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14 Cards in this Set

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What is Rheumatoid arthritis?
• a systemic disease characterized by inflammatory polyarthritis
• involves small and large joints and constitutional features
What are characteristics clinical features of Rheumatoid arthritis?
• morning stiffness
• improvement of symptoms with activity
• "gelling"
Which human leukocyte antigen is a genetic risk factor for Rheumatoid arthritis?
HLA DR4
What is the synovial pannus?
• 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
What are non-articular presentations of Rheumatoid arthritis?
• Felty's Syndrome
• leg ulcers
• pleuropericarditis
• rheumatoid nodules (subcutaneous, pulmonary, scleral)
• scleritis and episcleritis
• vasculitis
Describe rheumatoid nodules
a granuloma with a central zone of fibrinoid necrosis
Over time, rheumatoid arthritis can progress to joint destruction and deformities. What are the most common deformities?
• boutonneire deformity
• "swan-neck" deformity
• ulnar deviation of the finers
• valgus deformity of the knee
What is a boutonniere deformity?
hyperextension of the DIP joint with flexion of the PIP joint
What is a "Swan-neck" deformity?
flexion of the DIP joint with extension of the PIP joint
What is Caplan's syndrome?
the occurrence of multipleplumonary nodules in patients with Rheumatoid arthritis and pneumoconiosis
What is Felty's syndrome?
• splenomegaly
• leukopenia
• recurrent pulmonary infections
What are some laboratory findings of rheumatoid arthritis?
• 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
What are possible x-ray findings of rheumatoid arthritis?
• 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
What are the different classes of drugs that can be used to treat Rheumatoid arthritis?
• NSAIDS
• DMARDS: disease-modifying antirheumatic drugs
• anti-cytokine-directed therapies
• corticosteroids