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RA
Question | Answer |
---|---|
Define RA | chronic, progressive, autoimmune disorder that affects the connective tissues in the synovoal joints |
What makes RA an autoimmune disorder? | the development of autoantibodies (Rhuematoid factor) |
Which gender is RA more prevalent? | women |
What are other theories as to why RA occurs? | smoking, human leukocyte antigen (HLA-DR4) |
How is RA diagnosed? | morning stiffness that lasts for more than 1h, symmetrical joint swelling in 3 or more joints (especially in the hands, erosion/decalcification on XRAY, +RF, rheumatoid nodules, increased ESR, increased C reactive protein |
What is the preferred diagnosis between Xray and bone scan? | bone scan, xray will only show in later stages |
What type of meds do PTs w RA usually take? | DMARDs (methotrexate, gold compounds) |
What is the con to taking DMARDs? | Bone marrow suppression, hepatoxicity, needs freq CBC and Chem 7 |
What type of drugs can be given instead of DMARDS? | biological agents (enebrel, remicade, orencia, Humira) |
When is apheresis (prosorba column) used? | When PT does nto resond to DMARDs. TX is for 12 wekks 1-2 times a week to remove RF from blood |
Why are splints used in RA? | to prevent deformities and for rest of an inflamed joint, make sure to remove regularly for skin care and ROM |
What is the baseline TX for RA? | Methotrexate |
When should RA be treated? | Within the first 1-6 months to decrease severity, however systemic complications remain the same hence the mortality rate is the same |
What are the manifestations of Sjogren's syndrome? | decreased lacrimal and salivary gland secretion (dry mouth, itchy eyes) photo-sensitivity |
Which PTs are more prone to Felty's syndrome? | Those with nodular forming RA |
What are the manifestations of Felty's syndrome? | splenomeagaly, inflammatory eye disorder, lymphadeopathy, pulmonary dz, blood dyscrasis |