Mrs. C is a 50-year-old woman who presents with joint pain. She reports the pain has been present for about 2 years. The pain affects her hands and her wrists. She describes the pain as a “dull aching” and “a stiffness.” It is worse in the morning and improves over 2 to 3 hours. She says that on particularly bad days she uses aspirin with moderate relief. She is otherwise well, except for a history of mild hypertension managed with angiotensin-receptor blocker. She reports no other joint pain. She does not have a history of psoriasis. Her vital signs are: 37.1 C; B/P 128/84; P 84; R 14. There is a 2/6 systolic ejection murmur. Joint exam revealed limited range of motion of the MCPs and wrists bilaterally. There is swelling of the third and fourth MCP on the right and the third on the left. There is pain at the extremes of motion and a boggy quality to the joints. A detailed skin exam is normal. Rheumatoid arthritis (RA) is suspected. 1. What type of hypersensitivity is rheumatoid arthritis? 2. Discuss the pathogenesis related to this particular type of hypersensitivity. 3. What manifestations are exhibited due to the immune dysfunction and why?

Understanding Health Insurance: A Guide to Billing and Reimbursement
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Chapter6: Icd-10-cm Coding
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Mrs. C is a 50-year-old woman who presents with joint pain. She reports the pain has been present for about 2 years. The pain affects her hands and her wrists. She describes the pain as a “dull aching” and “a stiffness.” It is worse in the morning and improves over 2 to 3 hours. She says that on particularly bad days she uses aspirin with moderate relief. She is otherwise well, except for a history of mild hypertension managed with angiotensin-receptor blocker. She reports no other joint pain. She does not have a history of psoriasis. Her vital signs are: 37.1 C; B/P 128/84; P 84; R 14. There is a 2/6 systolic ejection murmur. Joint exam revealed limited range of motion of the MCPs and wrists bilaterally. There is swelling of the third and fourth MCP on the right and the third on the left. There is pain at the extremes of motion and a boggy quality to the joints. A detailed skin exam is normal. Rheumatoid arthritis (RA) is suspected. 1. What type of hypersensitivity is rheumatoid arthritis? 2. Discuss the pathogenesis related to this particular type of hypersensitivity. 3. What manifestations are exhibited due to the immune dysfunction and why?
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