Question

Describe to me the etiology, pathogenesis, clinical manifestations, and treatment options for Rheumatoid Arthritis. Since these patients are on immune suppressive drugs, what lifestyle modifications do they have to make (vaccinations, epidemics in the community, prepping for surgery, and effects on liver).

Answer 1

Rheumatoid arthritis is a autoimmune disorder, in which defense system of body attacks own cells of body and causes inflammation and i.s; present mainly at joints. It involves various joints of body which are of hands or legs.

Etiopathogenesis

Etiopathogenesis depends on genetic and environment factors. Little is the progress of knowledge the environment factors but the strong is association with HLA DR4/DR1. The hypothesis being proposed is that RA is a chronic immune-mediated disease whose initiation and perpetuation is dependent on T-cell CD4 helper is connected by activation monocyte/macrophage cells which per production proteolytic enzymes and prostaglandins way to local inflammation and destruction articular cartilage and bone. Lymphocytes B proliferate to plasmocytes, which produce rheumatoid factor and other antibodies. Production of antibodies leads to production immune complexes, activation complement and migration and activation granulocytes. In the end of the process of RA occurs destruction articular cartilage and osteoclasts activated to erode bone together with mastocytes and growing pannus leads to synostosis. Like self perpetuation inflammation never disappears.

Clinical features:-

Pain: in the joints, back, or muscles

Joints: stiffness, swelling, tenderness, or weakness

Whole body: fatigue, anaemia, or malaise

Skin: lumps or redness

Hand: bump on the finger or swelling

Treatment:-

There is no specific treatment for RA but, drugs are used to slow progression of of symptoms of disease.

Drugs includes :-

NSAIDS (ibuprofen) relieve pain and inflammation

Steroids (prednisolone) reduces inflammation,and slows joint deteoration

DMARD's:- slows the progression of disease and saves joint (sulfasalizine, methotrexate, hydroxychloroquine)

biological agents (adalimumab)

Lifestyle changes :-

Exercise regularly

Apply heat or cold (Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and can reduce swelling.)

Find ways to deal with your pain.

If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and improve function.

Synovectomy

Joint fusion

Tendon repair