10 minute topic RA Flashcards
Rheumatoid Arthritis
chronic, progressive, inflammatory, autoimmune disease
principally attacks the joints producing an inflammatory synovitis
symmetric, bilateral
has exacerbations and remissions
RA risk factors
Female Age 20 to 50 years Genetic predisposition Relation to the Epstein-Barr virus Stress
Early RA sx
fatigue
joint discomfort
RA sx
pain at rest and with movement morning stiffness pleuritic pain (on inspiration) xerostomia (dry mouth) anorexia fatigue
Labs for RA
Anti CCP antibodies RF antibody ESR C reactive protein Antinuclear antibody Elevated WBC
Anti CCP antibodies test
detects antibodies to cyclic citrullinated peptide (anti-CCP)
will be positive before sx develop
more sensitive than RF test
RF antibody test
Diagnostic level is 1:40 to 1:60 (expected reference range 1:20 or less)
Can be increased by other autoimmune diseases
ESR test
20 to 40 mm/hr is mild inflammation
40 to 70 mm/hr is moderate inflammation
70 to 150 mm/hr is severe inflammation
Can be increased by other autoimmune diseases
C reactive protein test
Shows response to anti-inflammatory therapy
can be done in place of ESR
Antinuclear antibody test
Can be increased by other autoimmune diseases
Shows antibodies produced against one’s own DNA
RA diagnostic procedures
Arthrocentesis
X-ray
Arthrocentesis
Synovial fluid aspiration
there are increased WBCs and RF are present in the fluids
take tylenol for pain
x-ray for RA
used to determine the degree of joint destruction and monitor the progression of the disease
no need for CT or MRI if x-ray is used
Meds for RA
NSAIDS
Corticosteroids
DMARDs
Plasmaphoresis
NSAIDS
should get rx for acid lowering agent
first choice for pain
