4. Rheumatoid Factor

Question 1

Autoimmune and inflammatory disease

Immune system attacks healthy cells of the body by mistake causing inflammation (Painful swelling)

Answer 1

Rheumatoid factor

Question 2

What causes RA?

Answer 2

Unknown

Question 3

Even if the cause is unknown, what are the factors that can increase the risk?

Answer 3

Age
Sex (Female)
Genetics
Smoking
Obesity

SAGOS

Question 4

Signs and Symptoms of RA

Answer 4

Pain or aching in more than one joint

Stiffness in more than one joint

Tenderness and swelling in more than one joint

Weight loss

Fever

Fatigue

Weakness

Question 5

What are the late stage symptoms of RA?

Answer 5

Boutonniere deformity of thumb

Ulnar deviation of metacarpophalangeal joints

Swan-neck deformity of fingers

Question 6

ACR-EULAR means?

Answer 6

American College of Rheumatology - European Alliance of Association for Rheumatology

Question 7

For joint involvement, What is the score if 1 large joint?

Answer 7

0

Question 8

For joint involvement, What is the score if 2-10 large joint?

Answer 8

1

Question 9

For joint involvement, What is the score if 1-3 small join, +- Large joint

Answer 9

3

Question 10

For joint involvement, What is the score if >10 joints (at least 1 small joint)

Answer 10

5

Question 11

For Serology, what is the score if Negative RF, negative anti CCP Ab?

Answer 11

0

Question 12

For Serology, what is the score if Low positive RF or Low positive anti CCP Ab?

Answer 12

2

Question 13

For Serology, what is the score if High positive RF or high positive anti CCP Ab

Answer 13

3

Question 14

For Acute phase reactants, What is the score if Normal CRP and normal ESR?

Answer 14

0

Question 15

For Acute phase reactants, What is the score if Abnormal CRP or abnormal ESR?

Answer 15

1

Question 16

For duration of symptoms, what is the score if < 6 weeks

Answer 16

0

Question 17

For Acute phase reactants, What is the score if > or = to 6 weeks?

Answer 17

1

Question 18

What is the score for definite RA?

Answer 18

> or = to 6/10

Question 19

An autoantibody which attacks self or own tissue, mostly relevant to RA

Answer 19

Rheumatoid factor

Question 20

Has the affinities to the Fc portion of immunoglobulins:?

Answer 20

IgM, IgG or IgA

Question 21

What is the most common affinity when it comes to Isotypes?

Answer 21

IgM RF

Question 22

How is RF produced?

Answer 22

Arrangement and somatice hypermutations of germline genes

Question 23

What are the cell involved in the production of RF?

Answer 23

CD4+ T cells

Activated Lymphocytes

Plasma cells

Macrophage

Question 24

Cytokine secretion by these activated cells leads to? (in RF production)

Pannus formation leading to joint destruction

Answer 24

Inflamed synovium

Question 25

How many percent in healthy persons if a positive RF is not specific to RA?

Answer 25

5%

Question 26

Lab methods that detects mostly IgM-RF isotypes

Qualitative test - Used as a screening test

Semi-quantitative - determine the RF titer

Answer 26

Manual Passive agglutination test

Question 27

What are the other test to detect RF?

Answer 27

ELISA

Immunochromatographic

Nephelometric methods

Immunotubidimentric

Question 28

Can detect different RF isotypes for prognositcation

Answer 28

Nephelometric methods

Question 29

Old method, that uses charcoal RBCs or latex particle

Answer 29

Manual Passive agglutination

Question 30

What is the normal value for Manual Passive agglutination in qualitative test?

Answer 30

<14 IU/mL

Question 31

What is the normal value for Manual Passive agglutination in semi-quantitative test?

Answer 31

<1:80