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Course 2-rheum > RA > Flashcards

RA Flashcards

1
Q

who has a higher risk of developing RA?

A
  • HLA-DR4+
  • women (esp 50-70s)
  • twins and first degree relatives of affected
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2
Q

what is a systemic rheumatic disease?

A

affect whole person, complaint in joint and muscle (RA and SLE)

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3
Q

what are the potential causes of arthralgia?

A

viral illness, overuse, exercise, ligament laxity

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4
Q

how does DC contribute to initiation and propagating RA?

A

present self-Ag to T cells (activated via TLRs by pathogens)

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5
Q

what are the roles of B cells in RA pathogenesis?

A
  • Ag presentation/T cell activation
  • autoAb production
  • cytokine production
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6
Q

what are the positive and negative roles of fibroblast?

A

positive: produce hylauronan (part of joint fluid)
negative: produce metalloproteinases (breakdown ECM)

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7
Q

which autoAbs can trigger RA?

A

collagen II, proteoglycans, chondrocytes, IgG

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8
Q

what is the most common form of polyarthritis?

A

RA

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9
Q

what are the Old criteria for RA classification?

A
  • morning stiffness >1hr
  • arthritis in >3 joints
  • arthritis in hand joints (PIP, MCP, wrist)
  • symmetric arthritis
  • RF, nodules
  • XR changes, erosion

need 4/7 for classification, #1-4 must be present for 6 wks

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10
Q

the american college of rheumatology requires___criteria to classify RA

T/F: the same number is needed to Dx RA to start Tx

A

6/10

False

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11
Q

what are the features of stage 1 RA?

A

Ag presentation to T/B cells, no Sx

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12
Q

what are the features of stage 2 RA?

A

T/B proliferate, cytokine release, angiogenesis

clinically unwell, joint pain/swelling/tender

high ESR/CRP, soft tissue swelling on XR

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13
Q

what are the features of stage 3 RA?

A

synovial hypertrophy w cell accumulation in joint space

joint pain/swelling, malaise, low energy

soft tissue/joint swelling, low ROM, nodules

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14
Q

what are the features of stage 4 RA?

A

pannus joint invasion, enzymatic damage to cartilage

like stage 3 but w increased function loss, early deformity in joints, nodules

osteopenia on XR, pannus on MRI

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15
Q

what are the features of stage 5 RA?

A

bone erosion, cartilage loss, ligament damage

joint pain, swelling, loss of function, deformity

swollen joints, contracture deformity, nodules, systemic manifestation

joint space narrowing and erosion on XR

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16
Q

what is the most common arthritis affecting the big toe?

A

OA

17
Q

fever and poor appetite in RA are the effects of:

A

TNF

18
Q

what vascular issue impacts the small vessels in RA?

A

atherosclerosis

19
Q

what are the Sx of vasculitis?

A

skin-ulcers/gangrene
bowels-perforation/gangrene
nerve-mononeuritis
eye-scleritis/episcleritis

20
Q

where are RA nodules likely to occur?

A
  • skin (achilles, pulp of digits–>where there is pressure)
  • tendon
  • lung, heart, brain, eye
21
Q

which systems are affected by RA?

A

vascular, resp, CV, neuro

22
Q

what therapy is used in nerve compressions in RA?

A

TNFi

23
Q

what extra-articular syndromes are associated with RA?

A

Sjogren’s (dry eyes/mouth/lung/vagina)

Felty’s (RA, splenomegaly, granulocytopenia)

anemia/osteoporosis

24
Q

Describe the functional classifications of RA:

A

C1-can self care, vocation, rec

C2-can self care and vocation, limited rec

C3-unable to do daily activities w comfort

C4-needs assistant with everything, stays in bed

25
Q

what factors lead to poor prognosis in RA?

A

greater disease load, RF+, anti-CCP/HLA-DR4+, erosion on XR

26
Q

does RF in serum make a Dx of RA?

A

no

27
Q

which autoAb is involved in RA?

A

IgM-Ab

28
Q

which autoAb is involved in SLE?

A

DNA-Ab

29
Q

synoviocytes include:

A

macrophage and fibroblasts in intimal layer of synovium

Course 2-rheum (7 decks)

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