Rheumatoid Arthritis

Question 1

RA:

Answer 1

chronic, systemic, inflammatory disease(auto-immune disease) causing joint pain/damage or other diseases

Question 2

RA pathogenesis:

Answer 2

inflammation of synovium + destruction of joint

Question 3

RA pathophysiology:

Answer 3

enviro factor triggers biochemical reaction (T-cell activation), creation of autoantigen causing immune system response, T-cells cause production of antibodies (ACPA or RF) and causes inflammation of synovium

Question 4

RA bone erosion:

Answer 4

T-cells activate FLS which increases RANKL creating osteoclasts

Question 5

pannus:

Answer 5

rapid growth of cells - causes thick synovium, destroys joint capsule and bone

Question 6

RA diagnosis:

Answer 6

symptoms (swelling, decreased ROM, disease), lab assessment (RF, antibodies, ACPA, ESR, C-reactive protein), X-ray (bone erosion, joint space narrowing)

Question 7

joints affected by RA:

Answer 7

C spine, shoulder, elbow, hand, wrist, hip, knee, foot, ankle

Question 8

consequences of RA:

Answer 8

joint deformities, disability, increased risk of fracture

Question 9

joint deformity:

Answer 9

caused by joint immobilization, destruction of cartilage/bone, inflamed tenosynovium, altered muscle/tendon, altered ligaments

Question 10

swan-neck deformity:

Answer 10

extended PIP and flexed DIP

Question 11

boutonniere deformity:

Answer 11

flexed PIP and extended DIP

Question 12

ulnar drift:

Answer 12

ligament laxity causing ulnar deviation of ext/flex tendons, contractures

Question 13

cachexia:

Answer 13

weight loss associated with reduced appetite, insulin resistance = loss of BCM

Question 14

RA exercise:

Answer 14

resistance, functional and balance; prevent joint deformity, restore ROM and maintain fitness/strength