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. Colleagues Post Rheumatoid Arthritis An autoimmune condition known as rheumatoid arthritis (RA) causes the body’s immune system to target the lining of joints all over the body. In severe cases, rheumatoid arthritis can cause permanent joint damage and disability due to inflammation of the joints. In addition, the skin, eyes, blood vessels, lungs, and heart can all be impacted by RA. Rheumatoid arthritis affects one in every 200 adults globally, with women experiencing the condition 2 to 3 times more frequently than men. Although anyone can be affected, the peak onset occurs between the ages of 50 and 59 (Smith, 2023). The Role Genetics Plays in Rheumatoid Arthritis Individuals with specific genes at birth are predisposed to Rheumatoid Arthritis. Furthermore, the HLA (human leukocyte antigen) class II genotypes that result from these genes may exacerbate your arthritis. Those who have these genes and smoke or are obese may be at higher risk of developing RA (Rheumatoid arthritis, 2022). In addition to genetics, environmental factors also play a huge role in RA. Why the patient is presenting with the specific symptoms described The patient is exhibiting the signs and symptoms of rheumatoid arthritis. The joints are the primary target of RA, often several joints at once. Hand, wrist, and knee joints are frequently impacted by RA. Joint tissue is harmed by the inflammation of the joint’s lining in RA-affected joints. This tissue damage can result in deformity, unsteadiness, and chronic or persistent pain. In addition, RA can also cause issues with the heart, lungs, and eyes (Rheumatoid arthritis, 2022). Patients who have Rheumatoid Arthritis frequently experience fever and fatigue. The patient also has stiffness, which may stem from edema in the bilateral 4th and 5th PIP joints, along with tenderness in the same joints. The Physiologic Response to the Stimulus Presented The patient’s physiologic response was prompted by the fact that he frequently types while working at a bank. Typing difficulties can result from Rheumatoid Arthritis-related joint damage. The patient presents with bilateral edema to the 4th and 5th PIP joints along with tenderness in the same joints. In addition, both of his grip strengths are diminished, which are all signs/symptons of RA. The Cells that are Involved in this Process The fundamental characteristic of RA is an autoimmune disease characterized by abnormally elevated levels of auto-reactive CD4+ T cells, pathogenic B cells, macrophages, inflammatory cytokines, chemokines, and autoantibodies. Growing evidence points to a variety of pathogenetic mechanisms for RA, including intricate roles for different immune cells (Jang, 2022). How Another Characteristic (e.g., gender, genetics) Would Change Your Response With the patient having a temperature of 100.1 I would want to make sure that it is not due to an infection. I know that a fever is a symptom of Rheumatoid Arthritis, but I would want to rule out any other factors that could be causing his symptoms and not overlook anything. References Centers for Disease Control and Prevention. (2022, April 7). Rheumatoid arthritis. Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/types/rheumatoid-arthritis.html Jang, S., Kwon, E. J., & Lee, J. J. (2022). Rheumatoid Arthritis: Pathogenic Roles of Diverse Immune Cells. International journal of molecular sciences, 23(2), 905. https://doi.org/10.3390/ijms23020905 Smith MH, Berman JR. What Is Rheumatoid Arthritis? JAMA. 2022;327(12):1194. doi:10.1001/jama.2022.0786
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