The following are rheumatoid disease modifying drugs except: March 2011

Ans. D: BAL Commonly used DMARD's include 1) hydoxychloroquine, 2) sulfasalzine, 3) D-penicillamine, 4) gold, 5) methotrexate, 6) azathioprine etc. RA: Disease stas in synovium Synovium is the pa most affected The characteristic feature of Rheumatoid ahritis is persistent inflammatory synovitis, usually involving peripheral joints in a symmetrical distribution Causes implicated: Familial, immunological, infective etiology Women are affected thrice then men Earliest lesion in RA: Microvascular injury and an increase in the number of synol lining cells It usually causes symmetric ahritis with characteristic involvement of ceain specific joints (proximal interphalangeal/ PIP and metacarpophalangeal/ MCP joints) Boutonniere deformity: Flexion contracture of PIP and extension of the distal IP joints Trigger finger may be associated Rheumatoid nodules are pathognomic Extra-aicular manifestations occur in individuals with high titre of auto-antibodies to the Fc component of IgG (Rheumatoid factor) Hand Joints involvement: PIP: RA, osteo-ahritis/ OA, psoriatic ahritis/ PA PIP and DIP: OA, PA PIP, DIP, MCP and wrist: PA