Term
| What people are most likely to have Rheumatoid Arthritis and what eveidence points to genetic influence |
|
Definition
Women 30-50
HLA-DR4 or DR1,
Dw4, Dw14, Dw15
DRB1 |
|
|
Term
| What joints are typically spared by rheumatoid arthritis |
|
Definition
| Distal Interphilageal Joint |
|
|
Term
| What are the characteristic conformations of the fingers in rheumatoid arthritis |
|
Definition
Swan Neck: DIP flexed, PIP extended
Buccaneer's: DIP extended, PIP flexed |
|
|
Term
| Describe the X-ray evidence of bone degeneration as rheumatiod arthritis progresses |
|
Definition
Periarticular Osteopenia->
Joint Space Narrowing->
Erosion(First evident on the styloid process of the Radius) |
|
|
Term
| What are some Extra-Articular Manifestations of Rheumatoid Arthritis |
|
Definition
Ocular: Scleritis
Derm: Ischemic Ulcers, Nodules
Lung: Rheumatoid Nodules, Effusion
Cardiac: Pericarditis
Neurologic: Peripheral neuropathy
Hematologic: Neutropenia, Lymphoma, Anemia |
|
|
Term
| What is the typical evaluation of a patient suspected of Rheumatoid Arthritis |
|
Definition
Synovial Analysis
ESR/CRP
RF: Sensitive, not Specific
Anti-CCP: Very Specific
Hep C and B, or Parvovirus if < 6 wk onset
X-Ray
ANA |
|
|
Term
| Why is it dangerous to intubate a patient with rheumatoid Arthritis? |
|
Definition
| These patients are more prone to subluxations of the neck, which under stress(intubation) could lead to paralysis |
|
|
Term
| What is the typical treatment after rheumatoid arthritis diagnosis |
|
Definition
Corticosteroids short term til DMARDs are active
DMARD's-Methotrexate etc.
Biologicals- Anikinra Il-1 Receptor Antagonist,
Etanercept:TNF-R antagonist, Infiximab: TNF block(mouse), Adatimumab: TNF block(Human) |
|
|
Term
| Severe adverse effects of Methotrexate |
|
Definition
Interstitial lung disease
Myelosuppression
Teratogenic
Lymph maligancies
Cirrhosis |
|
|
Term
| What is the pathogenesis of Rheumatoid Arthritis |
|
Definition
Macrophages T-cells and B-cells produce inflamatory cytokines
Cytokines induce synovial proliferation
Proliferation forms of synovial forms pannuses which invade the bone tissue and damage the joint |
|
|
Term
| What onset, acute, subacute, or insidious does rheumatoid arthritis typical present with? |
|
Definition
|
|
