Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
48 Cards in this Set
- Front
- Back
|
Definition of arthritis
|
is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement
|
|
|
Leading cause of work absenteeism
|
Rheumatic diseases
|
|
|
Sources of pain in rheumatic disease
|
Inflammation
Articular cartilage loss Muscle spasm Nerve irritation or compression Bone spur or fx Stretched or torn tissue Referred pain Reflex sympathetic dystrophy |
|
|
Acronym for the warning signs of inflammatory arthritis
|
SERIOUS
|
|
|
Warning sings for inflammatory arthritis
|
Swelling in one or more joints
Early morning stiffness Recurring or tenderness in any joint Inability to move joint normally Obvious redness and warmth of joint Unexplained weight loss, fever, or weakness Symptoms like these persisting for 2 wks |
|
|
Factors in the development of osteoarthritis
|
Aging
Genetics Metabolic factors Biochemical factors Biomechaniacl stress Excessive repetitive stress |
|
|
What joints are typically affected in osteoarthritis?
|
OA typically affects only certain joints, such as the hips, hands, knees, low back and
neck. |
|
|
Disease process of osteoarthritis
|
focal erosive lesions, cartilage destruction, subchondral sclerosis, cyst formation, and large osteophytes at the margins of the joint
|
|
|
How much reduction of weight on each knee is there for each lb lost?
|
4 lb reduction on the load to each knee with each step
|
|
|
Treatment for Osteoarthritis
|
Treatment plans often include a combination of drugs, rest, physical activity, joint
protection, use of heat or cold to reduce pain, and physical or occupational therapy. Corticosteroids or hyaluronic acid derivatives can be injected into joints that are unresponsive to treatment |
|
|
Definition of Rheumatoid arthritis
|
is a chronic inflammatory disease of the joints that affects an estimated 1.3 million Americans. The disease occurs when the body’s immune system – which normally protects from us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, inflammation, loss of function and disability.
|
|
|
Can symptoms of Rheumatoid arthritis go away completely?
|
Yes with appropriate treatment
|
|
|
What joints are typically involved in Rheumatoid arthritis?
|
Polyaticular, symmetric
MCP,PIP, wrist, knee, and MTP joints |
|
|
Systemic effcts of RA
|
feer, weight loss,fatigue, muscle atrophy,prolonged morning stiffness
|
|
|
What might you see on a physical exam on a person with RA
|
synovitis, loss of joint motion, crepitus, nodules,systemic signs such as vasculitic lesions, episcleritis
Lymphadenopathy,peripheral neuropathy |
|
|
What lab values will be elevated in RA?
|
Rheumatoid factor and ESR
WBC Platelets elevated in active disease CRP usually present H&H may be decreased |
|
|
What is Felty's sydrome?
|
rheumatoid arthritis, an enlarged spleen, an abnormally low white blood count),
|
|
|
Clinical features of Rheumatoid foot
|
pronation of the foot
Hallux valgu-bunion depression of the metatarsal heads Hammer or claw toes Tendocalcaneal bursitis subplantar spur formation |
|
|
What are DMARDS?
|
An acronym for disease-modifying antirheumatic drugs, DMARDs are drugs that work slowly to actually modify the course of the disease. In recent years, the most commonly used DMARD for rheumatoid arthritis is methotrexate. But there are about a dozen others that fall into this category. They include hydroxycholorquine (Plaquenil), sulfasalazine (Azulfidine, Azulfidine EN-Tabs), leflunomide (Arava) and azathioprine (Imuran).
|
|
|
Why would corticosteriods be used in RA?
|
are potent and quick-acting anti-inflammatory medications. They may be used in RA to get potentially damaging inflammation under control
|
|
|
What is Ankylosing spondylitis ?
|
Ankylosing spondylitis is a chronic inflammatory disease that primarily causes pain and inflammation of the joints between the vertebrae of your spine and the joints between your spine and pelvis (sacroiliac joints). However, ankylosing spondylitis may also cause inflammation and pain in other parts of your body as well. EVENTUALLY CAUSES FUSION OF THE SPINE
|
|
|
Initial symptoms of Ankylosing spondylitis
|
Early signs and symptoms of ankylosing spondylitis may include:
Chronic pain in your lower back and hips, especially in the morning and after periods of inactivity Stiffness in your lower back or hip area |
|
|
Progressive symptoms of Ankylosing spondylitis
|
. Over time the pain and stiffness, which usually begin gradually, may progress up your spine and to other joints. You may experience inflammation and pain in these other parts of your body:
Where your tendons and ligaments attach to bones Joints between your ribs and spine Joints in your hips, shoulders, knees and feet Your eyes |
|
|
Symptoms of advanced stages Ankylosing spondylitis
|
Restricted expansion of your chest
Chronic stooping Stiff, inflexible spine Fatigue Loss of appetite Weight loss Eye inflammation (uveitis) Bowel inflammation |
|
|
Joints typically involved in Ankylosing spondylitis
|
Spine,sacroilliac, shoulders, hips
|
|
|
What is Psoriatic arthritis ?
|
a form of arthritis that affects some people who have psoriasis, a serious skin condition. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but arthritis can sometimes develop before skin lesions appear.
Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission. Inflammatory with accelerated skni turnover |
|
|
What is reactive Arthritis?
|
is a condition triggered by an infection that occurs in another part of your body — most often your intestines, genitals or urinary tract
|
|
|
Defining feaatures of reactive arthritis
|
Painful and swollen joints are a defining feature of reactive arthritis, which typically targets the knees, ankles and feet. Reactive arthritis can also cause inflammation in your eyes, skin and the tube that carries urine from your bladder (urethra).
|
|
|
Another name for reactive arthritis
|
Reiter syndrome
|
|
|
What is Scleroderma?
|
is a group of rare, progressive diseases that involve the hardening and tightening of the skin and connective tissues — the fibers that provide the framework and support for your body.
|
|
|
What does localized scleroderma affect?
|
The skin
2 types Morphea. This variety features oval-shaped thickened patches of skin that are white in the middle, with a purple border. Linear scleroderma. This variety, which is more common in children, features bands or streaks of hardened skin on one or both arms or legs, or on the forehead. |
|
|
What does systemic scleroderma affect?
|
Systemic scleroderma also harms internal organs, such as the heart, lungs, kidneys and digestive tract
|
|
|
What is CREST syndrome?
|
calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome
|
|
|
What is Raynaud's phenomenon?
|
An exaggerated response to cold temperatures or emotional distress, this condition constricts the small blood vessels in the hands and feet and causes numbness, pain or color changes in the fingers or toes.
|
|
|
What is polymyositis
|
is an uncommon connective tissue disease. It's a type of inflammatory myopathy, which is characterized by muscle inflammation and weakness. The most noticeable characteristic of polymyositis is weakness of the skeletal muscles, which control movement.
|
|
|
Goals of Rheumatic Disease Management 8
|
Control inflammation
Relieve pain Maintain/improve function prevent/correct deformity provide psychosocial support provide pt education encourage self management tecniques modify activity appropriatly |
|
|
Elements of Comprehensive management of Rheumatic disease
|
Early intervention
Individualized approach Team approach Continuity of care patient Education Family involvement |
|
|
Reasons for NSAID failure in rheumatic diseases
|
inadequate dosing
drug interactions Insufficient time to obtain response Inefficacy of the drug nonadherence Reverse placebo effect toxicity |
|
|
How do DMARS work
|
They reduce inflammation and suppress the immune system
|
|
|
Examples of DMARDS
|
Hydroxychloroquine
IM gold Oral gold MTX Penocillamine Azulfidine Azathloprine |
|
|
Common side effects of DMARDS
|
Protien, WBC and RBC in urine
Rash, pruritis decreased cbc N/V/D mouth sores Liver and lung fibrosis Increased risk of cancer |
|
|
What is Fibromyalgia?
|
is a chronic condition characterized by widespread pain in muscles, ligaments and tendons, as well as fatigue and multiple tender points
|
|
|
What are sx of Fibromyalgia/
|
Widespread pain and tender points; widespread meaning it affects both sides of the body, as well as above and below the waist
Pain is described as a constant dull ache, typically starting from the muscles Fatigue Sleep disturbances |
|
|
Tender points associated with fibromyalgia
|
Occiput
Low cervical Trapezuis Supraspinatus Second rib Lateral epicondyle Gluteal Greater trochanter knees 18 when you count both sides |
|
|
Other than tender points more symptoms of Fibromyalgia
|
Occiput
Low cervical Trapezuis Supraspinatus Second rib Lateral epicondyle Gluteal Greater trochanter knees Night sweats Visual problems Dizziness Painful menses GI complaints Memory impairment Anxiety Depression |
|
|
Some coexisting conditions associated with fibromyalgia
|
Chronic fatigue syndrome
Depression Endometriosis Headaches Irritable bowel syndrome (IBS) Lupus Osteoarthritis Post-traumatic stress disorder Restless legs syndrome Rheumatoid arthritis Mitral valve prolapse Raynaud’s syndrome Episodic hypoglycemia |
|
|
DX criteria for fibromyalgia
|
History of widespread pain; must be present for 3 months
Pain in 11 of 18 tender/trigger point sites on digital palpation |
|
|
Treatment for fibromyalgia
|
Analgesics: to help reduce pain
Anti-Depressants Gabapentin (Neurontin): Pregabalin (Lyrica) 75mg Physical therapy: Specific exercises can help restore muscle balance and may reduce pain; stretching techniques and the application of hot or cold also may help Massage therapy Acupuncture Stress Management Relaxation Techniques TENS units Injection of trigger points with 1% solution of lidocaine |
