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25 Cards in this Set
- Front
- Back
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Are men or women more commonly affected by rheumatoid arthritis?
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Women (2-4 times more affected)
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What types of joints, in general, does RA affect?
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Diarthroidal (freely movable) joints
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What inflammatory cascade drives both synovial inflammation and joint destruction seen in RA?
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TNF overproduction and overexpression
(Leads to overproduction of many cytokines such as IL-6, which also drives persistent inflammation and joint destruction) |
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What are the dominant local cell populations in joints affected by rheumatoid arthritis?
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1. Synovial cells (fibroblast-like and macrophage-like synoviocytes)
2. Cartilage cells |
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Which cells in the joints are believed to be responsible for the overproduction of proinflammatory cytokines?
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macrophage-like synoviocytes
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Which cells in the joint are thought to lead to fibroblasts invading cartilage (behavior that correlates with joint destruction)?
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Fibroblast-like synoviocytes
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In RA, what causes the synovium of a joint to swell?
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Due to an infiltrate consisting of
1. Fibroblast-like and macrophage-like synoviocytes 2. Macrophages 3. T cells 4. B cells |
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What genes are associated with rheumatoid arthritis?
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HLA-DR4
PTPN22 QLRAA (shared epitope in the peptide binding pocket) |
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Which two autoantibodies are associated with Rheumatoid arthritis?
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1. Rheumatoid factor
2. Anti-CCP |
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What is the dominant environmental risk factor for developing Rheumatoid arthritis?
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Smoking
(doubles risk!) |
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What 3 cytokine polymorphisms may contribute to RA?
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1. TNF-a
2. IL-1 3. IL-10 |
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T or F.
Higher levels of Rheumatoid Factor are associated w/ poorer prognosis. |
TRUE.
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Which antibody has a high positive predictive value for RA and may be detectable earlier than RF?
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Anti-CCP
(Anti-cyclic citrullinated peptide) |
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RA makes an individual more susceptible to what 3 conditions?
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1. Infections
2. Cardiac disease 3. Lymphoma |
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What are the clinical features of RA?
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1. Chronic pain (worse with rest, better with exercise)
2. Morning stiffness 3. Joint destruction 4. Extra-articular manifestations |
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What are some constitutional symptoms seen in RA?
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1. Fatigue
2. Low grade fever 3. Myalgia 4. Weight loss 5. Depression |
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What should you look for upon physical exam when you suspect RA?
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1. Symmetrical effusions and soft tissue swelling (MCP, PIP)
2. Tenderness to the touch 3. Occasionally erythema 4. Warmth over joint 5. Restricted range of movement 6. Reduced grip strength |
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List some physical deformities commonly seen in RA.
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1. Boutinnier deformity
2. Swan neck deformity 3. Ulnar deviation |
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What radiographic features are characteristic of RA?
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1. Affected MCP, PIP, MTP joints
2. Symmetric involvement 3. Periarticular soft-tissue swelling 4. Juxtaarticular osteopenia 5. Joint-space narrowing 6. Marginal erosions 7. Deformities in advanced disease (*Periarticular osteopenia, joint space narrowing, and erosions are radiographic changes that meet criteria for RA) |
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What types of skin manifestions can be seen with RA?
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1. Rheumatoid nodules
2. Skin ulcers |
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What types of vasculitic lesions can be seen with RA?
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1. Palpable purpura
2. Splinter haemorages 3. Nail fold infarcts 4.. Ulcerated lesions |
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What types of eye conditions can result from RA?
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1. Keratoconjunctivitis Sicca (Sjogren's syndrome)
2. Episcleritis 3. Scleritis 4. Scleromalacia |
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What types of lung diseases are sometimes seen in RA?
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1. Interstitial fibrosis
2. Pulmonary nodules 3. Organizing pneumonia 4. Pleural effusions |
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What types of heart diseases can result from RA?
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1. Pericarditis/ pericardial effusion
2. Myocarditis 3. Coronary artery disease |
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What types of kidney disease can result from RA?
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1. Focal glomerulonephritis
2. Amyloidosis |
