Rheumatoid Arthritis

Question 1

Rheumatoid Arthritis is characterized by

Answer 1

recurrent inflammation of connective tissue, primarily of joints and related structures

Question 2

Rheumatoid Arthritis – ACR Functional Classes-Class I

Answer 2

Complete ability to perform daily activities
self-care, vocational and avocational

Question 3

Rheumatoid Arthritis – ACR Functional Classes CLASS II

Answer 3

Ability to perform usual self-care and vocational
activities; limited avocational activities

Question 4

Rheumatoid Arthritis – ACR Functional Classes CLASS III

Answer 4

Ability to perform usual self-care activities;
limited vocational or avocational activities

Question 5

Rheumatoid Arthritis – ACR Functional Classes CLASS IV

Answer 5

Limited ability to perform usual self-care or
vocational or avocational activities

Question 6

Diagnosis OF RA

Answer 6

 Morning stiffness
 Arthritis of 3 or more joints
 Arthritis of hand joints
 Symmetric arthritis
 Rheumatoid nodules
 Serum rheumatoid factor
 Radiographic changes

Question 7

Physical Examination

Answer 7

 Symmetric joint swelling
 Fusiform (soft tissue) swelling
 Pain on passive motion

Question 8

Signs and symptoms

Answer 8

 Morning stiffness – but it gets better with activity
 Constitutional symptoms – fatigue, even weight loss are common, but fever is VERY RARE
 Symmetric pain and swelling in small joints of hands, wrists, feet, ankles most common, followed by knees, elbows, shoulders

Question 9

Serum Rheumatoid Factor

Answer 9

Blood test that measures the amount of the RF antibody in the blood

Question 10

Laboratory tests for RA

Answer 10

Erythrocyte sedimentation rate (ESR)
* Measures the degree of inflammation in the joints

C-Reactive Protein (CRP)
* More sensitive as compared to ESR

Question 11

Athrocentesis:

Answer 11

synovial fluid is aspirated and analysed for inflammatory components

Question 12

Abnormal synovial fluid:

Answer 12

cloudy, milky, or dark yellow containing leukocytes

Question 13

MEDICATIONS FOR RA

Answer 13

 Non-steroidal anti-inflammatory drugs
(NSAIDs)
 Disease-modifying anti-rheumatic drugs
(DMARDS)
 Corticosteroids
 Biologic Response Modifiers (“Bioligics”)

Question 14

Dietary Manipulations for Rheumatoid Arthritis

Answer 14

 Vegetarian eating plan
 Cretan Mediterranean eating plan
 Elimination diet
 Elemental eating plan

 Possible benefits: reduced pain
 Apparent complications: weight loss

Question 15

The Mediterranean Diet

Answer 15

 Whole Grains
 Fresh Fruits and Vegetables
 Beans and Legumes
 Olive Oil (High in Monounsaturated fats)
 Some dairy
 Very little meat
 Very little refined, processed foods

Question 16

FIber and RA

Answer 16

High fiber multigrain supplementation can lower oxidative stress and resulting in mediated immune response. It affects oxidant properties by increasing total antioxidant capacity (TAC) increasing superoxide dismutase (SOD) enzymatic activity, and thus reducing disease activity score. The short-chain fatty acids (SCFA) intestinal microbial fermentation is also enhanced.