Arthritis Flashcards
Which arthitisis is more common in men? In women?
Gout- men
AS-men
RA- women
OA- women
How do the inflammatory arthitises compare and differ?
What structure is affected and how?
OA- wear and tear
-low grade inflamm
RA- autoimmune
-poly articular, symmetrical, migrating,
Lots of inflamm to jt
As- autoimmune, genetic
Gout-caused by uric acid deposits, chemical arthritis not autoimmune
What’s the first thing you do in gout op?
Undrape the foot. Don’t touch it.
Hydro- gout
Cool foot bath- only thing they can tolerate.
Bucket filled with cool water, slowly gonna put your foot into it, gonna leave for 5-10 min
What is a positioning modification you must consider for gout?
Foot must be higher than the knee or else it won’t drain for the treatment bc there is swelling and inflamm.
What are some compensatory features in gout?
-other leg
-back
Change in gait
Acute- gout means it is absolute CI in treatment.
T/F?
True.
AS: where do the changes occur?
-Where ligaments insert into home
Differentiate Btwn the two types of AS and name them.
-Marie strumpell type- most common, begins in SI and goes up spine
Bechterew- rare, starts in cervical region and goes downward
Which vertebra of c-spine are most commonly affected for each type of arthritis?
-
What are some factors found in the blood of ppl with arthritis?
RA-
AS- HLA-B27
Bamboo spine is a characteristic of which type of arthitis? What is it?
AS- result of inflammation of ligaments that make it look like a bamboo in an X-ray (ossification of annulus fibrosis)
Organs and tissues In other parts of body can be affected with arthitis. What are some of the organs and what is the name of the conditions?
- uveitis/ iritis (for eyes)
- liver, spleen, kidneys and adrenal cortex (amyloidosis- metabolic disorder caused by the production and depositing of a protein-polysaccharide complex resembling starch, structures become waxy and translucent)
Is constipation relevant to treat for AS?
Yes. It can be a result of the medication or from the vertebrae fusing.
What is the focus of remex for AS?
Back strengthening of extensor mm.
- standing up tall, shoulder retractors, glutes
What are factors that make RA diff?
RF factor in blood, exacerbation and remission, joints very swollen, flu like symptoms in flare up
What does DMARDs stand for and what is it used for?
Disease modifying anti-rheumatic drugs, fast acting medication
Differentiate Btwn the different types of deformities seen with RA?
Boutonnière deformity Swan neck deformity Bouchards nodes (inflamm of pips)
State the definition for gout and gouty arthritis:
Do they always go together?
Gout- high amounts of uric acid in blood (does not always develop into gouty arthritis)
Gouty arthitis- inflamm arthitis by mono sodium urate crystals in jts and tendons. Chemical cause.
What is one of the oldest recorded diseases in medical history?
Gout
Which gender is most likely to get gout?
Males
What is uric acid?
A metabolite; waste product from meats
2 reasons body may not be able to dispose of uric acid?
1) too much of the chemical- overindulgence of food or alcohol
2) kidney compromised
What are tophus/ tophi and which condition are they associated with?
Clusters of sodium urate combined with dead cells and enzymes. Look like punched out lesions on X-rays. Can be mistaken for rheumatoid nodules. Usually happen 10 yrs after first gout attack.
What is the most common attack site of gout?
MT joint of digit 1
What makes AS presentation in women unique?
Tends to present unilaterally
What is the cause of AS?
Idiopathic. But 30 times more common with family history of it. Genetic markers.
How does AS present in children and what is it commonly misdiagnosed as?
Starts in peripheral joints first. Misdiagnosed as juvenile RA.
What culture most frequently seen with AS?
North American native
AS is classified as a aero negative apondyloarthropathy because there is a presence of rheumatoid factor.
False. Rheumatoid factor is absent.
Where is the most common site of inflamm for AS?
Ligaments, periosteum, synovium of Si and lumbar jts
Which arthritis can mimic sciatica?
AS
Fatigue, fever, anorexia. Weight loss and anemia are signs of which type of arthitis?
AS
What conduction would present with question mark deformity on postural assessment? What is this posture?
AS- loss of lumbar lordosis, thoracic kyphosis, head forward carriage
Define RA
Chronic systemic autoimmune disorder causing symmetrical erosive synovitis of the joints. Eyes lungs and cardiovascular system may also be affected
Name the 7 clinical manifestations of RA; how many need to be present and for how long for a diagnosis?
At least 4 for minimum 6 weeks:
1) morning stiffness at least 1 hr
2) arthritis of 3 or more joints
3) arthritis of hand joints
4) symmetric arthritis
5) rheumatoid nodules
6) serum rheumatoid factor
7) radio graphic changes
What are some of the causes of RA?
- idiopathic
- genetic marker HLA
- rheumatoid factor present
- bacterial or viral
- emotional and physical trauma or stress exacerbate attacks
What is the rheumatoid personality?
Psychological component: hostility and rigidity
Now seen as a response to chronic pain and fear, depression and anxiety
Describe how the joints are affected in RA:
Bilateral, symmetrical, poly articular, migrating
Rheumatoid nodules, ulnar deviation and bakers cyst are some possible symptoms of which arthritis condition?
RA
Vasculitis, pericarditis, pleuritis, episcleritis and scleritis (nodules on whites of eye), sjorgens syndrome (pathologically dry eyes and mouth) are possible to which arthitis?
RA
