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Which of the following cells are involved in the pathogenesis of rheumatoid arthritis?

Which of the following cells are involved in the pathogenesis of rheumatoid arthritis?. B cell T cell Macrophage All of above. Which of the followings is not anti-TNF?. Rituximab Etanercept Adalimumab Golimumab. DAS-28 is used to assess the disease activity of which disease?.

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Which of the following cells are involved in the pathogenesis of rheumatoid arthritis?

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  1. Which of the following cells are involved in the pathogenesis of rheumatoid arthritis? • B cell • T cell • Macrophage • All of above

  2. Which of the followings is not anti-TNF? • Rituximab • Etanercept • Adalimumab • Golimumab

  3. DAS-28isusedtoassessthediseaseactivityofwhichdisease? • systemiclupuserythematosus • rheumatoidarthritis • ankylosingspondylitis • osteoporosis

  4. Thefollowingsideeffectsareincreasedwithanti-TNFtherapyexcept • Infection • Tuberculosis • HepatitsB • Lymphoma

  5. TheTBincidencerateinTaiwanisaround • 10-24/100,000population • 24-49/100,000population • 50-100/100,000population • 100-299/100,000population

  6. WhichisthecorrectstatementregardingscreentestsTST(tuberculinskintest)andIGRA(interferon-rreleaseassay)forlatentTBinfection?WhichisthecorrectstatementregardingscreentestsTST(tuberculinskintest)andIGRA(interferon-rreleaseassay)forlatentTBinfection? • TSTisofbettersensitivitythanIGRA • IGRAisofbettersensitivitythanTST • TSTisofbetterspecificitythanIGRA • IGRAisofbetterspecificitythanTST

  7. WhichofthefollowingtreatmentcarriesthehighestriskofHBVreactivationWhichofthefollowingtreatmentcarriesthehighestriskofHBVreactivation • Methotrexate • Steroid • Anti-TNFplussteroid • Rituximabplussteroid

  8. WhichofthefollowingantiviraldrugscarrythehigherriskofemergenceofHBVmutantvariant?WhichofthefollowingantiviraldrugscarrythehigherriskofemergenceofHBVmutantvariant? 1. Lamivudine 2. Adefovir 3. Entecavir 4. Telbivudine

  9. Which of the following cells are involved in the pathogenesis of rheumatoid arthritis? • B cell • T cell • Macrophage • All of above

  10. Cytokine signalling pathways involved in RA Tocilizumab IL-4 IL-10 RF IL-4 IL-6 IL-10 Th2 Macrophage Etanercept Infliximab Adalimumab Golimumab Certolizumab ThO Abatacept Plasma cell IFNg IFNg IL-12 Rituximab B cell CD4 + T cell CD11 Synovium TNF IL-1 IL-6 OPGL CD69 CD11 CD69 Osteoclast Chondrocyte Fibroblast Tocilizumab Production of metalloproteinases and other effector molecules Migration of polymorphonuclear cells Erosion of bone and cartilage Choy EH, Panayi GS. N Engl J Med 2001;344:907-916

  11. Which of the followings is not anti-TNF? • Rituximab • Etanercept • Adalimumab • Golimumab

  12. Woodrick, R. S. & Ruderman, E. M. Nat. Rev. Rheumatol. 7, 639–652 (2011)

  13. DAS-28isusedtoassessthediseaseactivityofwhichdisease? • systemiclupuserythematosus • rheumatoidarthritis • ankylosingspondylitis • osteoporosis

  14. Measuresofdiseaseactivityofrheumatoidarthritis DAS-28,SDAI,CDAI 1.Remission(緩解) 2.Lowdiseaseactivity(低度疾病活動度) 3.Moderatediseaseactivity(中度疾病活動度) 4.Highdiseaseactivity(重度疾病活動度)

  15. Thefollowingsideeffectsareincreasedwithanti-TNFtherapyexcept • Infection • Tuberculosis • HepatitsB • Lymphoma

  16. TheTBincidencerateinTaiwanisaround • 10-24/100,000population • 24-49/100,000population • 50-100/100,000population • 100-299/100,000population

  17. 臺灣仍是結核病中度流行區 結核病例報告率為西元2004年之每十萬人74例至2007每十萬人85例; 在2010年則降為每十萬人57例 Hong Kong 77 N. Korea 178 China 102 S. Korea 87 Taiwan 66.7 Singapore 41 Japan 31 Australia 5.7 Phillipines 296 USA 4.6 Canada 5.5 Malaysia 106 UK 12 S. Africa 536 Indonesia 285 Guam 60 Every 100,000 people Data From WHO: World TB Report 2005 Vietnam 178 Thailand 142

  18. WhichisthecorrectstatementregardingscreentestsTST(tuberculinskintest)andIGRA(interferon-rreleaseassay)forlatentTBinfection?WhichisthecorrectstatementregardingscreentestsTST(tuberculinskintest)andIGRA(interferon-rreleaseassay)forlatentTBinfection? • TSTisofbettersensitivitythanIGRA • IGRAisofbettersensitivitythanTST • TSTisofbetterspecificitythanIGRA • IGRAisofbetterspecificitythanTST

  19. A recent meta-analysis: QFT assay has high specificity (96%), whereas TST has low specificity in BCG-vaccinated people (Ann Intern Med 2008;149:177-84 ) Sensitivity Specificity TST QFT

  20. WhichofthefollowingtreatmentcarriesthehighestriskofHBVreactivationWhichofthefollowingtreatmentcarriesthehighestriskofHBVreactivation • Methotrexate • Steroid • Anti-TNFplussteroid • Rituximabplussteroid

  21. Hepatitis flares in HBsAg (-) NHL patients Hui CK et al: Gastroenterology 2006; 131: 59-68 • A retrospective study of 244 HBsAg (-) lymphoma patients • 8 patients developed hepatitis (median follow-up 12.4 months) • 3 fulminant hepatitis 6/49  12%

  22. WhichofthefollowingantiviraldrugscarrythehigherriskofemergenceofHBVmutantvariant?WhichofthefollowingantiviraldrugscarrythehigherriskofemergenceofHBVmutantvariant? 1. Lamivudine 2. Adefovir 3. Entecavir 4. Telbivudine

  23. Cumulative Incidence of HBV Resistance lamivudine telbivudine entecavir tenofovir adefovir J Hepatol 2009; 50: 227–42.

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