RA Flashcards

1
Q

chronic systemic autoimmune inflammatory disease characterized by joint swelling, joint tenderness, destruction of synovial joints leading to the severe disability and mortality

A

RA

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2
Q

age range?

A

45-65 years

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3
Q

what joints are affected in 90% of patients?

what else

so most common joints?

A

MTJ

midfoot, ankle, STJ

MCP
PIP
MTP
wrist

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4
Q

risk factors?

A
genetic link
gender
tobacco
bacteria
virus
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5
Q

primary site of inflammation in RA?

A

synovium

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6
Q

increases depth of synovial lining with mononuclear cells infiltrate sub lining- edema, blood vessel proliferation, increase in tissue volume

A

synovium

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7
Q

synovial membrane derived villus projections protrude into the joint cavity which invade cartilage and bone, results in destruction of cartilage and bone

A

pannus

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8
Q

name this deformity

hyperextension of the PIPJ of the finger and flexion of the DIPJ

A

swan neck deformity

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9
Q

name this deformity

flexion of the PIPJ and extension of the DIPJ

A

boutonniere deformity

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10
Q

name this deformity

subcutaneous, central area of necrosis rimmed by palisading fibroblasts surrounded by collagen capsule and perivascular inflammatory cells

A

rheumatoid nodules

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11
Q

name this deformity

deviation and subluxations occur here

A

ulna

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12
Q

what are the diseases associated with RA?

A

cervical spine
felty’s syndrome
sjogrens syndrome
raymauds phenomenon

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13
Q

rheumatoid arthritis can be systemic?

A

yes

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14
Q

labs and diagnostic testing?

other ones?

A
CBC with diff
positive RF factor
positive ACPA
ANA, SS-A. SS-B
Uric Acid-WNL
 synovial fluid analysis straight up straw colored
ESR
CRP
radiograph
MRI
ultrasound
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15
Q

the RF is what kind of antibody?

A

IgM

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16
Q

radiographic hallmarks?***

A
joint effusions
periarticular soft tissue swelling
juxta articular osteopenia
lack of new bone formation
symmetric joint space narrowing
marginal osseous erosions
synovial cysts 
subluxations
17
Q

RA differentials?

A
gout 
fibromyalgia
CPPD
infectious process
Osteoarthritis
seronegatives
lyme disease
HIV
18
Q

RA goals of treatment?

A

treat early

make disease low activity/remission

19
Q

RA treatment?

A
rheumatology consult
custom orthotics
AFO/Braces
extra depth shoes
debridement 
PT/OT
thermotherapy 
ultrasound
electrotherapy
20
Q

Pharma treatment, in order?

A

analgesics
NSAIDs
DMARDs
glucocorticoids

21
Q

treatment surgical intervention?

A

metatarsal head resection
fusions
implants