RA Flashcards
what is rheumatology
the study of arthritis and other related conditions
what is arthritis
inflammation of a joint
what are some of the symptoms of arthritis
- pain
- swelling
- functional impairment
- stiffness
- redness over joint
what are the clinical signs of arthritis
- limited range of movement
- redness/heat over joint
- swelling
- tenderness
name some different types of arthritis
- osteoarthritis
- RA
- crystal arthritis
- seronegative arthritis
what is the normal function of the synovium
1) lubrication of the cartilage
2) nutrition of the cartilage
3) maintenance of the tissue surface
what is the synovium
a membrane that surrounds the inner surface of the cartilage of synovial joints
what happens if a joint is affected with RA
there is inflammation of the synovial and the tendon sheath - as the disease progresses there is destruction of the cartilage and the bone and this makes movement painful
what are the most common joints addicted in RA
the small joints of the hands and feet
what cells are found in the synovial during flare ups of RA
neutrophils
name some antibodies that are associated with RA
RF and anticitruinated antibodies (anti CCP and ACPA)
what is the difference between seropositive and sero-negative arthritis
sero+ means there are antibodies detectable in the patients serum and sero- means that there are no antibodies detectable in the patients serum
name some environmental factors that are associated with RA
- smoking
- bronchial stress/exposure to silica
- periodontal disease
- E. coli infection
- viruses (EBV and CMV)
what is citrullination
this is the conversion of the amino acid arginine into the amino acid citulline - in RA some antibodies are directed against the citrullinated proteins and these antibody markers are used in the diagnosis of RA
what happens in synovitis
synovitis = inflammation of the synovial membrane
there is villous hyperplasia, infiltration of B cells and T cells, fibroblast proliferation and increased vascularity
what mediates the bone and cartilage destruction in RA
the osteoclasts
what is RA
a chronic and symmetrical autoimmune disease that is characterised by peripheral arthritis
what are specific signs that lead to the diagnosis of RA
- morning stiffness that lasts at least 1 hour before maximum movement can be reached
- small joints in the hands and feet
- symmetrically arthritis
- rheumatoid nodules
- at least 3 joints affected at the same time
- serum antibody markers
- radiographic changes - erosion or decalcification of the affected joints
who is most commonly affected by RA
women usually between 40-50 years old
what are the symptoms of RA
pain, stiffness, swelling, poor mobility of the joint, systemic symptoms (fatigue, weight loss, anaemia)
what is the DAS
this is the disease activity score used in RA - a score of less than 2.4 indicates clinical remission and a score of >5.1 is the cut off for eligibility for biologic treatment
How is life expectancy affected in RA
reduced by 7 years on average
name some therapeutics that are used in RA
- NSAIDs
- DMARD (disease modifying anti rheumatic drugs)
- biologics
- corticosteroids
what is the DMARD of choice
methotrexate
