Rheumatoid Arthritis 2 (Week 12) Flashcards Preview

Pathophysiology > Rheumatoid Arthritis 2 (Week 12) > Flashcards

Flashcards in Rheumatoid Arthritis 2 (Week 12) Deck (28):
1

side effects of RA

fever
rash
lymph node enlargement
spleen enlargement
malaise
Raynaud's

2

Rheumatoid nodules cause

excessive esudate escapes from the joint capsule and forms nodules in the region of the joint

3

where do rheumatoid nodules most commonly occur

dorsum of hands

4

Tx of RA

minimize inflammatory and immune processes
joint replacement

5

OT and PT goals for RA patients

-maintain joint ROM and muscle strength
-maintain independence in daily fxn
-modify activities to minimize stress and avoid continued joint destruction

6

best OT/PT interventions when not in a flare

heat application
ROM exercise
mild/moderate physical activity
pool exercise (warm pool)
splinting to prevent further contracture

7

best OT/PT interventions during a flare

cold application
rest affected joints
NO EXERCISE

8

vasculitis

inflammation of vascular endothelium

9

adenopathy

swollen lymph nodes

10

pathologies involved in RA

vasculitis
neurologic dysfunction
cardiopulmonary disease
splenomegaly
adenopathy

11

what percent of the population has RA

1%

12

what is the peak age for RA

7th decade

13

genetic predisposition for RA?

genetic predisposition that requires an environmental trigger

14

gender and RA

age 15-45: more women (6:1)
after 60: equal genders

15

other diseases associated with RA

smoking
pulmonary disease
epstein barr
e. coli
periodontal disease

16

what happens at the affected joint in RA

-chronic inflammation of synovial tissue
-inflammation of synovial tissue forms pannus, which invades cartilage and bone
-pannus destroys cartilage and bone

17

rheumatoid factors

autoantibodies in the IgM or IgG class
-present in blood of all RA patients
-bind to synovial membranes to form immune complexes

18

anticitrullinated protein (ACPA)

antibody produced by patients with RA
-typically present before symptoms are present

19

RA progression at synovial membrane and articular cartilage

-inflammation of the synovium causes movement of leukocytes into the tissue
-immune complexes promote inflammation

20

how do immune complexes promote inflammation at joint

-proinflammatory cytokines (TNF, IL-1, IL-6) promote release of more free radicals and hydrogen peroxide
-macrophages cause production of prostaglandins and other cytotoxins

21

what is used to treat RA

TNF inhibitors (biologic DMARDs)

22

janus kinase

hastens maturation and activity of leukocytes in the area

23

what is released at joint in RA

janus kinase
histamines
kinins
leukocytes
prostaglandins
free radicals
hydrogen peroxide

24

how does RA damage joint structure

-swelling of articular cartilage & synovial membrane
-swollen synovial membrane puts pressure on small vessels and other joint structures
-causes decreased BF to joint
-decreased BF causes hypoxia and acidosis (carbon dioxide levels increase)

25

what does acidosis cause in the joint

stimulate the release of hydrolytic enzymes from synovial cells

26

what do hydrolytic enzymes do

erode articular cartilage and inflame tendons and ligaments
-they break down just about anything

27

joints most commonly affected in RA

fingers
feet
wrists
elbows
ankles
knees

28

areas less commonly affected in RA

shoulders
hips
cervical spine
lungs
heart
kidney