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                          Ans :  Rheumatoid arthritis means a chronic inflammatory joint disorder.  A symmetrical, destructive and deforming polyarthritis affecting small and large 
                          joints with associated systemic disturbances.
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 Q.2) Whom does it affect the most? 
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                    Ans: It is most common among
                     females and affects the age group between 30 to 50
                    years of age.
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                      Q.3) How does Rheumatoid Arthritis progress? | 
                  
                  
                    
                    Ans: 
                    An autoimmune disorder in which the body produces antibodies that attack the synovial membrane and, in some cases, other body tissues.
                    There is inflammation of the synovial membrane, which encloses each joint. As a result the affected joints become stiff and swollen. 
                     
                    Gradually the ends of both the bones and the cartilage that covers them
                    are damaged. The tendons and ligaments, which give the joints support,
                    become worn-out and slack thereby deformity of the joints occurs.
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                      Q.4) What are the causes of Rheumatoid Arthritis? | 
                  
                  
                    
                    Ans: Causes are obscure usually genetic
                    predisposition of individuals with HLA class II haplotypes.       
                         
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                      Q.5)What are the symptoms and signs of Rheumatoid Arthritis? | 
                  
                  
                    
                    Ans: The signs and symptoms are
 - Stiff, painful, and symmetrical swelling  of a number of joints.
 - Early morning stiffness. 
 - Typically small joints of the fingers and toes are first to get affected. 
 - Ankles, knees, shoulders, wrists also get affected as the disease progresses.
 - Swelling of the proximal, but not the distal, interphalengeal joints gives the fingers a "spindled"
   
 appearance 
 - Broadening of the forefoot.
 - Fever
 - Painless, small bumps (nodules) on areas of pressure such as the elbows.
  
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                      Q.6) What are the investigations? | 
                  
                  
                    
                    Ans:
                     The tests conducted are
                    
                      - Blood tests
 
                         Rheumatoid factor [RA] 
                         ESR 
                         Anti nuclear antibodies [ANA] 
                         Hypergammaglobinemia 
                      - Joint [synovial] Fluid Analysis
 
                      - X-rays  especially of the hands.
                      
 
                     
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                      Q.7) What are the treatment measures? | 
                  
                  
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                    Ans: Common Drugs generally used are
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  - 
 Disease modifying anti-rheumatic drugs
 
  - Non Steroidal Anti-inflammatory Drugs
 
  - Steroids, may be used     
 
  
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                    Surgery
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                     For advanced disease 
                    
                      - Synovectomy
 
                      - Arthroplasty
 
                      - Joint fusion
 
                     
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                    Physical Therapy
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                    Heat 
                    Splinting 
                    Exercises 
                     
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                    Complication
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                      - 
                    Osteoporosis in the bones around the affected joints. 
 
                      - In very severe cases, osteoporosis of the whole skeleton.
 
                     
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                      Q.8) What is the prognosis? | 
                  
                  
                    
                    Ans: Prognosis is
                     good with regular medical treatment. Many people are able to lead a normal life. Lifelong drug treatment may be needed. Only
                               10% patients may become severely disabled. 
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