Rheumatoid Arthritis Flashcards
1
Q
General Considerations
A
- Autoimmune Disorder
- More common in women
- Genetic Predisposition
- Can cause early deaths
2
Q
Pathologic Findings
A
- Chronic Synovitis
- Pannus: abnormal granulation tissue
3
Q
Pannus
A
Abnormal Granulation Tissue
-Healing process starts with this
4
Q
Joint Symptoms
A
Predominant Symptoms
- Starts insidiously
- Hurts in the morning
- Notice swelling
- A lot of inflammation
- lasts for >30 minutes
- Symmetric Involvement
5
Q
Common Joints Involved
A
- PIP
- Synovial Cyst
- Rupture of Tendon
- Spares spine except cervical spine
6
Q
What should you do right away?
A
Get an X-Ray - don’t get sued
7
Q
Rheumatoid Nodules
A
- seen in 20% of patients
- Seen around bursa, tendon sheaths, lungs, sclerae
- Rheumatoid factor in blood increased chance of nodules
8
Q
Ocular Symptoms
A
- dryness of eyes, mouth and other mucous membranes
- inflammation of different parts of the eye (Episcleritis, scleritis)
- Scleromalacia from scleral nodule
9
Q
Other organs that can be affected
A
- Lung
- Pericarditis and Pleural disease
- Small vessel vasculitis
- Necrotizing arteritis
- Felty Syndrome
- Aoritis
10
Q
Interstitial lung disease
A
cough
progressive dyspnea
11
Q
Small Vessel vasculitis
A
Tiny hemorrhagic infarcts in the nail folds or finger pulps
12
Q
Felty Syndrome
A
RA (severe destructive arthritis) + splenomegaly + neutroopenia
13
Q
Aortitis
A
Rare late complications
Cause aortic regurgitation or rupture
14
Q
Most specific blood test for RA
A
Anti-CCP antibodies
15
Q
Rheumatoid Factor Lab findings
A
- IgM antibody directed against the Fc fragment of IgG
- Present in 70-80% of patients with established RA
- Sensitivity of only 50% in early disease
- Seen in other autoimmune disease
- Chronic infections (Hep C, syphilis, sub-acute bacterial endocarditis, tuberculosis)
- prevalence of rheumatoid factor positivity also rises with age in healthy individuals
