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6 Cards in this Set

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1) Is RF Specific for RA (Rheumatoid Arthritis)?
A) How specific is RF for dx of RA?

2) Since RF is not very specific for RA, their is an increased risk of false positives. What are 11 cond'ns that can --> false positive RF?

3) What is 2ne serological test for RA besides RF?
A) How specific is CCP for RA?
B) How sensitive is CCP for RA?
C) What % of RF pts who are seronegative for RF are seropositive for CCP?
D) Positive CCP suggests what 2 things?

4) If a pt is positive for RF & CCP, how reliable is it for a Dx of RA?

5) If you have a pt who has severe sx of RA, but is seronegative to RF and CCP and not responding to tx, what Ab can you use?
A) When is anti-MCV considered positive?
B) Specificity?
C) Sensitivity
D) Overall accuracy?
1) No!
A) 75%

2) "SHHIT the COESS are false positive"
-SLE
-Hep B
-Hep C
-Interstitial Pulmonary Fibrosis
-TB

-Cryoglobulinemia
-Osteomyelitis
-Endocarditis
-Sarcoidosis
-Syphilis

3) CCP (Cyclic Citrullinated Peptide)
A) 95% (way better than RF)
B) 70%
C) 40%
D) Future RA development and more aggressive dz
(Fnctnl disability, erosive bone damage, extra-articular dz)

4) > 98% reliable for dx of RA

5) Anti-MCV (anti-Mutated Citrullinated Vimentin)
A) > 20 U / ml
B) 93.2%
C) 76.9%
D) 82.9%
RA DMARDS:

1) For RA, all DMARDS are synergistic when combined w/ what?

2) Do you remember the major AE of hydrochloroquine?
A) Consequently, pts should get what?

3) Do you rememberthe 8 AEs / CIs of MTX?
A) BC of the risk of hematologic suppression and liver hepatotoxicity, what 2 tests should you order every 8-12 wks?
B) What results would indicate that the pt should not receive MTX?

4) Do you remember the 6 AEs / CIs of the Biologic DMARDS?
A) BC of the risk for TB, pts should get an annual what?

5) Pts on DMARDS should avoid what 2 things?
1) Biologic-DMARDS

2) Retinal Toxicity -->
Changes in color vision
A) Annual Ophthalmology Exam

3) Pneumonitis, Hair Loss, hematologic suppression, stop before surgery, Mouth sores, GI Sx, Hepatotoxic, CI'ed in preggos
A) CBC and CMP
B) WBC < 3,000
PLTs <100,000
Transaminases > 3X normal

4) Viral Infxns
Fungal Infxns
TB
Rashes
Lymphoma
Demyelinating Dz
A) PPD / TB Skin Test

5) Excess ROH and Pregnancies
MOA of Biologic DMARDS for RA:

1) Do you remember the 3 major groups of Biologic DMARDs for RA?

2) MOA of Anakinra?

3) MOA of "ACE-I" (Adalimumab, Certolizumab, Etanercept, Infliximab)!!!!!!

4) MOA of Abatacept?

5) MOA of Rituximab?

6) MOA of Tocilizamab?
1) Anakinra
"-cepts"
"-mabs"

2) anti-IL1 --> Dec T-Cells

3) Inhib TNF --> Dec T-Cells

4) Inhib CD28 recept from binding to T-cells

5) Inhib CD20 --> Inhib Maturation of B-Cells

6) Inhib IL-6 --> Dec T-cells
Some Terminology for Biologic DMARDS for RA:

1) Ending "-CEPT" usually means what?

2) Ending "-XIMAB" usually means what?

3) Ending "-MUMAB" usually means what?

4) Suffix "u" means what?

5) Suffix "o" means what?

6) Suffix "xi" means what?

7) Suffix "zu" means what?

8) Suffix "xizu" means what?
1) ) Rx that bind receptors and block the binding of these receptors to cells

2) Chimeric monoclonal Ab

3) Humanized monocloan Ab

4) Human

5) Mouse

6) Chimeric (human / foreign)

7) Humanized

8) chimeric / humanized hybrid
1) Can you name the 6 AEs of biologic DMARDS that are T-cell Inhibs?

2) Now, remember, Biologic DMARDS should be stopped before surgery and CI'ed w/ the administration of what?

3) Which biologic DMARD may increase serum lipid levels?
1) Viral Infxn
Funal Infxn (Histo & Coccidiomycosis)
TB
Rashes
Lymphoma
Demyelinating Dz

2) Live Vaccines (Shingles)

3) Tocilizumab
HLA-B27

1) HLA-B27 is found in what percent of pts w/ AS?

2) HLA-B27 is found in what percent of pts w/ other forms of Spondyloarthropathies (SpA)?

3) HLA-B27 is found in what % of ppl w/out an SpA?

4) HLA-B27 more frequently and less frequently in what groups?
1) 90%

2) 50-75%

3) 5-15%

4) More frequently in African Americans
Less frequently in Native Americans