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14 Cards in this Set
- Front
- Back
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What is Rheumatoid arthritis?
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• a systemic disease characterized by inflammatory polyarthritis
• involves small and large joints and constitutional features |
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What are characteristics clinical features of Rheumatoid arthritis?
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• morning stiffness
• improvement of symptoms with activity • "gelling" |
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Which human leukocyte antigen is a genetic risk factor for Rheumatoid arthritis?
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HLA DR4
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What is the synovial pannus?
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• a proliferative synovium infiltrated with mononuclear cells (particularly monocytes and T lymphocytes)
• invades at the bone-cartilage-synovium interface with progressive destruction of the bone and cartilage • evident radiographically as marginal bony erosions |
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What are non-articular presentations of Rheumatoid arthritis?
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• Felty's Syndrome
• leg ulcers • pleuropericarditis • rheumatoid nodules (subcutaneous, pulmonary, scleral) • scleritis and episcleritis • vasculitis |
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Describe rheumatoid nodules
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a granuloma with a central zone of fibrinoid necrosis
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Over time, rheumatoid arthritis can progress to joint destruction and deformities. What are the most common deformities?
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• boutonneire deformity
• "swan-neck" deformity • ulnar deviation of the finers • valgus deformity of the knee |
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What is a boutonniere deformity?
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hyperextension of the DIP joint with flexion of the PIP joint
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What is a "Swan-neck" deformity?
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flexion of the DIP joint with extension of the PIP joint
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What is Caplan's syndrome?
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the occurrence of multipleplumonary nodules in patients with Rheumatoid arthritis and pneumoconiosis
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What is Felty's syndrome?
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• splenomegaly
• leukopenia • recurrent pulmonary infections |
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What are some laboratory findings of rheumatoid arthritis?
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• CCP antibody (cyclic citrullinated pepdide): most specific for RA
• Rheumatoid factor: an IgM antibody directed against IgG • ANA (antinuclear antibodies): found in 20% of patients |
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What are possible x-ray findings of rheumatoid arthritis?
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• Early: soft tissue swelling and juxta-articular demineralization of the wrist or feet
• Late: uniform joint space narrowing and erosions (first found at the ulnar styloid • Much later: C1-C2 subluxation |
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What are the different classes of drugs that can be used to treat Rheumatoid arthritis?
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• NSAIDS
• DMARDS: disease-modifying antirheumatic drugs • anti-cytokine-directed therapies • corticosteroids |
