
What is Z deformity of the thumb
What is swan neck deformity
What is Boutonniere deformity
What are the key investigations in suspected RA?
Bloods: FBC, CRP, ESR, U+E, LFT, RF, ANA, anti-cyclic citrullinated peptide antibodies
Imaging: XR hands and feet, CXR, US/MRI joints
What can happen to CRP and ESR in RA?
inflammatory markers, so raised
Does a raised RF diagnose RA?
can be raised in other infam diseases and in healthy!
What can a raised ANA (antinuclear antibodies) suggest?
What are the systemc problems causes in RA
peripheral nerve entrapment
What vaccines need to be given to those taking DMARDs?
influenza - annual
pneumococcal - 10y
live vaccines contraindicated
Does RF or anti-CCP antibodies have a greater specificity for RA?
What factors indicate a poor prognosis for RA?
rheumatoid factor positive
poor functional status at presentation
X-ray: early erosions (e.g. after < 2 years)
extra articular features e.g. nodules
What complications can methotrexate cause?
What complications can prednisolone cause?
Impaired glucose tolerance
What monitoring needs to happen in methotrexate treatment
Monitoring of FBC & LFTs is essential due to the risk of myelosuppression and liver cirrhosis
How long does is take for DMARDs to produce a full response
Why are DMARDs the best treatment for inflammatory arthritis
suppress disease progress
control the signs and symptoms
limit joint damage.
What treatment should be initiated in newly diagnosed active rheumatoid arthritis,
combination of DMARDs (including methotrexate and at least one other DMARD)
a short-term corticosteroid,
within 3 months of the onset of persistent symptoms.
When should you consider changing DMARD for a patient?
If a disease-modifying anti-rheumatic drug does not lead to an objective benefit within 6 months, it should be replaced by a different one.
When can a TNF inhibitor be prescribed in RA
an inadequate response to at least two DMARDs including methotrexate
What type of hypersensitivity reaction is SLE?
What are someof the risk factors for SLE?
exposure to sunlight