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WEEK 32:

RHEUMATOID ARTHRITIS PLENARY:

QuestionAnswer
RA periodontal + autoimmune disease leading to irreversible joint destruction and swelling, muscle atrophy tendon rupture affecting joints and systemic effects eg nonspecific fibrosing lesins not age related
factors related to RA sex genetics obesity smoking NOT AGE
variable clinical features pain at rest and night can be associated with swelling hands MCP PIP (no DIP) recent onset starts in hands + feet morning stiffness >30m systemic symptoms weight loss, fatigue
examination may show warm swollen joints tender along joint margins systemic signs
blood tests to do RF anti-ccp CRP ESR
diagnostic tests to do XRAY ULTRASOUND WITH DOPPLER SIGNAL
initial management methotrexate with folic acid short term oral steroids as bridging therapy education on disease + treatment goals + monitoring early escalation planned if inadequate response
when to make rheumatology referral persistent synovitis (more than 1 joint swelling lasting more than 6 weeks) early inflammatory arthritis symptoms positive autoantibodies (anti ccp) rapid symptom progression elevated inflammatory markers
pharmacological treatment of RA monotherapy (conventional disease modifying anti rheumatic drugs) eg oral methotrexate sulfasalazine other cDMARDs eg gold complexes penicillamine short bridging treatment biological DMARDS combination therapy of rituximab and methotrexate
non pharmacological treatment physiotherapy and occupational therapy
Created by: kablooey
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