36912752 rheumatoid arthritis ppt

7/28/2019 36912752 Rheumatoid Arthritis Ppt

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RHEUMATOID ARTHRITIS


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What is RA?A Chronic,

systemic inflammatory disease,

characterised by symmetrical

joint involvement which is

typically erosive/destructive.

hallmark feature: persistentsymmetric polyarthritis (synovitis)


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Recap on the anatomy and physiology

Function of JOINTS:

To allow articulation between twoor more bones and

secondarily to permit movementby contraction of opposing

muscles.


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Unknown

Genetic

Auto immune

Etiology


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Pathophysiology

Antigen

Environmental agent, infectious agent

Activates CD4 helper

T cells and probably

B lymphocytes

T cells stimulatessynovial macrophage

and fibroblast

Activates

B lymphocytes

Genetic

Susceptibility

HLA-DR4HLA-DQ

HLA- DPCytokines


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Pathophysiology

Pannus formation

Joint destruction

Cartilage fibrosis

Ankylosis

Joint injury

RANKL

Activatesosteoclast

Formation of

rheumatoid

factor

Formation ofautoimmune complexes

and probable deposition

in the joint

Cytokines

Fibroblast

Chondrocytes

Synovial cells

Enzymes release

(collagenase, streptomelysin,

elactase, PGE2 and matrix

metalloproteinases, others)

T cells stimulates

synovial macrophage

and fibroblast

Activates B lymphocytes

Proliferation


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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


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1. arth rit is

Clinical Manifestations

Associated with

low fever

Fatigue

Morning stiffness

Joint soft, warm to

touch


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2. extra-articu lar featu res


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3. Associated syndromes(possib le compl icat ion s)


(a) Sjgrens syndrome-salivary gland

inflammation and keratoconjunctivitis

(b) Feltys syndrome-profound neutropenia,

thrombocytopenia and splenomegaly

(C) Pulmonary involvement-(pleuritis, interstitial

pneumonitis, alveolitis and intrapulmonaryrheumatoid nodules)

(d) Cardiac involvement-pericarditis


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ns


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Diagnnostic criteria1. 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.


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o l igoart icu lar JIA

Polyart icu lar J IA

System ic J IA

Types of JIA


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1. Acute Pain r/t inflammation & swelling

2. Fatigue r/t increased metabolic rate

3. Impaired physical mobility r/t decreasedrange of motion

4. Disturbed body image r/t physical &

psychological changes

Nursing Diagnosis:


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36912752 rheumatoid arthritis ppt

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