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50 Cards in this Set

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ra
autimmune dz where the body loses its ability to distinguish between synovial and foreign tissue
factors invlove in ra
environmental influences
genetic markers
tumor necrosis factor alpha
interleukin1
IL-6
growth factors
inflammed synovium
environmental influences
bacterial and viral infxn
HLA-DR4
human leukocyte antigent has been assoc with triggering the inflam process in RA
tumor necroses factor alpha
interleukin 1
growth gactors
propagate the inflam process and agents found to alter these cytokines show promise in reducing pain and deformity
inflammed synovium
hallmark of the pathophysiology of ra
synovium
proliferated abnormally, growing into the joint space and into the bone forming a pannus
pannus
migrates to the srticular cartilage and into the subchondral bone
stimulation of the cytokines
cells of the pannus produce proteolytic enzymes
proteolytic enzymes
degrade cartilage
cytokines
activate osteoclasts which causes the demineralization of bone
ra sx
malaise
anorexia
tender, swollen joints
pain the joints
aggravated by movement
metacarpophalangeal (MCP)
proximal interphalangeal (PIP)
joints 1st affected by ra
PIP
joints of hands
metatarsophalangeal (MTP)
joints of the feet and wrist
other areas aff by ra
spine
shoulder
ankle
hip
extra-articular manifestations of ra
rheumatoid nodules
anemia
peripheral neuropathy
kidney dz
CV
pulmonary dz
osteoporosis
may occur 2ndary to ra in pts rec tremt w/ corticosteroids
criteria for ra
- morning stiffness
- arthritis of 3 or more joint area
- arthritis of hand joints
- symmetrical arthritis
-rheumatoid nodules
-serum rheumatoid factor
-radiological changes
symmetrical arthritis
simultaneous involvement of the same joint areas on both sides of the body
rheumatoid nodules
observable subcutaneous nodules over bony prominences or extensor surfaces
lab assessment
rheumatoid factor
erythrocyte sedimentation rate
c-reactive protein
cbc
antinuclear antibody
radiographic exam
rheumatoid factor (rf)
IgM
IgG
IgA
erythrocyte sedimentation rate (ESR)
C reactive protein (CRP)
markers of inflam
elevated
helpo indicate the activity of dz
common in ra
anemia

hypochromic
mild leukocytosis
antinuclear antibody (ANA)
+ in ra
radiograph
good indicator of the extent of bone erosion and cartilage loss
MRI
detects the proliferative pannus
ra drug list
salicylates
nsaids
cox 2
corticosteroids
dmard
etanercept
infliximab
anakinra
reduce joint pain
salicylates
nsaids
cox2
corticosteroids
prednisone
methylprednisolone
bridge therapy
corticosteroids

aninflam
immunosuppressants
disease modifying antirheumatic drugs
dmards
objective of dmard
reduce or prevent joint damage and preserve joint fxn
inflammatory markers
esr
crp
more commonly used dmards
hydroxychloroquine
seulfasalazine
methotrexate
less frequently used dmards
auranofin
azathioprine
cyclosporine
gold salts
d-penicillamine
newer dmards
leflunomide
etanercept
infliximab
anakinra
leflunomide
inhibits pyrimidine synthesis and is indicated as monotherapy for ra
hepatotoxicity
assoc with use of leflunomide
etanercept
binds to TNF aldpha and Beta

inhibiting the inflam response mediated by immune cells
indication etanercept
monotherapy
immunosuppression
occurs with use of etanercept
edv eff enbrel
pancytopenia
lupus like sx
paresthesias
visual
gait
disturbances
confusion
infliximab
binds to TNF alpha and only FDA approve in combo with methotrexate
se of infliximab
immunosuppression
anakinra
newest dmard
interleukin 1 rec antagonist
se of anakinra
immunosuppression
triple therapy of ra
mtx
hydroxychloroquine
sulfasalazine