Rheumatoid Arthritis Flashcards
What is Rheumatoid Arthritis?
Inflammatory Joint disease that is more common in women than men
It peaks in those that are 70 or older
About 5% will have rheumatoid arthritis by the age of 70
Considered an autoimmune disease
What is an autoimmune disorder?
Body attacks itself
Rheumatoid arthritis shortens life expectancy
Rheumatoid arthritis tends to be very symmetrical=tend to have bilateral symptoms
Some people will have specifically designed utensils to make it easier to live with the disorder
What is the pathophysiology of Rheumatoid arthritis?
- It is an aberrant (abnormal) immune response in genetically susceptible host
- Normal antibodies become autoantibodies and produce rheumatoid factor
- May be some environmental factors like such as smoking
- Could be caused by a virus or bacteria or genetic=not really known
- Leukocytes are attracted to synovial membrane
- Neutrophils and Macrophages destroy tissue and it is replaced with scar tissue
What tissue does Rheumatoid Arthritis create?
Pannus tissue in the synovial membrane
- abnormal tissue withing synovial membrane
- Leads to greater loss of bone and cartilage
- Leads to scar formation
What changes does Rheumatoid Arthritis cause?
Joint space begins to narrow and the muscle begins to atrophy due to disuse
What is the most common type of arthritis in older adults?
Osteoarthritis
When can Rheumatoid arthritis develop?
It can occur at any age
Typical age of onset is between 40-60
It can start in children as early as 2 years old but can go into remission for the rest of their lives
What are the Risk factors of Rheumatoid Arthritis?
Family History of Rheumatoid Arthritis Female Sex Obesity Heavy Smokers Risk can be reduced if stop smoking but doesn't guarantee that RA won't develop
What are manifestations of Rheumatoid Arthritis?
Joint Deformity
Redness, Warmth, pain, swelling at effected sites
Fever, Anorexia and Fatigue are very common
Nodules on Joints are pronounced
Symptoms will by cyclical= Have flare-ups then symptoms will simmer down and stagnate but don’t disappear
What are the manifestations that can be seen in the Joints?
Most won’t realize they have it
15% of the time it is diagnosed after an acute flare-up
Stiffness is more pronounced in the morning lasting over an hour
Pain may be more severe after exercise
Skin over joint may be red/purple/ blue and skin appears to be very thin
What manifestations may be seen in the Knees, Hands and Fingers?
Hands and Fingers=Ulnar deviation, Swan neck deformity, Boutonniere deformity
Knees= Will swell and be unstable
What manifestations may be seen in the feet, ankles, and spine?
Feet and Ankles=Bunions are related Rheumatoid Arthritis
Spine=Usually limited to cervical vertebrae
What are Extra-Articular manifestations?
May be resistant to Iron Therapy
May have numbness in extremities
80% of Rheumatoid arthritis patients will have rheumatoid factor
Many have sensory changes, lymph node enlargement, weight loss,
Can check C reactive protein (inflammation), erythrocyte sedimentation rate=both will be elevated
What are systemic effects of Rheumatoid arthritis?
Fever, weight loss, fatigue
lymph node enlargement
Neuropathy
Scleritis (swelling of sclera)
Pericarditis
Sjorgen’s Syndrome=dry mucous membranes (mouth, vagina)
Raynaud’s syndrome=poor circulation in the fingers and toes that is very sensitive to cold temps
Why is Rheumatoid arthritis connected with an increased risk of Coronary Heart disease?
It increases risk for Low HDL levels
High cholesterol and triglycerides
Hypertension
High homocysteine levels
All of these are S+S that the synovial membranes are being attacked
These put people at risk for heart attack
