Arthritis Review: RA, PSA, and Gout

Vocabulary flashcards covering rheumatoid arthritis, psoriatic arthritis, and gout concepts from the lecture notes.

Rheumatoid arthritis (RA)

Chronic systemic autoimmune inflammatory arthritis characterized by morning stiffness, symmetric joint involvement, swelling, fatigue, and potential extra-articular manifestations; disease can have remissions and exacerbations.

Shared epitope

A common five-amino-acid sequence in MHC Class II molecules associated with increased risk of RA; thought to bind self antigens and activate T cells.

MHC Class II

Major histocompatibility complex class II molecules that present extracellular antigens to CD4+ T helper cells; genetic variations linked to RA.

Citrullination

Post-translational modification converting arginine to citrulline; generates citrullinated peptides that can trigger autoimmunity in RA.

PAD (peptidyl arginine deaminase)

Enzyme that catalyzes citrullination; variations or overexpression linked to RA susceptibility.

Anti-citrullinated peptide antibodies (ACPA)

Autoantibodies detectable in up to ~80% of RA patients; highly specific for RA.

Rheumatoid factor (RF)

Autoantibody against the Fc portion of IgG; supports RA diagnosis but is not completely specific.

Extrarticular manifestations

Symptoms outside joints in RA, such as fatigue, weight loss, fever, anemia, and organ involvement.

Subluxation

Partial dislocation of a joint due to joint damage in RA.

Boutonniere deformity

Finger deformity with flexed PIP and hyperextended DIP seen in RA.

Ulnar deviation

Deviation of fingers toward the ulnar side due to joint destruction in RA.

Ankylosis

Fusion of a joint, leading to loss of movement in advanced RA.

Erythrocyte sedimentation rate (ESR)

Inflammatory marker often elevated in RA.

C-reactive protein (CRP)

Acute-phase inflammatory marker elevated in RA; indicates active inflammation.

DMARDs

Disease-modifying antirheumatic drugs that slow RA progression; include conventional, biologic, and targeted synthetic agents.

Conventional DMARDs

Traditional DMARDs (e.g., methotrexate) used as first-line therapy to slow joint damage.

Biologic DMARDs

Biologic agents targeting inflammatory pathways (e.g., TNF inhibitors, IL-6 inhibitors) for RA treatment.

Targeted synthetic DMARDs

Small-molecule inhibitors (e.g., JAK inhibitors) that interfere with intracellular signaling in RA.

NSAIDs

Non-steroidal anti-inflammatory drugs used to reduce pain and inflammation in RA.

Corticosteroids

Steroids used for rapid anti-inflammatory effects; long-term use risks include osteoporosis and infection.

Physical therapy

Rehabilitation to restore joint function and mobility; can include exercise and aquatic therapy.

Psoriatic arthritis (PSA)

Autoimmune arthritis associated with psoriasis; can affect skin and joints with multiple clinical patterns.

Psoriasis

Chronic skin condition with red, scaly patches; precursor to PSA in many patients.

Symmetric PSA

PSA affecting both sides of the body with joint involvement similar to RA.

Asymmetric PSA

PSA affecting one side of the body; often milder in some joints.

DIP predominant PSA

PSA type affecting distal interphalangeal joints near fingertips.

Spondylitis PSA

PSA with spinal involvement (sacroiliitis/axial disease) causing back stiffness.

Psoriatic arthritis mutilans

Severe, rare PSA with severe deformities and tissue destruction.

Gout

Inflammatory arthritis due to deposition of urate crystals from hyperuricemia; often nocturnal and starts in a single joint.

Uric acid / urate

Waste product from purine metabolism; crystallizes in joints causing gout.

Hyperuricemia

Elevated serum urate levels, a risk factor for gout.

Monosodium urate crystals

Urate crystals deposited in joints causing gouty inflammation.

Tophi

Deposits of urate crystals in soft tissues around joints.

Urate nephrolithiasis

Urate kidney stones formed from urate crystals; can obstruct urine flow.

Synovial fluid analysis

Diagnostic test to detect urate crystals in synovial fluid during gout attack.

Allopurinol

Urate-lowering medication that reduces uric acid production to prevent gout attacks.

Purines

Nitrogenous bases in DNA/RNA; high-purine foods raise uric acid production.

High-purine foods to avoid

Organ meats (liver, kidney), certain seafood (shrimp, sardines, shellfish), and red beans.

Dactylitis

Diffuse swelling of an entire finger or toe ('sausage finger'), common in PSA.

Sacroiliitis

Inflammation of the sacroiliac joints; common in PSA and axial spondyloarthritis.

Steroids and osteoporosis risk

Corticosteroid use can cause bone loss (osteopenia/ osteoporosis) and fractures.

Nursing diagnoses in RA/PSA

Chronic pain, impaired physical mobility, disturbed body image, and self-care deficits related to disease.