Case Two: I5 pointsl A 30-year old woman, recently diagnosed with rheumatoid art

Question

Case Two: I5 pointsl A 30-year old woman, recently diagnosed with rheumatoid arthritis (RA), complains general fatigue and weight loss along with symmetric joint swelling, stiffness and pai The stiffness is more prominent in the morning and subsides during the day with activity. Her blood labs reveal a rheumatoid factor (RF) of 120 IU/mL (values of 0-39 lU/mL considered non-reactive; 40-79 IU/mL are weakly reactive; and >80 IU/mL are considered reactive) and a positive anti-CCP antibody test A. Describe the etiology and pathophysiology (i.e., the mechanism of normal physiology disruption) of the joint damage that occurs with RA. B. What does RF stand for and explain what it does in the body? C. What is the meaning of her RF lab results? D. What is the significance of this woman's positive anti-CCP test results? E. Explain why general fatigue and weight loss occur during the RA disease pr References: Case Three:15 points Upon taking the history of a 28-year old female that came to your clinic you learn she has been experiencing Heart palpitations

Explanation / Answer

A) Etiology of Rheumatoid Arthritis (RA)

Pathophysiology of Rheumatoid Arthritis (RA)

B) RF stands for Rheumatoid Factor (RF), an auto anti body directed against immunoglobulin G (IgG). Rheumatoid factors are proteins produced by your immune system that can attack healthy tissue in your body. The body produces an anti body RF against its own anti body (IgG) and in effect, transforms IgG to an antigen or foreign protein that must be destroyed.

C) Her RF lab level is 120 IU/mL which indicates reactive and suspected to have RA.

D) A positive anti-CCP test result in rheumatoid arthritis patients can be used as a prognostic tool to determine the severity of symptoms the patient may have throughout the disease course. Anti-CCP positive patients can potentially experience a more aggressive disease course. The prognosis of anti-CCP positive patients also depends greatly on early diagnosis of rheumatoid arthritis and how soon treatment can begin.

E) Inflammation in the joints and other tissues can cause fatigue in people with inflammatory arthritis and autoimmune diseases. Chemicals called cytokines, which are found in inflamed tissues, are similar to chemicals released in viral illnesses such as colds and flu, and they can cause extreme fatigue.

RA involves the immune system, which mistakenly attacks your body's own tissues. In addition to the joints, symptoms of RA include: fatigue, particularly during the day. unintended weight loss.

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