Rheumatoid Arthritis Flashcards
(31 cards)
what is rheumatoid arthritis
disease of the synovium with gradual inflammatory joint destruction
what are the two different patterns of joint involvement in rheumatoid arthritis
sero-positive RA
sero-negative RA
what does sero-positive RA mean
the rheumatoid factor is present
what does sero-negative RA mean
rheumatoid factor not present
what cells are present in an inflammatory synovium compared to a healthy one
t cells
macrophages
fibroblasts
B cells
pannus
inflammatory cytokines
what are symptoms of RA
fatigue
morning stiffness
joint stiffness
joint pain
fever
numbness and tingling
decrease in range of motion
what are early signs of RA
symmetrical synovitis of MCP joints
symmetrical synovitis of PIP joints
symmetrical synovitis of wrist joints
what are late signs of RA
ulnar deviation of fingers at MCP joints
hyperextension of PIP joints
Z deformity of thumb
subluxation of wrists
loss of abduction and external rotation of shoulders
deformity of feet and ankles
what are extra-articular features of RA
inflammation of blood vessels due to systemic vasculitis
psoriasis
eye involvement - dry eyes and Sjogrens syndrome
amyoidosis
normocytic anaemia
what are some options to treat RA
physiotherapy
occupational therapy
drug therapy
surgery
what are the purpose of the active and passive exercises in physiotherapy for a RA patient
maintain muscle activity
improve joint stability
maintain joint position
what are the drug therapies for RA
analgesics
NSAIDS
disease modifying drugs
steroids
what analgesics are used to treat RA
paracetamol and cocodamol
what disease modifying drugs can be used to treat RA
hydroxychloroquine, methotrexate, sulphasalzine
what class of drugs are azathioprine, mycophenolate
immune modulators
what are examples of biologic immune modulators
TNF inhibitors - infliximab, adalimumab
what are some dental aspects of rheumatoid arthritis
reduced dexterity
sjogrens syndorme
drug effects
how can sjogrens syndrome impact dental treatment
association of disease with dry eyes/ mouth
what drug effects do dentists need to be careful with when treating patients with RA
bleeding - NSAIDs and sulphasalazine
infection risks - steroids
what medication associated with RA can increase risk of oral ulceration
methotrexate
what medication associated with RA can cause oral pigmentation
hydroxychloroquine
what issue with the atlanto-occipital joints can be found in RA
it can be damaged - this joint allows pivoting and turning of the head and the ligaments that allow this can become diseased - sudden trauma can cause ligaments ripping
when might the ligaments protecting the spinal cord be put at risk
when there is no muscle tone - eg under general anaesthesia and the head is moved inappropriately
when might the ligaments protecting the spinal cord be put at risk
when there is no muscle tone - eg under general anaesthesia and the head is moved inappropriately
