Rheumatoid Arthritis

Question 1

% of woman affected by rheumatoid arthritis?

Answer 1

80% of the 1-2 of adults that are effected

Question 2

where is it found?

Answer 2

not restricted to joints- also CT throughout the body

Question 3

what is it?

Answer 3

chronic autoimmune CT disease

-inflm, deformed synovial joints

Question 4

which joints are affected first?

Answer 4

non wt bearing joints

Question 5

Et?

Answer 5

multifactorial
viral trigger (EBV strongly indicated)
genetic predisposition (HLA genes)

Question 6

Patho

Answer 6

Alt T cell response–> targets synvolial membrane –> inflame and joint damage

Alt B cells –> Abs prod (rheumatoid factors [RF] –>target tissue)

RF forms ICs –> deposits in synovial membr –>inflm

repeated inflame –> deformity

Pannus (vascular, granuation tissue)

Question 7

what does the pannus do? what is it?

Answer 7

vascular, granulation tissue
-form of vascular tissue that attempts to bring about feeling (angiogenesis) you’re bringing it inside the joint
releases destructive enzymes -targeting the cartilage
has damaging inflame cells
dec joint mobility

Question 8

manifestations

Answer 8

extra articular and articular (joints)
subtle onset
-low grade fever, malaise (viral trigger)
inc fatigue
AM joint pain
stiffness after inactivity 
nonarticular
-heart, b/vessels, skin, lungs, eyes
also systemic

Question 9

Dx

Answer 9

hx and px
xray, labs (just exclude septic arthritis
RF (rheumatoid factor test-Ab
other Ab measured (ANA)
often have other autoimmune diseases as well

Question 10

Tx

Answer 10

limit progression
Pain (eg. Meloxican- NSAID) or maprosyn for pain relief
Start with plaquenil (anti-malarial) eye exam q6-12 mt
-antiinflm action
immunomodulatory
deposits in the eye and causes ocular problems
usually combination therapy
-sulfasalazine (anti-inflm and immunomodulatory) and methotrexate
labs- CBC, liver, Es and creatinine