RA Flashcards
RA
chronic, systemic, progressive, inflamm (warmth/pain/redness/swell) disorder
symmetric, polyarticular. morning stiffness >1hr post waking
targets synovium in small joints
systemic RA
fatigue, fever, malaise, weight loss
cardiovascular, cutaneous, hematologic, ovular, neuro, pulm, rare kidney
RA labs
-normochromic, normocytic, elevated platelets
inc CRP and ESR
ANA+
RF+ (IgM)
CCP/ACPA
Which two lab findings are associated with more severe disease?
rheumatoid factor (RF)
cyclic citrullinated peptide Abs (CCP/ACPA)
RA imaging findings
soft tissue swelling
periarticular osteopenia
symmetric joint space narrowing
marginal erosions
RA synovial fluid
wbc >2000 (NEUTROPHILS)
cloudy/yellow color
RA classification criteria includes:
joint involvement (4-10 small)
+RF or +CCP (3x upper limit)
elevated ESR/CRP
sx >6wk
pre-surgery w/ general anesthesia, RA pt should undergo
cervical spine x-ray to check for atlantoaxial subluxation
best support for RA dx
+ anti-CCP
highly specific
RA tx
initiate w/I 3 mo
biologic DMARDs
NSAIDs or steroids bridge
PT/OT
systemic RA complications
cardiac (MI/stroke/pericarditis/CHF/atherosclerosis)
heme (anemia, thrombocytosis, felty’s)
metabolic (osteoporosis)
pulmonary (pleurisy/fibrosis/intersitital)
neuro (carpal tunnel/peripheral neuropathy)
ocular (Sjorgrens/episcleritis/scleritis/uveitis)
Felty’s sundrome
- RA
- enlarged spleen
- low leukocyte count
- neutropenia
- (+/-) thrombocytopenia
- Rheumatoid nodules
- high RF
- bone marrow (maturation arrest/immature forms)
polymyalgia rheumatica (PMR)
- inflamm condition unknown cause
- > 5 y/o more common in women
- intense pain shoulders and hips, bursts and tendons
- constitutional sx
- inc ESR and CRP, IL-6 elevated
- low dose steroids
- associated with CGA
