Rheumatoid Arthritis Flashcards
(36 cards)
what type of disease is rheumatoid arthritis?
Systemic inflammatory disease
what does RA primarily affect?
synovial lining of joints but can affect other organs
what is characteristic of RA?
Persistent symmetric polyarthritis of hands & feet which is hallmark feature
Progressive articular deterioration
May lead to difficulty with ADLs
What does the build up of synovial cells cause?
damage of underlying cartilage
Products of this destruction stimulate inflammation New phagocytes clean up debris
what are the cardinal signs of RA?
Heat Swelling Redness Pain Eventual loss of fx
how does permanent inflammation occur?
swells up and back down
eventually soft tissue doesnt reshape itself
what is the diagnostic criteria for RA?
at least 4 Morning stiffness Arthritis of 3 or more joints Arthritis of hand joints Symmetric arthritis Rheumatoid nodules Serum rheumatoid factor Radiological changes
what is the monocyclic course of RA?
1 episode ending in 2-5 years after initial diagnosis May result from early and/or aggressive tx
what is polycyclic course of RA?
Levels of disease fluctuates over course of condition
what is progressive course of RA?
Continues to increase in severity, is unremitting
leading to Radiographic damage, Decline in fx, Work disability, Premature mortality by 10 – 15 years
what is the onset of RA?
Usually insidious, can be episodic, acute
what are systemic manifestations of RA?
Fever, malaise, fatigue, anorexia
what are Extra-articular Symptoms of RA?
rheumatoid nodules
affected respiratory and vascular systems
eye dryness
enlarged spleen
what are the comorbidities of RA?
Cardiovascular disease TB infection Anxiety Depression Leukemia, multiple myeloma
what can be physically seen in RA pts?
Stiffness,tenderness Pain w/ motion Deformity Decreased motion Rheumatoid nodules
what can be found on radiographs of RA pts?
not helpful early b/c cartilages arent destroyed yet
what can be found on lab reports of RA pts?
CBC blood count (Erythrocyte Sedimentation) Antibodytest, Rheumatoid Factor RA latex rate
what is RA progression and prognosis?
30% of all cases so mild, no MD involvement
10% severely disabled: WC, bed bound
what is the order of joint involvement frequency of RA?
- Hands
- Wrists
- Knees
- Elbows
- Feet
- Shoulders
- Hips
how does RA affect joints?
symmetrically
what is swan neck deformity? who is it more common for?
hyper extension of PIP with flexion of DIP. more common in rheumatoid arthritis than trauma.
what is Boutonniere deformity? who is it more common for?
flexion of PIP with extension of DIP. more common in trauma but can be seen in rheumatoid
what is Ulnar drift at MCP joints?
stretched out of place over time. hand goes radial, fingers go ulnarly. swelling over time causing slip of extensor tendons
what are early changes in RA?
soft tissue swelling, joint space narrowing, and erosions of the proximal interphalangeal (PIP) joints
