Rheumatoid Arthritis (Questions and correct answers)

What is the Etiology associated with Rheumatoid Arthritis? correct answers 1. Autoimmune in nature. 2. Inflammatory destruction of synovial joints. What are the mediators of Rheumatoid Arthritis? correct answers 1. Mediated by cytokines and Type III and Type IV Hypersensitivity reactions. What population is Rheumatoid Arthritis found in the most and what genetic factor is the disease associated with? correct answers 1. Classically arises in women of late childbearing age ("Middle-Aged"). 2. Associated with HLA-DR4. What is the characteristic joint findings in Rheumatoid Arthritis? correct answers 1. Hallmark is synovitis leading to formation of a pannus (inflamed granulation tissue). 2. Leads to destruction of cartilage and ankylosis (fusion) of the joint. What is that pathophysiology associated with Rheumatoid Arthritis? correct answers 1. Synovitis produces a thick layer of granulation tissue which is made up of fibroblasts, myofibroblasts, and immune cells. 2. The myofibroblasts contract leading to a dragging of the joints in different directions. What are the classic laboratory findings for Rheumatoid Arthritis? correct answers 1. IgM autoantibodies against Fc portion of IgF (Rheumatoid Factor); is a marker of tissue damage and disease activity. 2. Anti-cyclic citrullinated peptide (Anti-CCP) antibody is more specific. 3. Neutrophil and high protien in synovial fluid. What are the classic MSK symptoms associated with Rheumatoid Arthritis? correct answers 1. Arthritis with morning stiffness (>30 min) that improves with activity. 2. Symmetric involvement of PIP joints of the fingers (swan-neck deformity), wrists (radial deviation), elbows, ankles, and knees. 3. DIP is usually spared! What are the systemic symptoms that are associated with Rheumatoid Arthritis? correct answers 1. Fever, malaise, weight loss, and myaglias (reaction to inflammation). 2. Vasculitis (multiple organs). 3. Bakers Cyst (swelling of bursa behind the knee). 4. Pleural effusions, LAD, interstitial lung fibrosis. What are Rheumatoid Nodules? correct answers 1. Central zones of necrosis surrounded by epithelioid histiocytes. 2. Arise in skin and visceral organs.