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  • RA: Rheumatoid Arthritis

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    Liya Anjelina
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    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical and erosive polyarthritis of the joints. The cause is unknown but involves genetic and autoimmune factors. The pathophysiology involves antigens activating T cells and B lymphocytes, which stimulate synovial macrophages and fibroblasts to release enzymes and cytokines that cause joint inflammation, damage cartilage and bone, lead to pannus formation, and destroy joints. Clinical manifestations include arthritis, fever, fatigue, and morning stiffness in the joints. Extra-articular features and associated conditions like Sjögren's syndrome or lung involvement may also occur. Diagnosis is based on symptoms, physical exam, labs, and radiographic changes.

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    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical and erosive polyarthritis of the joints. The cause is unknown but involves genetic and autoimmune factors. The pathophysiology involves antigens activating T cells and B lymphocytes, which stimulate synovial macrophages and fibroblasts to release enzymes and cytokines that cause joint inflammation, damage cartilage and bone, lead to pannus formation, and destroy joints. Clinical manifestations include arthritis, fever, fatigue, and morning stiffness in the joints. Extra-articular features and associated conditions like Sjögren's syndrome or lung involvement may also occur. Diagnosis is based on symptoms, physical exam, labs, and radiographic changes.

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    156 views19 pages

    RA: Rheumatoid Arthritis

    Uploaded by

    Liya Anjelina
    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical and erosive polyarthritis of the joints. The cause is unknown but involves genetic and autoimmune factors. The pathophysiology involves antigens activating T cells and B lymphocytes, which stimulate synovial macrophages and fibroblasts to release enzymes and cytokines that cause joint inflammation, damage cartilage and bone, lead to pannus formation, and destroy joints. Clinical manifestations include arthritis, fever, fatigue, and morning stiffness in the joints. Extra-articular features and associated conditions like Sjögren's syndrome or lung involvement may also occur. Diagnosis is based on symptoms, physical exam, labs, and radiographic changes.

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    Attribution Non-Commercial (BY-NC)
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    of 19

    RHEUMATOID ARTHRITIS

    What is RA?
    A Chronic, systemic inflammatory disease, characterised by symmetrical joint involvement which is typically erosive/destructive.
    hallmark feature: persistent symmetric polyarthritis (synovitis)

    Recap on the anatomy and physiology Function of JOINTS: To allow articulation between two or more bones and secondarily to permit movement by contraction of opposing muscles.

    Etiology

    Unknown Genetic Autoimmune

    Pathophysiology
    Antigen Environmental agent, infectious agent
    Genetic Susceptibility
    HLA-DR4 HLA-DQ HLA- DP

    Activates CD4 helper T cells and probably B lymphocytes Cytokines

    T cells stimulates synovial macrophage and fibroblast

    Activates B lymphocytes

    Pathophysiology
    T cells stimulates synovial macrophage and fibroblast
    Activates B lymphocytes

    RANKL Cytokines Activates osteoclast Proliferation

    Formation of rheumatoid factor


    Formation of autoimmune complexes and probable deposition in the joint

    Fibroblast Chondrocytes Synovial cells


    Enzymes release (collagenase, streptomelysin, elactase, PGE2 and matrix metalloproteinases, others)

    Joint injury
    Pannus formation Joint destruction Cartilage fibrosis Ankylosis

    INTERLEUKIN 1
    IL-1 is a potent stimulator of synoviocytes, chondrocytes and osteoblasts (Figure 1).

    IL-1 is a proinflammatory cytokine that amplifies and perpetuates the disease process in RA

    Clinical Manifestations
    1. arthritis
    Associated with low fever

    Fatigue
    Morning stiffness Joint soft, warm to touch

    Clinical Manifestations

    2. extra-articular features

    Clinical Manifestations
    3. Associated syndromes (possible complications)
    (a) Sjgrens syndrome-salivary gland inflammation and keratoconjunctivitis (b) Feltys syndrome-profound neutropenia, thrombocytopenia and splenomegaly (C) Pulmonary involvement-(pleuritis, interstitial pneumonitis, alveolitis and intrapulmonary rheumatoid nodules) (d) Cardiac involvement-pericarditis

    ns

    Diagnnostic criteria
    1. Morning stiffness lasting more than 1 hour 2. Arthritis of 3 or more joint areas. 3. Arthritis of the hand joints 4. Symetric arthritis 5. Rheumatoid nodules over extensor surface or bony prominences. 6. Serum rheumatoid factor. 7. Radiologic changes.

    Types of JIA

    oligoarticular JIA Polyarticular JIA Systemic JIA

    Nursing Diagnosis:
    1. Acute Pain r/t inflammation & swelling 2. Fatigue r/t increased metabolic rate 3. Impaired physical mobility r/t decreased range of motion 4. Disturbed body image r/t physical & psychological changes

    THANK YOU FOR LISTENING!

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