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Arthritis. Clinical Quiz. DMARDs. Which drugs and how do they work?. Methotrexate. Folic acid antagonist → Cytotoxic, immunosuppressant. Sulfasalazine. Scavenger of toxic metabolites produced by neutrophils. Penicillamine. Immunosuppressant. Blocks IL-1 and collagen maturation. Gold.

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Presentation Transcript
arthritis

Arthritis

Clinical Quiz

dmards
DMARDs

Which drugs and how do they work?

Methotrexate

Folic acid antagonist → Cytotoxic, immunosuppressant

Sulfasalazine

Scavenger of toxic metabolites produced by neutrophils

Penicillamine

Immunosuppressant. Blocks IL-1 and collagen maturation

Gold

Blocks IL-1, TNF

Chloroquine

Antimalarial

biologicals
“Biologicals”

What are the targets, and what effect rheumatic disease?

Adalimumab

Infliximab

TNF → Anti inflammatory

Entanercept

Rituximab

CD20 → Anti B Cell

rheumatoid arthritis
Rheumatoid Arthritis

Clinical diagnosis requires ≥ 4 of these 7:

  • Morning stiffness > 1 hr for ≥ 6 weeks
  • Arthritis in ≥3 joints for ≥ 6 weeks
  • Arthritis of hand or wrist joints ≥ 6 weeks
  • Symmetrical arthritis
  • Rheumatoid nodules
  • Serum RhF
  • Typical radiological changes
imaging
Imaging

OSTEOARTHRITIS

Standing radiograph of the knee reveals narrowing of the medial and lateral femorotibial compartments with marginal osteophytes.

imaging1
Imaging

RHEUMATOID ARTHRITIS

Multiple erosions with deformity of the carpal bones in a patient with rheumatoid arthritis of the hands.

imaging2
Imaging

ANKYLOSING SPONDYLITIS

Hip joint changes. Frontal radiograph shows uniform joint space narrowing and a collar of osteophytes at the femoral head-neck junction. Left sacroiliac joint ankylosis is present.