Rheumatoid Arthritis Flashcards
1
Q
rheumatoid arthritis
A
- joint disease causing systemic inflm that affects connective tissue throughout body (not just joints)
- 80% affected are women
- affects non weight-bearing joints (small joints of fingers, toes, ankles)
2
Q
etiology
A
complex trait:
- environmental or viral trigger (ex. EBV)
- autoimmune (HLA & MHC gene mutation)
3
Q
patho (T-helper cells)
A
- T helper cells activated –> mediators/cytokines release (TNF, IL-1) –> inflm & damage within joint
- T helper cells activates T cells –> target synovial membrane –> inflm damage within joint
- T helper cells activate B cells that produce specific Ab that targets the joint (RF)
- T cells & Abs target synovial membrane specifically, but inflm damage that follows affects the membrane, cartilage, and underlying bone once cartilage damaged (inflm non-specific)
4
Q
patho (immune complex HS [Type III])
A
immune complex HS (Type III):
- RFs and IgG Abs form immune complexes that deposit on synovial membrane –> attempt to remove them –> inflm at site
- repeated autoimmunity & hypersensitivity –> ongoing inflm –> complement activated (inc inflm & WBC attraction) –> continuous damage –> deformity of joints (externally visiblie
5
Q
patho (other)
A
- calcification –> damaged bone releases Ca+ which deposits within joint
- joint fusion –> difficult to mobilize joint d/t extensive damage within it (“fused”)
- pannus –> granulation tissue that develops within joint
- as disease progresses, ligaments change their alignment –> alters how bones are attached to bones –> deformities
6
Q
onset of mnfts
A
early age (woman in 20s or 30s)
7
Q
mnfts (non-specific near beginning of disease)
A
- fatigue
- generalized pain
- malaise
8
Q
mnfts (later on)
A
- fatigue intensifies
- stiffness after inactivity
- morning joint pain d/t inactivity over night –> difficulty moving fingers & toes
- affects larger joints & diff areas of body
9
Q
extra-articular mnfts locations
A
heart, blood vessels, skin, lungs, eyes
10
Q
episcleritis
A
connective tissue b/w sclera & conjunctiva affected
11
Q
scleromalacia
A
thinning of sclera of eye
12
Q
extreme deformities
A
- swan neck deformity
- ulnar shift/drift/deviation
- subcutaneous nodules
- these mnfts avoided/delayed w/ good management of disease
13
Q
swan neck deformity
A
joint misaligned –> bent fingers/wrist like swan’s neck
14
Q
ulnar shift/drift/deviation
A
fingers moving away from thumb in direction of ulnar bones
15
Q
subcutaneous nodules
A
area of local swelling/tissue lump firm to touch (pain or non-painful, visually unappealing)
