Hello Students
Friendly reminders below for Week 1 assignments. We have add extra learning resources for you and if trouble understanding or getting anything to work, please let me know.
The case scenarios are different for each week. I will post these in announcements.
Scenario Week 1 – Discussion Board: Patient is a 48-year-old male with complaints of stiffness in his fingers that migrates to his upper arm joints and increased fatigue over the last few months. The patient works in a bank and types frequently. He commented that he thought he could have carpal tunnel syndrome, but the fatigue was beginning to worry him. The patient reports a family history of rheumatoid arthritis. He is currently taking Motrin for pain which partially relieves the symptoms. He rates his pain a 5/10 at present, aching in both hands. The patient’s vital signs are 120/80, Pulse 78, Res 16, Temp 100.1 F. He denies any recent weight changes. Physical exam reveals: Edema to 4th and 5th PIP joints bilaterally with tenderness in the same joints. His grip strength is decreased bilaterally. No edema of knees or ankles noted.
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your response.
Based on the scenario provided, it seems that the patient is likely suffering from rheumatoid arthritis (RA). Here’s how the various aspects of the scenario tie into the disease and the questions posed:
- Role of Genetics: Rheumatoid arthritis has a strong genetic component. Family history of rheumatoid arthritis increases the likelihood of an individual developing the condition. In this case, the patient reports a family history of RA, indicating a genetic predisposition to the disease.
- Specific Symptoms: The patient presents with stiffness in fingers migrating to upper arm joints, increased fatigue, and pain in the hands. These symptoms are typical of rheumatoid arthritis. The stiffness and pain in the fingers are likely due to inflammation and swelling of the synovial joints, common manifestations of RA. Fatigue is also a common symptom associated with autoimmune diseases like RA.
- Physiological Response: In rheumatoid arthritis, the immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. This results in inflammation, swelling, and eventually damage to the joint. The inflammatory response leads to the symptoms described in the scenario, such as pain, tenderness, and decreased grip strength. The presence of edema in the 4th and 5th PIP joints bilaterally indicates inflammation and swelling in these areas.
- Cells Involved: The primary cells involved in the pathophysiology of rheumatoid arthritis are immune cells, particularly T cells and B cells. These cells infiltrate the synovial membrane, leading to the production of inflammatory cytokines and autoantibodies, which contribute to joint inflammation and damage.
- Impact of Other Characteristics: Other characteristics such as gender can influence the presentation and progression of rheumatoid arthritis. Women are more commonly affected by RA than men, and their symptoms may vary in severity. Additionally, environmental factors and lifestyle choices can also influence the development and course of the disease.
In summary, the patient’s presentation aligns with rheumatoid arthritis, a chronic autoimmune disease characterized by joint inflammation, pain, and stiffness. Genetics, immune system dysregulation, and environmental factors play significant roles in the development and progression of the disease.
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