Rheumatoid Arthritis Flashcards
Etiology of RA
onset 25-55 years old
women > men
exact cause is unknown (shocker…) but triggered by environmental factors with a genetic predisposition
What are synovial joints?
occur where bones articulate and are physically the most moveable joints within the human body
What are the 6 types of synovial joints?
gliding, saddle, pivot, hinge, ball and socket, and condyloid joints
The greater the movement allowed by the joint, the greater the ____
risk for developing an injury
Signs and symptoms of RA include
tender, warm, swollen joints
morning stiffness that can last hours
firm bumps of tissue under the skin on arms
fatigue, fever, weight loss
Differences between osteoarthritis (OA) and rheumatoid arthritis (RA)
OA - degenerative, morning stiffness <30 mins, cartilage loss, asymmetrical
RA - autoimmune disease, morning stiffness >30mins, inflamed synovium, symmetrical
Early RA vs Progressed RA
early - affect smaller joints first (fingers and toes)
progressed - spread to wrists, knees, ankles, elbows, hips, and shoulders
What is responsible for most of the symptoms and chronic disability associated with RA?
inflammation and destruction of synovial tissues
What is ‘overproduced’ in RA? (3 things)
proinflammatory cytokines, tumor necrosis factor (TNF), interactions between T and B lymphocytes
C1-C2 instability results from
erosion and collapse of bones from destruction of supporting cervical ligaments
Atlanto-odontoid articulation separation may allow
the odontoid process of the axis to impinge on the spinal cord = neurologic damage
C1 is referred to as the ___ while C2 is referred to as the ___
atlas; axis
What is a diarthordial joint? Include an example
Surrounded by fibrous joint capsule and has synovial fluid lubricating the surfaces of the bones
example: cricoarytenoid joint
How does RA affect the cricoarytenoid joint?
causes inflammation of the synovial lining which spreads to the surface of the bones = fibrosis = rigidity and adhesion (ankylosis) = reduced mobility and function
Consequence(s) of cricoarytenoid joint involvement in RA
- less able to move the vocal cords
- less able to assist in breathing
- fixed in a position that obstructs airflow
Possible signs and symptoms indicative of cricoarytenoid joint involvement in RA
hoarseness, pain with swallowing, stridor, dyspnea
Pulmonary effects with RA (3 P’s)
pleural effusion
pneumonitis
pulmonary nodules
Cardiac effects with RA
pericarditis
pericardial effusion
mitral/aortic regurgitation
conduction defects
Eye effects with RA
destruction of lacrimal and salivary duct (dry eyes)
Muscle effects with RA
rheumatoid myositis (seen as muscle weakness and eventual muscle necrosis)
Mild to moderate RA treatment
rest, joint immobilization, NSAIDs, possibly glucocorticoids
Disease Modifying AntiRheumatic Drugs (DMARDs)
work to reduce the body’s overactive immune and inflammatory processes (joint pain and swelling)
Which drug is the ‘cornerstone’ of RA therapy?
Methotrexate
How does Methotrexate work?
interferes with cancer cells’ ability to absorb and use folate (vitamin B) which is necessary for cell survival
