IPLab:Lab 6:Rheumatoid Arthritis - Revision history

Peter Anderson: /* Images */

2020-07-08T20:52:46Z

‎Images

Peter Anderson: /* Autopsy Findings */

2020-07-08T20:47:43Z

‎Autopsy Findings

Peter Anderson: /* Clinical Summary */

2020-07-08T20:47:34Z

‎Clinical Summary

Peter Anderson: /* Clinical Summary */

2020-07-08T20:45:30Z

‎Clinical Summary

Seung Park at 16:16, 3 January 2014

2014-01-03T16:16:44Z

Seung Park: /* Images */

2013-08-30T01:34:42Z

‎Images

Seung Park at 21:23, 22 August 2013

2013-08-22T21:23:08Z

Peter Anderson at 15:17, 21 August 2013

2013-08-21T15:17:13Z

Seung Park at 14:22, 21 August 2013

2013-08-21T14:22:44Z

Seung Park at 18:10, 19 August 2013

2013-08-19T18:10:11Z

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 <gallery heights="250px" widths="250px">
 File:IPLab6RA1.jpg|This is a gross photograph of the patient's hands at autopsy. Note the swollen joints and the deforming arthritis.
-File:IPLab6RA2.jpg|This is a medium-power photomicrograph of the joint capsule surrounding the metacarpal joints. Note the thickening of the capsule and the focal accumulation of inflammatory cells surrounding a central area of fibrinoid necrosis (arrow).
+File:IPLab6RA2b.jpg|This is a medium-power photomicrograph of the joint capsule surrounding the metacarpal joints. Note the thickening of the capsule and the focal accumulation of inflammatory cells surrounding a central area of fibrinoid necrosis (arrow).
-File:IPLab6RA3.jpg|This is a high-power photomicrograph of the joint capsule with another granuloma surrounding a central area of fibrinoid necrosis (arrow).
+File:IPLab6RA3b.jpg|This is a high-power photomicrograph of the joint capsule with another granuloma surrounding a central area of fibrinoid necrosis (arrow).
 File:IPLab6RA4.jpg|This is a gross photograph of the foot from this same patient. Note the subcutaneous nodule on the medial aspect of the foot (arrow).
-File:IPLab6RA5.jpg|This is a low-power photomicrograph of the subcutaneous nodule from this patient.
+File:IPLab6RA5b.jpg|This is a low-power photomicrograph of the subcutaneous nodule from this patient.
 File:IPLab6RA7.jpg|This higher-power photomicrograph of the subcutaneous nodule again demonstrates the necrotic center and peripheral rim of macrophages, fibrocytes, and occasional lymphocytes. There are focal accumulations of hyaline material (fibrinoid material) within the granuloma.
 File:IPLab6RA8.jpg|This higher-power photomicrograph of the tissue illustrates the palisading nuclei of the monocytes which are located around the periphery of the central necrotic region (1).
 File:IPLab6RA9.jpg|This is a high-power photomicrograph of the mononuclear cells which surround the central area of necrosis. The focal accumulations of fibrinoid material are clearly visible. Lymphocytes are present in the extreme right of this image.
 </gallery>

← Older revision		Revision as of 20:47, 8 July 2020
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	There were numerous erosions and ulcers in the stomach and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring. The cut surface was whitish-yellow and fibrous.		There were numerous erosions and ulcers in the stomach and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring. The cut surface was whitish-yellow and fibrous.
−
−	~~== Autopsy Findings ==~~
−	There were numerous erosions and ulcers in the gastrointestinal tract and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring 2 x 1.5 cm. The cut surface was whitish-yellow and fibrous.

	== Images ==		== Images ==

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 This 73-year-old female had suffered from rheumatoid arthritis for 40 years.  She took large doses of aspirin in addition to her prescribed medications. The patient was came to the emergency room for weakness and hematemesis. Her hematocrit was 21%. Endoscopy demonstrated a large bleeding ulcer and fresh blood in the stomach. The sites of bleeding were cauterized; however, shortly after the procedure the patient became hypotensive and died despite aggressive resuscitation.
- There were numerous erosions and ulcers in the stomach and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring. The cut surface was whitish-yellow and fibrous.
+There were numerous erosions and ulcers in the stomach and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring. The cut surface was whitish-yellow and fibrous.
 == Autopsy Findings ==

@@ Line 1: / Line 1: @@
 == Clinical Summary ==
-This 57-year-old white female had suffered from rheumatoid arthritis for 20 years. During this period, many joints were involved, some seriously. Because of the severe pain of this arthritis the patient was placed on steroids and was given analgesics, some of which contained acetaminophen. The patient also took additional analgesics (aspirin and/or acetaminophen) to help control the pain. The patient was admitted to the emergency room for weakness and hematemesis. On admission the patient's hematocrit was 21%. Endoscopy demonstrated a large bleeding ulcer and fresh blood in the stomach and proximal duodenum. The sites of bleeding were cauterized; however, shortly after the procedure the patient became hypotensive and died despite aggressive resuscitation.
+ There were numerous erosions and ulcers in the stomach and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring. The cut surface was whitish-yellow and fibrous.
 == Autopsy Findings ==

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 File:IPLab6RA10.jpg|This is a high-power photomicrograph of another region with macrophages (right), fibrocytes (left), and occasional lymphocytes throughout the lesion.
 </gallery>
 == Study Questions ==

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 === Images ===
-* [http://peir.path.uab.edu/library/index.php?/tags/473-rheumatoid_arthritis PEIR Digital Library: Rheumatoid Arthritis Images]
+* [{{SERVER}}/library/index.php?/tags/473-rheumatoid_arthritis PEIR Digital Library: Rheumatoid Arthritis Images]
 == Related IPLab Cases ==

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 * <spoiler text="The exact pathogenesis of rheumatoid arthritis (RA) is not known. What are some of the factors that are associated with RA?">Genetic susceptibility, exposure to a primary exogenous arthritogen, an autoimmune reaction within the synovial membranes, and release of cytokines that mediate joint damage.</spoiler>
 * <spoiler text="What is rheumatoid factor?">IgM antibodies (perhaps originating from the joints) that are directed against the Fc portion of autologous IgG.</spoiler>
 {{IPLab 6}}
 [[Category: IPLab:Lab 6]]

← Older revision		Revision as of 14:22, 21 August 2013
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		+	== Clinical Summary ==
		+
		+	This 57-year-old white female had suffered from rheumatoid arthritis for 20 years. During this period, many joints were involved, some seriously. Because of the severe pain of this arthritis the patient was placed on steroids and was given analgesics, some of which contained acetaminophen. The patient also took additional analgesics (aspirin and/or acetaminophen) to help control the pain. The patient was admitted to the emergency room for weakness and hematemesis. On admission the patient's hematocrit was 21%. Endoscopy demonstrated a large bleeding ulcer and fresh blood in the stomach and proximal duodenum. The sites of bleeding were cauterized; however, shortly after the procedure the patient became hypotensive and died despite aggressive resuscitation.
		+
		+	== Autopsy Findings ==
		+	There were numerous erosions and ulcers in the gastrointestinal tract and a large quantity of fresh blood in the gastrointestinal tract. There was also significant swelling and deformation in multiple joints. On the medial aspect of the right foot there was a firm, irregular, rubbery subcutaneous nodule measuring 2 x 1.5 cm. The cut surface was whitish-yellow and fibrous.
		+
	== Images ==		== Images ==
	<gallery heights="250px" widths="250px">		<gallery heights="250px" widths="250px">

← Older revision		Revision as of 18:10, 19 August 2013
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−	[[IPLab:Lab 6]]	+	[[Category: IPLab:Lab 6]]