Flashcards
Rheumatoid Arthritis
Cards in this deck (23)
- 1Usual age of onset for RA20-40 years
- 2T/F: RA is more common in men.False; more common in women
- 3RA can involve every joint in the body except for ________DIP joints
- 4RA is unlikely if any of the following are true: 1) Joint distribution is ____________. 2) ____ joints are involved. 3) ______________ are absent.1) asymmetric
2) DIP
3) Constitutional symptoms (especially morning stiffness) - 53 characteristic hand deformities of RA- Ulnar deviation of the MCP joints
- Boutonnière (flexed PIPs, hyperextended DIPs)
- Swan-neck (hyperextended PIPs; flexed DIPs & MCPs) - 6Most common location for spinal involvement in RAC1 & C2 (subluxation and instability)
(30-40% of patients)
Less common in lower C-spine - 7Before undergoing any surgery, all patients with RA should have ____________, because....C-spine radiographs
Risk of neurologic injury during intubation d/t C1-C2 instability - 8Four classes of RA based on clinical courseA - One acute attack; never another (10%)
B - Undulating (exacerbations & complete remissions) (20%)
C - Exacerbations & improvements (symptomatic to some extent at all times) (65%)
D - Severe, progressive (5%) - 9Ocular manifestations of RA (3)Episcleritis
Scleritis
Scleromalacia - softening of the sclera; may perforate and cause blindness - 10Rheumatoid nodules nearly always occur in RA patients who are __________.seropositive (RF+)
- 11RF is present in ___% of the general population and ____% of RA patients (eventually)3% of gen pop
80% of RA - 12Fluid characteristics of pleural effusions related to RA (2)Very low glucose
Low complement - 13T/F: Rheumatic nodules can appear in the lungs and heart as well as the skin.True
Can cavitate and become infected as well - 14Felty syndrome involves the triad of _______, _______, and _________, as well as what other features?RA, neutropenia, splenomegaly
Also anemia, thrombocytopenia, LAD
Increased susceptibility to infection - 153 radiograph findings associated with RA- Periarticular osteoporosis (loss of bone mass near joint)
- Narrowing of joint space
- Bony erosions at joint margins - 16When should DMARDs be initiated in RA patients?At time of diagnosis
- 17Treatment of RA at diagnosisStart DMARDs
Due to slow onset of action of DMARDs, treat now with NSAIDs and corticosteroids. Can gradually taper once effects of DMARDs are evident. - 18For patients on MTX, you must closely monitor ____ and _____ function and supplement with _______.Liver and renal function
Folate - 19Side effects of MTX (6)- GI upset
- Stomatitis (oral ulcers)
- Mild alopecia
- BM suppression
- Hepatocellular injury
- Interstitial pneumonitis --> pulm fibrosis - 20Hydroxychloroquine, an alternative to MTX, requires what monitoring?Eye exams every six months (retinopathy)
- 21Anti-TNF inhibiting agents (etanercept, infliximab) are used when ___________ and require what monitoring?When MTX does not fully control disease
Require PPD screening (risk of TB reactivation) - 22Juvenile RA where extra-articular manifestations predominate is called...Still disease
- 23Caplan syndromeRA associated with pneumoconiosis
Information
- Description
- USMLE Step 2 Connective Tissue & Joint (6a Connective Tissue Disorders) Flashcards on Rheumatoid Arthritis, created by Aaron Samide on 05/06/2016.
- Created by
- Aaron Samide · Jun 2016
- Updated
- Jul 16, 2016
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