RDU RA

DR. KANG

Question 1
Features
-persistent symmetrical joint pain and stiffness
-pain in small joints of hands and feet
-morning stiffness
-female
-advanced age

Rheumatoid Arthritis
Radiographic changes- osteophytic changes
Extra-articulations changes
• Rheumatoid nodules

Question 2
Blood tests are ordered and the patient is immediately referred to rheumatologist because they are
the only practitioners able to prescribe DMARDs, if diseases remains untreated it will progress to
joint destruction within 3 months and once a joint is destroyed it cannot be recovered
• Rheumatic Factor- has a high sensitivity but a low specificity, it’s significant in the fact that
it is a poor prognostic factor
• Anti-CCP- High specificity but low sensitivity
• ESR
• CRP

Therefore Immediate treatment will benefit the user

Question 3
Corticosteroids control inflammation but they cannot be used for long term because of side effects
Corticosteroids cannot control pain directly but it can control inflammation induced pain
NSAIDs control pain directly and can also control inflammation pain
DMARDs take 6 months to reach maximum effect therefore corticosteroids can be used for rapid
suppression of inflammation
State the rational for using a drug

Question 4
DMARDs as the most effective treatment
Reduce risk of cardiovascular effects, deformity
Use powerful drugs as immediately as possible
Use non-biological DMARDs because of side effects