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Rheumatoid Arthritis (RA): > RA quiz 3 > Flashcards

RA quiz 3 Flashcards

1
Q

RA definition

A

Autoimmune disease w/predilection for synovial tissue &
associated tendon sheath

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2
Q

RA onset

A 
May
follow
viruses,
stress,
surgery,
infection,
trauma,
pregnancy
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3
Q

RA course

A

Highly variable
• 50% have progressive disease
• 3% have erosive arthritis

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4
Q

RA prognosis

A 
Better in men than women.
Patients
>50 at time of onset have poorer prognosis
• Poor prognosis =early age,
high RF titer,
high ESR,
swelling>20joints
&
extracurricular manifestations
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5
Q

RA stages

A
  1. Disease present , asymptomatic
  2. Disease interfering w/ADLs
  3. Major compromise in function
  4. incapacitation, confine to bed or w/c
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6
Q

RA is a

A

autoimmune disease

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7
Q

RA cartilage loss is

A

symmetrical

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8
Q

RA HPI ask

A
  1. Location, duration & characteristics of pain.
  2. Tenderness, inflammation and morning stiffness
  3. systemic fatigue, associated symptoms
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9
Q

RA FH; ID genetic markers

A

Id
genetic markers for RA
(class 2 human leukocyte antigen {HLA} w/an identical 5-­‐amino-­‐acid sequence

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10
Q

RA History could sound like

A
  1. Am stiffness several hours
  2. Arthritis of 3 or more joints
  3. Arthritis of the hands ( Metacarpal)
  4. Symmetric arthritis
  5. Rheumatoid nodules
    • RF
  7. Radiological changes
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11
Q

Diagnosis RA with

A

presence of 4-7 and 1-4 present for 6 weeks

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12
Q

2010 ACR/EULAR

A

score of >6/10 to classify as RA

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13
Q

RA Constitutional symptoms

A

fatigue
low grade fever
Malaise
wt. Loss

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14
Q

RA extra-articular symptoms

A 
Sjogren’s syndrome,
vasculitis,
pulmonary nodules,
Felty’s Syndrome
(splenomegaly, anemia,thrombocytopenia)
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15
Q

RA S/S

A

soft tissue swelling and tenderness
spongy joints warm to touch/tender
gelling

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16
Q

RA need to preform a full and total PE T/F

A

True

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17
Q

Physical Findings with RA

A 
Febrile
• Soft tissue swelling
• Muscle atrophy
• Effusions
• Decreased ROM
• Decreased strength
• Thickening of the volar aspect of the wrist
• Symmetry in changes
• Soft  tissue nodules
• Popliteal (Baker’s) cysts
–\behind the knees
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18
Q

RA deformity of the neck

A

Swan neck

19
Q

RA deformity of the fingers

A

Mallet and Boutonniere

20
Q

RA diagnosis you need to R/O

A

Reiters, SLE, gouty/GN/ psoriatic arthritis,
lyme disease
acute rheumatic fever

21
Q

RA what would you expect to see on the CBC

A

Mild to moderate anemia

22
Q

RA whattype of anemia is present

A

normochromic, normocystic

23
Q

RA what would you expect the ESR to be

A

elevated

24
Q

RA the RF level

is elevated with

A

Age and progression of disease

25
Q

RA the C- reactive protein level is

A

Elevated

26
Q

Why would you draw a LFT with suspected RA

A

R/O hepatitis

27
Q

RA synovial fluid aspiration is

A

> WBC, crystal search and C&S

28
Q

RA X-rays help determine

A

early changes
Progression
detect damage after 3 years into the disease

29
Q

Are wrist ankles and toes involved in RA

t/f

A

False

30
Q

Best description RA presentation

A

symmetrical early Am stiffness

31
Q

On an x-ray or MRi you would expect o see with RA

A

Joint erosions

32
Q

Which of the following hemograms would be expected for a 46-year-old woman with poorly controlled RA?

A

Hg = 9.7 g/dL (12–14 g/dL); MCV = 87 fL (80–96 fL); reticulocytes = 0.8% (1%–2%).
Hg = 11.1 g/dL (12–14 g/dL); MCV = 66 fL (80–96 fL); reticulocytes = 0.8% (1%–2%).
Hg = 10.1 g/dL (12–14 g/dL); MCV = 103 fL (80–96 fL); reticulocytes = 1.2% (1%–2%).
Hg = 11.4 g/dL (12–14 g/dL); MCV = 84 fL (80–96 fL); reticulocytes = 2.3% (1%–2%).

33
Q

Which of the following is not characteristic of rheumatoid arthritis (RA)?

A

It is more common in women at a 3:1 ratio.
B. Family history of autoimmune conditions often is reported.
C. Peak age for disease onset in individuals is age 50 to 70 years.
D. Wrists, ankles, and toes often are involved

34
Q

5.

RA disease progression is typically evaluated using all of the following approaches except:

A

A. x-ray.
B. MRI.
C. echosonography.
D. ultrasound.

35
Q 
Which of the following tests is most specific to the diagnosis of RA?
A. elevated levels of rheumatoid factor
B. abnormally high ESR
C. leukopenia
D. positive ANA titer
A

A. elevated levels of rheumatoid factor

36
Q 
A 52-year-old woman has RA. She now presents with decreased tearing, "gritty"-feeling eyes, and a dry mouth. You consider a diagnosis of:
 systemic lupus erythematosus.
B. vasculitis.
C. Sjögren syndrome.
D. scleroderma.
A

C. Sjögren syndrome.

37
Q 
X-rays will fail to show changes in affected joints in approximately what percent of patients with RA at disease onset?.
 30%
B. 50%
C. 75%
D. 95%
A

. 30%
B. 50%
C. 75%
D. 95%

38
Q

Which test is specific to RA

A

elevated RF

39
Q

Hemogram in RA

A

reveals Normocytic, normochromic

40
Q

RA diagnostic test CBC

A

Mild to moderate anemia

41
Q

RA Mild to moderate anemia is

A

Normochromic, normocytic

42
Q

RA ESR

A

elevated

43
Q

RA the C reactive protein is

A

elevated

Rheumatoid Arthritis (RA): (7 decks)

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