Which is a chronic inflammatory and autoimmune disease affecting peripheral synovial joints of bone?

RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Explanation

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder that causes the immune system to attack the body's own tissues, specifically the synovium (the lining of the membranes that surround the joints).
The condition is characterized by a nonsuppurative proliferative and inflammatory synovitis, which perfectly matches the 'chronic inflammatory' and 'autoimmune' descriptors in the question.
RA principally affects the peripheral joints, such as those in the hands, wrists, feet, and ankles, often in a symmetrical pattern (affecting the same joints on both sides of the body).
The inflammation can eventually lead to bone erosion and joint deformity if not adequately treated.

Option B: Polyarthritis is a descriptive term, not a specific disease. It simply means that five or more joints are inflamed.
Option C: Osteoarthritis is primarily a degenerative ('wear-and-tear') disease, not an autoimmune or primarily inflammatory condition. It results from the breakdown of cartilage in joints over time.
Option D: Ankylosing Spondylitis is an inflammatory arthritis, but it primarily affects the axial skeleton—the spine and sacroiliac joints—not the peripheral joints as its main feature.

Visual 1: Diagram - A side-by-side comparison of a healthy joint, a joint with Rheumatoid Arthritis (showing synovial inflammation and pannus formation), and a joint with Osteoarthritis (showing cartilage loss and osteophytes). This helps visually differentiate the core pathologies.
Visual 2: Illustration - The typical symmetrical pattern of joint involvement in Rheumatoid Arthritis, highlighting the small joints of the hands and feet.
Visual 3: X-ray Image - An X-ray of hands affected by advanced RA, showing characteristic features like joint space narrowing, bony erosions, and ulnar deviation.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of inflammatory and degenerative joint diseases helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in managing RA by administering medications (like DMARDs and biologics), educating patients on disease management, and helping with pain control and mobility.
Patient education is key. Nurses must teach patients about the importance of balancing rest and activity, joint protection techniques, and recognizing signs of a disease flare-up.
RA is a systemic disease, meaning it can affect other organs like the skin, eyes, lungs, and heart. Nurses must perform holistic assessments to monitor for these extra-articular manifestations.

How to Approach the Question

First, break down the question stem into its key components: 1) chronic inflammatory, 2) autoimmune, and 3) affects peripheral synovial joints.
Next, evaluate each option against these three criteria.
Consider Option A, Rheumatoid Arthritis. It is known to be chronic, inflammatory, autoimmune, and primarily affects peripheral joints. This is a strong match.
Evaluate Option B, Polyarthritis. Recognize this is a symptom (inflammation in many joints), not a specific disease.
Analyze Option C, Osteoarthritis. Recall that this is a degenerative 'wear-and-tear' condition, not primarily autoimmune or inflammatory.
Examine Option D, Ankylosing Spondylitis. This is inflammatory but primarily affects the axial skeleton (spine), not peripheral joints.

Concept Tested & Keywords

Concept Tested: Pathophysiology of inflammatory and degenerative joint diseases
Stem keywords: chronic inflammatory, autoimmune disease, peripheral synovial joints
Lead-in keywords: Which is

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