Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Con II > RA > Flashcards

RA Flashcards

1
Q

what is the definition of RA

A

chronic, systemic, inflammatory autoimmune disease of uknown etiology
-chronic, symmetric, erosive synovitis of peripheral joints
-extraarticular manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is phase 1 of RA

A

genetic risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is phase 2 of RA

A

preclinical autoimmunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is phase 3 of RA

A

clinical disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which antigens can cause RA?

A
  1. viruses: retroviruses, EBC, parvo
  2. mycoplasma: GI system/ microbiome
  3. heat shock proteins, carilage antigens, peptides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the genetic susecptability

A

HLA-DR1
HLA-DR4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the screening tool for RA

A
  1. significant discomfort with squeezing the MCP and MTP joints
  2. prescene of 3 or more swollen joints
  3. more than 1 hour of morning stifness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the RA history

A

-degree of joint pain
-duration of morning stifness
-poor sleep patterns:
-prescense or absense of fatigue
-limitation of function: especially hand
-weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the RA physical exam

A

-joint count of actively inflammed joints
mechanical joint problems:
-loss of motion
-crepitus
-instability
-malalignment
-deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some extraarticular manifestation

A

-scleritis
-rhematoid nodules
-vasculities
-intersitial lung disease
-pericardial disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

talk about sclertisi

A

blood shot eyes
-someone needs to see eye doctor immediatley because they are at risk of losing their eyesight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

talk about vasculities

A

the tissue becomes necrotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some poor prognostic indicators

A

-earlier age at onset, female
-polyarticular synovitis >13 joints
-lab tests: high tier rhemaotoid factor or anti CCP, elevatedf ESR or CRP level, HLA-DR4
-erosions or cartilage loss on x-ray
-poor functional status
-extra articular manifestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is on the HAQ

A

-dressing/grooming
-arising
-eating
-walking
-pain
-fatigue/tiredness
-sleeping
-ambulatpru aiodes and independence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

talk about the cervical spine manifestation

A

-atlantoaxial subluxation due to laxity/rupture of the transverse ligament
-fracture/erosion of the odontoid process
-anterior sublux of the atlas on the axis=most common
-posterior sublux of atlas on axis due to fracture= rare
-vertical sublux of odontoid in relation to atlas= brainstem impingement

symptoms: asymp, cergical/occipital pain, cord impingement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

talk about thoracic manifestation

A

usually spared in RA
-compression fractures secondary to steroid therapy is a risk

17
Q

talk about the shoulder manifestastion

A

-GH joint and AC joint
-subacromial bursitis
-rotator cuff tendinitis/rupture
-bicipital tendinitis/rupture

18
Q

talk about the elbow manifestation

A

-flexion deformities and loss of lateral stability can develop
-entrapment of ulnar nerve or radial nerve due to synovitis
-olecranon bursitis: infection
-extensor surface of forearm: nodules

19
Q

talk about hand and wrist manifestations

A

-DIPs spared
-ulnar drift at MCP
-palmar subluxation of MCP
-swan-neck and boutonnieere deformity
-tenosynovitis:
flexor tendons= weakness, creptius, carpal tunnel syndrome, extensor tendons= 3/4/5 tendon ruputure due to abrasion by eroded ulnar styloid

20
Q

talk about hip manifestations

A

-1/2 pts with RA have radiographic evidence of hip disease
-protrusio acetablui: 5%
-trochanteric, iliopsoas and ischial bursitis
-avascular necrosis of the femoral head

21
Q

talk about knee manifestations

A

-effusions and synovial thickening
-quad atrophy; loss of full ext
-tricompartment loss of joint space on x-rays
-bakers (popliteal) cyst

22
Q

what is RA initial treatment

A

-NSAIDs to reduce joint pain and swelling and improve function
-multidisiplinary care: RA consultation, PT and OT, podiatry, orthopedics
-steroids?
-disease modifying drugs (DMARDs) start within 2-3 months of diagnosis

23
Q

what are the drug treatment options

A
  1. NSAIDS: symptom relief, improved function, no change in disease progression
  2. low-dose steroids: may substrituee for NSAID, used as bridge therapy, if long term, OA risk
  3. intraarticular steroids: useful for flares
  4. DMARDs: immunosuppressive drugs
  5. biologic therapies: TNF inhibitors
24
Q

what is the health-care maintenance

A
  1. OA: dexa scans, calcium/Vit D, bisphosphonates
  2. CV disease risk/modify
  3. quit smoking
  4. infection risk: flu vaccine, pneumococcal vaccine, shingles vax

Med Con II (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions