Manifestari non-articulare mai putin frecvente

Question 1

Plamani

afectare cai respiratorii

Answer 1

bronsiectazie = tuse + sputa

bronsiolita obliteranta = dispnee progresiva

Question 2

afectare pleurala

Answer 2

pleurezie - asimptomatica → dispnee usoara

ingrosare pleurala

Question 3

boala pulmonara interstitiala

Answer 3

inflamatie + fibroza pulmonara bazala

Question 4

noduli periferici intrapulmonari

Answer 4

asimptomatici, pot cavita in asociere cu:

pneumoconioza (sd Caplan)

Question 5

leziuni infectioase

Answer 5

tuberculoza

la pacientii cu DMARD biologice

Question 6

Vasculita

Answer 6

titruri ridicate FR + manifestari extra-articulare active in alta parte

• vasculita cutanata importanta cu necroza
• mononevrita multiplex

Question 7

Risc cardiovascular independent de factorii de risc traditionali (hipercolesterolemie + HTA)

Answer 7

AR slab controlata

+

PCR crescut persistent

+

Hipercolesterolemie

Question 8

Alte probleme cardiovasc

Answer 8

pericardita

endocardita

boala miocardica

evidentiate postmortem - 20%

Question 9

Neuropatii senzoriale periferice

Answer 9

mononevrita multiplex

neuropatie periferica simetrica din cauza vasculitei vasa nervorum

Question 10

Neuropatii de compresie

Answer 10

sindrom de tunel carpian / tarsian → din cauza sinovitei

Question 11

Compresia medulara

Answer 11

din cauza subluxatiei atlanto-axiale

Question 12

Ochi

Sindromul sicca (Sjogren)

Answer 12

xeroftalmie

xerostomie

Question 13

Sclerita + episclerita

Answer 13

boala severa seropozitiva

ochi rosii durerosi

Question 14

Scleromalacia perforans

Question 15

Rinichi

Amiloidoza

Answer 15

proteinurie

sd nefrotic

BCR

rar

AR severa, de lunga durata

depunere proteina amiloida serica A inalt stabila in matricea intracelulara a unei varietati de organe

Question 16

Splina, gg limfatici, sange

Sindrom Felty

Answer 16

SANTA

Splenomegalie

Anemie normocroma, normocitara (deficit de Fe - pierdere GI de sange post ingestie AINS / rar anemie hemolitica Coombs+)

Neutropenie

Trombocitoza → boala activa

Artrita reumatoida

Pancitopenie din cauza hipersplenismului / complicatie trat cu DMARD

complicatii: ulcere picioare + sepsis

HLA-DR4 la 95% dintre pacientii cu AR + Felty