RA And OA Conditions Flashcards
Gouty arthritis is common among
Asians
SLE is common among
Africans/blacks
Most common site for inflammation in RA
Synovium
Pannus formation results to
Erosion
RA has reversible or irreversible deformities
Irreversible
The gene that may increase the risk of having RA
Only a predisposing factor
HLA DR4
Series of antibodies that recognizes IgG as an antigen
Rheumatoid factor(RF)
How many percent of pxs with RF has RA
70%
Positive for RF is called
Seropositive
Negative for RH factor is called
sero negative
Found in pxs whos sero positive
seen over the joints, extensor surfaces of FA and weight bearing areas
Rheumatoid nodules
Sero means
Blood
Oligo means
Few
Metabolism of dead cells
Citrollination
targets protein antibodies and doesnt want the process of eliminating or metabolising dead cells
Anticitrullinated protein antibody(ACPA)
Sx are aggraviated all throughout the day specially during WB
Osteoarthritis
Morning stiffness for at least 1 hour(should be >30 mins)
RA
No of joints affected to consider RA has poor prognosis
> 10 jts
No of joint on B hands(MCP,wrist,PIP)
20 joints
Erosion in X-Ray(ABCDES)
Abnormal alignment Bone involvement Cartilage involvement Deformity Erosion Soft tissue swelling
Found inside rheumatoid nodules
Necrotic tissues/deadcells
Out of the 7 criterias how many should be present and for how long?
4 criterias(1st 4) for 6 consecutive weeks
Perfect score for the grading of 2010 ACR-EULAR(european league against rheumatism)
Ideal score (most likely RA)
10
>6
Formula for ESR
Age+10 (divide by) 2
Most commonly affected joint in RA
MCP
Least commonly affected jt in RA
TMJ
Joint spared in RA
DIP
Swan neck joint position
DIP flexed
PIP extended
Rupture of lateral slip of extensor hood
Swan neck
Rupture of cental slip of extensor hood
Boutonnière
Boutonnière joint positions
DIP extended
PIP flexed
Mallet finger joint position
PIP neutral
DIP flexed
@thumb NALE BUFF
Type I
I. Boutonnière of thumb
Boutonnière of thumb position
MCP flexed
IP extended
@thumb NALE BUFF
Type II
II. Boutonnière of thumb+add/subluxation of CMC jt.
@thumb NALE BUFF
Type III
Swan neck of thumb+add/subluxation of CMC jt.
@thumb NALE BUFF
Type IV
IV. Game keepers thumb
Gamekeeper’s thum is also called
Skiers thumb
Rupture of ulnar collateral ligament of the thumb
Gamekeeper’s thumb/skiers thumb
@thumb NALE BUFF
Type V
Swan neck alone
@thumb NALE BUFF
Type VI
VI. Bone loss
Fingers appears shorter than normal
Arthritis mutilans
Opera glass hand
Arthritis mutilans
Flexion contructure of MCP appears as
Intrinsic plus
Ulnar drift/Z deformity/zigzag
Wrist is in
MCP is in
Wrist is in radial dev
MCP is in ulnar dev
Code: Wradial Mulnar
Up and down movement of ulna upon pressing dt the rupture of ulnar collateral lig
Piano keys sign
Enlargement @ popliteal fossa in oxs with RA
Baker cyst
Toe deformity comkon in pxs with RA
Hammer toes
Most common toe deformity in OA
Hallux valgus
Claw toes joint position
MTP extension
PIP flexion
DIP flexion
Hammer toe joint position
MTP extension
PIP flexion
DIP extension
Absent push off gait
Appropulsive gait
Subluxation of shoulder in RA is dt
Disuse attropy
LOM of shoulder in RA
Ext. rotate
Shoulder joint affected in inflammatory arthritis
Glenohumeral joint
Separation of toes
Splay foot
Colapsed transverse arch causes
Splay foot
Shoulder joint affected in osteoarthritis
Acromioclavicular joint
Cervical level affected in RA
What joint?
LOM?
C1-C2
Atlantoaxial joint
LOM in Rotation
Subluxation of cervical spine in RA causes
Spinal cord injury dt compression
Percentage of mortality in cervical subluxation leading to SC compression
25%
Cervical level affected by OA
C5-C6
LOM in hip in pxs with RA
Internal rotation
Hip condition in RA dt pannus formation>erosion>protrusion
Protrusio acetabuli
Located of pain in pxs with RA
Groin/medial aspect of hip
Referred pain in hip RA
Buttoks
Knee
Elbow joint in RA causes loss of what movement and contracture of what
Loss of pronation supination
Flexion contracture
ROM Limitation of mouth opening in RA of TMJ
About 2 inches
rA complication in the heart
Pericarditis
Law that states the ability of the heart to contract c greater stretch the greater the force of contraction
Frank starling law
2 types of pericarditis that can be present with an RA px
Constrictive pericarditis
Cardiac tamponade
Most common cause of death in RA
Cardiac arrest
Prolonged use of this drugs contributes to having heart dse
Corticosteroids
Lung dse in pxs with RA
Caplan’s
+Rheumatoid nodules at the lining of the lung that causes fibrosis.
Caplan’s
Rheumatoid dse c CNA manifestations
SLE
RA affects
PNS or CNS
PNS
Peripheral nerves that may be affected by RA
Median nerve(CTS) Ulnar nerve(cubital tunnel) Tibial nerve(bakers cyst)
Largest lymphoid organ
Spleen
Chronic dse of RA causes ___ in the blood
Anemia
Feltys syndrome in RA
Spleenomegaly Lymphadenopathy Leukopenia Anemia Arthritis Neutropenia Thrombocytopenia
Dryness of eyes in RA
Keratoconjunctivitis sicca/sicca syndrome
Sjogrens triad
Xenopthalmia(dry eyes)
Xerostomis(dry mouth)
Arthritis
Tests used for xerophthalmia
Schrimers
Rose bengal
Painful sexual intercourse experience by pxs with sjogrens
Dyspareunea
Other names for sjogrens
Gougerots
Mikulicz
Autoimmune exocrinopathy
Test that measures the amount of wetness of the eyes in pxs with xenopthalmia seen in sjogrens
Schrimers
Test that uses a film in the eyes and shows the part of the eyes that has dryness can be used in pxs with xenopthalmia seen in sjogrens
Rose bengal
Bilateral parotiditis that causes dry mouth
Xerostomia
What stage of RA is aerobic exercise done?
Chronic stage/severe stage
Stage of RA progression where in there is juxtaarticular osteoporosis
I. Mild
Stage of RA progression where in there is osteoporosis c or s slight bone destruction, ADJACENT ms atrophy, nodules
II. Moderate
Stage of RA progression where in there is deformities, extreme/extensive ms atrophy, nodules
III. Severe
Stage of RA progression where in there is bony ankylosis or fusion
IV. Terminal
Functional class of RA pxs which they are independent/completely able to perform self care, vocational, avocational activities
Class I
Functional class of RA pxs which they are independent/are able to perform selfcare and vocational but limited avocational activities
Class II
Functional class of RA pxs which they are independent/able to perform selfcare but limited to vocational and avocational activities
Class III
Functional class of RA pxs which they are dependent in all aspect/unable to perform selfcare, vocational and avicational activities
WC bound
Bedridden
Class IV