Questions and Answers
What should be assessed for a patient with latent TB and never been treated?
Hepatitis B and hepatitis C
Why is liver and kidney monitoring recommended for most DMARD therapy?
It can cause elevation of the liver enzymes and affect kidney function
What is the most common radiographic study used to track disease progression?
Plain x-ray
When should joint damage be followed as indicated?
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What is the purpose of using X-ray, ultrasound, or both of the hands, wrists, and feet?
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Why is MRI also useful in addition to plain x-ray for disease evaluation?
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If a patient tests positive for hepatitis, what should be done prior to starting medication?
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What could impact treatment strategies if positive for hepatitis B and hepatitis C?
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Why is reactivation of latent TB a concern?
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What is the impact of DMARD therapy on liver and kidney function?
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What is the approximate percentage of the population worldwide affected by rheumatoid arthritis?
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At what age does the onset of rheumatoid arthritis commonly occur?
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What is rheumatoid arthritis referred to when it occurs after the age of 65?
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Which of the following is identified as a modifiable risk factor for rheumatoid arthritis?
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What is the main consequence of pannus formation in rheumatoid arthritis?
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What is the main consequence of the RA inflammatory process?
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What is the exact mechanism of action for the etiology of RA according to the text?
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What does the RA synovium break down, leading to pannus formation?
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What are the additional risks identified for rheumatoid arthritis in the text?
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What is the incidence of RA after the sixth decade of life according to the text?
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What initial clinical manifestations are associated with Rheumatoid Arthritis?
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What is used to evaluate Rheumatoid Arthritis activity and guide treatment decisions?
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Which antibody has a high specificity for detecting Rheumatoid Arthritis?
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How is Rheumatoid Arthritis diagnosed?
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What are some extra-articular features of Rheumatoid Arthritis?
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Which laboratory test for Rheumatoid Arthritis indicates active disease?
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What is impacted by Rheumatoid Arthritis inflammation?
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Where does Rheumatoid Arthritis typically start?
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What are the initial symptoms of Rheumatoid Arthritis?
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What may early Rheumatoid Arthritis stages cause due to inflammation?
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Study Notes
Rheumatoid Arthritis: Clinical Manifestations and Assessment
- Rheumatoid arthritis (RA) may interfere with the production of high-density lipoprotein cholesterol, contributing to atherosclerosis.
- The nervous system is impacted by RA inflammation, leading to neuropathies, paresthesias, and potential axonal degeneration.
- Criteria for diagnosing RA involve a point system based on joint involvement, serology, acute phase reactants, and duration of symptoms.
- Initial clinical manifestations of RA include symmetric joint pain and morning stiffness lasting over an hour.
- RA symptoms vary by disease stage, with classic symptoms including joint pain, swelling, warmth, erythema, and lack of function.
- RA typically starts in small joints, progressing to knees, shoulders, hips, elbows, and other joints.
- Early RA stages may cause limitation in joint function due to inflammation, leading to joint deformities and contractures.
- RA is a systemic disease with extra-articular features like fever, weight loss, fatigue, anemia, lymph node enlargement, Raynaud’s phenomenon, and rheumatoid nodules.
- Assessment findings associated with RA include rheumatoid nodules, joint inflammation, and certain laboratory findings.
- Disease activity scores are used to evaluate RA activity and guide treatment decisions.
- Antibodies to cyclic citrullinated peptide (antiCCP) have a high specificity for detecting RA.
- Laboratory tests for RA include rheumatoid factor, ESR, CRP, and CBC, with elevated ESR and CRP indicating active disease.
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