2

Question 1

autoimmune disease

Answer 1

when recognition system come across foreign substance B-cells are activated which produce antibodies against body cells and tissues

Question 2

Rheumatoid Arthritis

Answer 2

imflammatory disease that attacks joints leading to joint destruction

Question 3

Epidemiology

Answer 3

1% of population
3:1 female:males
any age mosstly 30-50
genetic predisposition
no known cause

Question 4

Aetiology

Answer 4

Infection occurring in a person with a genetic predisposition, triggers an auto immune response causing synovial inflammation and ultimately, joint destruction.

Question 5

initiating factors

Answer 5

activation of helper T-cells
release of cytokines
activation of B cell
antibody formation

Question 6

synovial membrane

Answer 6

increased WBC
angiogenesis
thickening of the membrane which create a destructive granulation tissue called Pannus
Pannus project into joint space in junction of articular cartilage and subchondral bone

Question 7

Pannus Invasion

Answer 7

the pannus grows from the joint margin across the articular surface
blocks articular cartilage from receiving nutrition from synovial fluid
cytokines released directly damage chondrocytes
thinning of cartilage
exposure of underlying bone

Question 8

Pathology

Answer 8

early RA changes to synovial tissue
systemic disease-extra articular features
insidious onset
acute presentation

Question 9

Presentation

Answer 9

Begins as inflammatory arthropathy

onset 3 pattens

• widespread symmetrical poly-arthritis
• monoarticular arthritis
• episodic arthritis evolving into poly arthritis

extensive joint pathology may be rapid or slow

Question 10

systemic symptoms

Answer 10

swelling of peripheral joints
morning stiffness
diffuse aching
fatigue 
weight loss
flu like symptoms
disturbed sleep
depression

Subcutaneous nodules
Serum Rheumatoid Factor
Radiographic Change

Question 11

joint symptoms

Answer 11

insidious onset ofjoint pain
stiffness
symmertrical pain
joint temperature increases
joint swelling
pain with movement
deformity
osteoporosis

Question 12

Blood Test

Answer 12

inflammtion present with high value of rheumatoid factoe -ESR and CRP

not always reliable

Question 13

Treatment

Answer 13

drug management
surgery
physio
OT
Multidiscipilnary

Question 14

Drug management

Answer 14

steroids
NSAIDS-nonsteroidal anti-inflammatory drugs
DMARD-disease modifying Anti-rheumatic drug
Biological agents
analgenic

Question 15

surgical management

Answer 15

reliece pain
restore stability
improve function
prevent stress on other joint

Question 16

physiotheraphy management

Answer 16

Detailed assessment
Relief of pain
Prevention of deformity
Correction of deformity
maintenance and restoration of joint range
Maintenance and improvement of muscle power
Maintenance of optimum function

Question 17

RA TO OA

Answer 17

RA is a systemic disorder affecting joints and other connective tissue
autoimmune response causing inflammatory process that destroys the joint

OA is a degenerative wear and repair elements occur as a response destruction of the joint