Rheumatoid Disease Flashcards
Systemic auto-immune disease characterized by symmetrical inflammation the synovial Membrane in 5 or more joints.
Rheumatoid Arthritis
Most common of the inflammatory diseases
True or false, RA can affect blood vessels, heart, lungs etc
true
this type of RA consists on one episode which ends within 2-5 year of initial diagnosis. May be the result from early dx or aggressive treatment.
Monocyclic RA
this type of RA continues to increase in severity and is unremitting
Progressive RA
in this type of RA, The levels of disease activity fluctuate over the course of the condition.
Polyciclic RA
One natural history study found that 75% of people with RA experienced remission within ____years of diagnosis.
five
Peak age onset of RA is _____ of age
60 years
Primary pathological event in this disease takes place in the synovium, suggesting the offending agent is carried to the joint via the bloodstream
RA
an invasive granulation tissue that invades. and erodes subchondral bone and cartilage
pannus
In RA, Synovium hypertrophies and will produce
_________:
an invasive granulation tissue that invades
and erodes subchondral bone and cartilage
pannus
THE 2010 American College of Rheumatology CLASSIFICATION CRITERIA FOR RHEUMATOID ARTHRITIS
a score of ≥6/10 is needed for classification of a
patient as having definite RA
RA, differential diagnosis
- systemic lupus erythematosus
- psoriatic arthritis
- gout
RA co-morbidities:
- Cardiovascular disease: ischemic heart disease.
-
Infections
- Tuberculosis, due to inmmunosuppresion.
-
Mental health conditions
- Anxiety and depression due to decrease physical function.
-
Malignancies
- increase incidence of lymphoproliferative malignancies (such as leukemia and
multiple myeloma).
- increase incidence of lymphoproliferative malignancies (such as leukemia and
- Systemic complications
Systemic Complications in RA:
- Vasculitis: Inflammation of blood vessels
- Peripheral neuropathies
- Spinal cord compression
- Pleuritis
- Pulmonary nodules
- Scleritis: Can lead to blindness
Acute RA:
Pain, swelling, redness about joints
RA clinical features:
- Pain swelling, redness in joints.
- Genrealized malaise (low fever)
- Limited ROM
- Deformities
- Morning stiffness of at least 1 hour
- Symmetric
- (+) rheumatoid factor
- radiographic changes
- subcutaneous rheumatoid nodules.
true or false, osteoporosis may be seen in RA
true
- Chronic synovial inflammation of unknown cause
- before age 16
- Symptoms last from 6 weeks to 3 months
- One or more joints
- Often accompanied by fever, rash, eye inflammation (uveitis)
Juvenile Rheumatoid Arthritis
Juvenile Idiopathic Arthritis
RA, CHANGES IN CERVICAL SPINE
- Affects cervical spine in over 50% patients within first 10 years.
- Common findings: narrow facet joints
and intervertebral joints - Subluxation of Atlanto-axial joint from laxity of transverse ligament
______________________act by altering the underlying disease (RA) rather than treating symptoms. They’re not painkillers, but they’ll reduce pain, swelling and stiffness over a period of weeks or months by slowing down the disease and its effects on the joints.
Disease-modifying anti-rheumatic drugs (DMARDs)
There are two types: conventional DMARDs and biological therapies.
side effects of corticosteroids tx fro RA include:
thinning of bones, weight gain
Balancing a to reflect fatigue and energy levels is one of the most important coping mechanisms for people with ____and fatigue, according to a report in the May 2013 issue of the journal Clinical Rheumatology.
RA
__________may ease pain and inflammation in people with rheumatoid arthritis. Some
suggest ___________capsules may be as effective for relieving pain and inflammation as nonsteroidal anti-inflammatory drugs
Fish oil
American Rheumatism Association lists 4
criteria for diagnosis of JRA:
- Chronic synovial inflammation of unknown cause
- Onset in children younger than 16 y.o.a.
- Evidence of arthritis in 1 or more joints for 6 consecutive weeks
- Exclusion of other diseases
- Lyme disease, Lupus, bone disorders, cancer
categories of JRA:
- PAUCIARTICULAR / OLIGOARTICULAR: 4 or fewer joints within first 6 months of symptoms
- POLYARTICULAR: 5 or more joints
-
SYSTEMIC: illness begins with high spiking
fevers likely complicated by pericarditis, pleural effusions, enlargement of liver, spleen, lymph nodes -
PSORIATIC ARTHRITIS: Arthritis with
psoriasis
polyarticular JRA:
5 or more joints
PAUCIARTICULAR / OLIGOARTICULAR juvenile RA:
4 or fewer joints within first 6 months of symptoms
Oligoarticular juvenile idiopathic arthritis (formerly called pauciarthritis or pauciarticular-onset juvenile rheumatoid arthritis) is defined as juvenile idiopathic arthritis (JIA) involving fewer than_____joints
five
Chronic progressive inflammatory arthritis characterized by joint sclerosis & ligamentous ossification moslty occuring in SI jts & spinal facet jts
ANKLYOSING SPONDYLITIS
cause of anklyosing spondylitis
genetic factors
onset of anklyosing spondylitis
Insidious onset: late adolescence/early adulthood
patients describe insidious onset of LBP with stiffness in the morning. LBP/bilat SI jt pain; may have pain in
buttocks/hips – Pain relieved with activity, worsens
with rest/inactivity
ANKYLOSING SPONDYLITIS
classic bamboo spine radiographic appearance of ANKLYOSING SPONDYLITIS
