Question

9. What would be the treatment for rheumatoid arthritis? 10. What would be the blood test for lupus? 11. What would indicate worsening SLE (what system findings)? 12. What is ankylosing spondylitis (pathogenesis) and the treatment?

Answer 1

9.The treatment for rheumatoid arthritis are

• Anti inflammatory drugs to reduce inflammation is the first line of treatment (NSAID)
• Corticosteroids to prevent the inflammatory process
• Immunosuppressive drugs if it because of autoimmunity
• Application of heating pad to relieve pain
• Exercise in mild form to endure the movements
• Arthrocentesis by removing the synovial fluid
• Surgical intervention by joint replacement ,synovectomy

10.The Anti Nuclear Antibody tests are generally positive

CBC:will show decreased hemoglobin level ,platelets and WBC

Increased ESR rate

Urine routine may show presence of protein and RBC

Collection of fluid in the lungs can be passed by chest X ray

Biopsy

11.Systemic Lupus Erythematous worsening can be indicated in the following ways

• Decreased renal output ,hematuria
• Edema,severe fatigue ,elevated temperature ,severe headache
• Increased joint pain
• Reynaud phenomenon can be seen in thes patients
• Nausea, vomiting, increased bowel movements
• Dyspnea
• Chest pain

12.Ankylosing spondylitis refers to the inflammation of the joints and spine.Due to certain genetic causes this will lead to alteration in MHC ,HLA B27 causing genetic alteration in the gene .This cause irreversible damages to the CD4+,CD8+,T cells,natural killer cells are affected .Thi causes autoimmune reactions at the site triggering inflammatory process at the joints causing the symptoms

The treatment are medication like anti inflammatory, NSAID, immunosuppressive agents,steroids exercise .