RA and FM

Question 1

Define RA

Answer 1

chronic, systemic, inflammatory autoimmune disease unknown etiology

chronic, symmetric and erosive synovitis of peripheral joints

Question 2

If left untreated what can RA result in?

Answer 2

joint destruction/deformity
disability
premature death

Question 3

How do you diagnose RA?

Answer 3

RF and anti-CCP antibodies

Question 4

What cells are involved in the pathogenesis of RA

Answer 4

T cells— B cells— plasma cells- release antibodies acting to destroy the synovial membrane

Question 5

What are 3 common screening tools to diagnose RA

Answer 5

1. significant discomfort with squeezing the MCP and MTP
2. presence of 3 or more swollen joints
3. more than 1 hour of morning stiffness

Question 6

What are some bad extracellular manifestations of RA

Answer 6

1. scleritis- pt needs to go to eye doctors
2. Rheumatoid nodules-
3. Digital artery vasculitis

Question 7

Poor prognostic factors of RA

Answer 7

1. early age onset; female
2. more than 13 joints
3. high ESR and CRP levels
4. poor functional status at 1 year of disease
5. extra-articular manifestation

Question 8

Should you do a cervical manipulation on an individual with RA and why or why not

Answer 8

No because they have increased laxity and potential of rupture to the transverse ligament in the C1-C2

Question 9

What joints are typically spared in RA

Answer 9

thoracic, lumbar and sacral spine and DIP