Patho: Joints 2 RA

Question 1

RA define

Answer 1

is a chronic systemic inflammatory disorder that affects may tissues and organs including the joints, skin, blood vessels, heart and lungs and muscles

Question 2

Joints are the principal thing attached what joints are affected?

Answer 2

• Diarthrotic joints symmetrically and bilaterally
• May progress first in one hand, than the other
• Proximal interphalangeal and metacarpophalangeal joints, elbows, knees, ankles, and spine

Question 3

what would you expect the joint infiltrate to look like on aspiration?

Answer 3

Produces a nonsuppurative (not a WBC infectious process) proliferative and inflammatory synovitis – inflammation but if you drain, will not be purulent

Question 4

RA will often progress to what?

Answer 4

Often progresses to destruction of the articular cartilage and ankylosis (fusion) of the joints (consolidation of bone). May not be able to close hand due to this.

Question 5

what genetic factors influence RA?

Answer 5

HLA (human leukocyte antigen) proteins : HLA-DR4, DR1, DR10, DR14

Seropositive RA (poor prognosis): High frequency of arginine in the DR epitope

Seronegative RA (good prognosis)
High frequency of lysine in the DR epitope

PTPN22: Tyrosine phosphatase enzyme, when mutated activates inflammatory cells (T-cells)