Busy. Please wait.
Log in using Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Rheumatoid Arthritis


Joints most affected by RA ankles, wrists, shoulders
RA epidemiology Worldwide: 0.8% adult; US: F 40-50/100,000; M 20-25/100,000; by age 65 M:F = 1:1; Lifelong; 3-5 yr reduction in life exp; Incidence is declining
RA pathogenesis Genetics: both susceptibility & dz severity; HLA-DR 1 and DR4 alleles
RA: Poss infectious triggers: Mycoplasma, Mycobacterium, enteric bacteria; rubella, parvovirus B19, EBV
RA: Other poss risks: tea, high vitamin D intake, silicate exposure
RA pathology trigger; prolif syn macrophages / fibroblasts; lympho invade perivascular space; affected jt vessels occluded, synovium forms pannus (which invades cart & bone); cytokines, proteinases, ILs released; jt destn
RA Clinical manifestations: slow, insidious onset; durations of sx = wks to mos; fatigue, malaise, low-grade fever, wt loss; 10-15% advanced, fulminant sx; joints are typically swollen (boggy) and/or warm; erythema not common
RA: pts c/o pain & stiffness: 2/3 pts c/o pain & stiffness in multiple joints, 1/3 c/o pain and stiffness in one or a few joints
RA classic presentation: small bones of hands/feet most likely to be affected early (PIPs, MCPs, MTPs)
RA: progression to larger joints: wrists, knees, elbows, ankles, hips, shoulders
RA: around inflamed joints: may be atrophy of muscle around inflamed joints
RA typical course: waxing/waning over years with acute episodes involving single or multiple joints
RA: Articular manifestations: hands ulnar devn; swan neck deform (PIP hyperext), boutonniere (PIP hyperflex & DIP hyperext)
RA: Articular manifestations: feet affected in 90% of pts w/ longstanding RA; subluxation of MTP joints leads to callus formation
RA: Articular manifestations: wrists in most pts; radial deviation; inc synovial proliferation leads to median n. compression, tendon rupture
RA: Articular manifestations: other joints: any synovial joint can be affected; TMJ, cricoarytenoid, sternoclavicular joints
RA: Articular manifestations: c-spine: C1-C2 articulation; atlantoaxial subluxation is feared complication (d/t ligamentous laxity induced by synovial prolif)
RA atlantoaxial subluxation presenting sxs: pain radiating up occiput; slowly prog quadriparesis w/ inc sensation in hands; UE paresis triggered by head movements; transient episodes of vert art compression
RA: joints most commonly affected MCP, PIP, wrists, knees, shoulders
RA: Labs no single dx test confirms RA; acute phase reactants (ESR, CRP, thrombocytosis); autoAbs (RF, anti-CCP, ANA); anemia of chronic dz; synovial fluid analysis; inc WBCs, mostly PMNs
RF testing RF result changes over time (some: seroneg RA) (so if neg, sd test periodically later)
Lab results: Ro, La, Smith, & RNP: don’t change over time
RA labs: CCP more specific for RA than RF; 30% RA pts are RF neg; 60% RA pts CCP pos; CCP pos at risk for severe dz
RA Imaging: must ID changes early (avoid irreversible joint damage); sig amt genl skeletal bone lost early in dz
RA: prevalence of osteoporosis = 2x that of general population
RA Imaging: early findings: soft tissue swelling, peri-articular osteopenia, marginal erosions
RA Imaging: late findings: diffuse osteopenia, joint space narrowing, deformities
RA Tx: mod-severe dz at dx: start with DMARDs (combo tx); titrate dose upward as needed; add biologic tx for uncontrolled joint pain, swelling
RA Tx: mild dz: less aggressive DMARDs (hydroxychloroquine, sulfasalazine)
RA Tx: adjuncts: glucocorticoids, NSAIDS, analgesics, PT / occupational tx
RA complications: Inc risk of CV disease: premature, accelerated atherosclerosis 2nd to chronic inflame; Inc rate of malig (usu lymphoma); atlantoaxial subluxation
Felty’s syndrome: rare: RA & splenomegaly, leukopenia & recurrent pulmonary infxn; poss also leg ulcers, vasculitis
Baker’s cyst: rupture of synovial fluid from knee into calf; mimics DVT, cellulitis
RA: Predictors of poor prognosis: low functional score, low SES, inc ESR, CRP, early radiographic changes
RA: Plain films show joint damage after: 2 years of dz duration in 70% of cases
RA: MRI scans reveal: erosive joint damage as early as 4 months
RA: Primary care mgmt: disability; med AE (edema); surveil for infxn, malig, osteoporosis, depression; immunizations; CV risk reduction
Joints most affected by RA ankles, wrists, shoulders
RA pathogenesis Genetics: both susceptibility & dz severity; HLA-DR 1 and DR4 alleles
RA: Poss infectious triggers: Mycoplasma, Mycobacterium, enteric bacteria; rubella, parvovirus B19, EBV
RA Clinical manifestations: slow, insidious onset; sxs wks to mos; fatigue, malaise, low-grade fever, wt loss; joints typically swollen (boggy) and/or warm; erythema uncommon
RA classic presentation: small bones of hands/feet, usu affected early (PIPs, MCPs, MTPs); progression to larger joints (wrists, knees, elbows, ankles, hips, shoulders)
Created by: Abarnard



Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards