Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RS PTRS 746 Musculoskeletal Conditions > Arthritis > Flashcards

Arthritis Flashcards

1
Q

Arthritis consists of over ___ different diseases/conditions

-___ under age 65

A
  • 100

- 2/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define rheumatoid arthritis

A

a systemic inflammatory disease primarily affecting joint synovium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

define osteoarthritis/ degenerative joint disease

A

localized process involving destruction of cartilage tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does OA look like on a radiograph?

A

sclerosis/thickening of the bone. lights up bright white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does RA look like on a radiograph?

A

washed out bone, inflammation, joint space narrowing, joint erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

RA

  • spontaneous ____
  • related to _____
A
  • exacerbation and remission

- other rheumatologic conditions (JRA, SLE, scleroderma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Criteria for RA (conditions)

A

must meet 4/7, 1-4 must be > 6 weeks duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Criteria for RA

A
  1. morning stiffness (at least 1 hour)
  2. arthritis of 3 or more joint areas
  3. arthritis of hand joints
  4. symmetry
  5. rheumatoid nodules
  6. positive serum rheumatoid factor
  7. radiographic evidence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

RA

  • women __ men
  • peak age
A
  • more women than men (2:1 or 3:1 ratio)

- between 60-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

RA

  • type of disorder
  • etiology
  • rheumatoid factor
A
  • autoimmune
  • unknown
  • autoantibody against IgGFc; in about 70% of patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patho of RA

  • infiltration of synovium by ___
  • production of ____
  • hyperplastic synovium invades ___
  • other things that occur
A
  • CD4+ Tcells, B cells, monocytes/macrophages
  • inflammatory cytokines and chemokines
  • (pannus) invades cartilage, subchondral bone, articular capsule, and ligaments
  • venous distension, cap. obstruction, thrombus, hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic tests for RA

A

no single test
exclude other diagnoses
clinical presentation
lab/radiographic findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

differential diagnosis (name a few)

A

OA, reiter’s syndrome, IBD, gout, psoriatic arthritis, polymyalgia, infection, fibromyalgia, SLE, sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical presentation of RA

A

insidious onset, symmetrical morning stiffness, generalized fatigue, weight loss, depression, rapid progression in first 6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 types of disease course

A
  • monocyclic: (20%) one episode that abates within 2 yrs
  • polycyclic: (70%) fluctuating
  • progressive and unremitting (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

patterns of RA involvement

  • symmetrical
  • ____ most commonly involved
  • joint _____
  • crepitus
  • 80% develop _____ within 10 years
A
  • hands and wrists
  • inflammation
  • permanent joint abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

patterns of RA involvement

  • _____ rarely involved
  • ______ sometimes affected
  • may be accompanied by ________
A
  • axial skeleton
  • cervical spine
  • joint ankylosis or ankylosing spondylitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ABCs of radiology

A

alignment, bone density, cartilagenous spacing, soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RA involvement of wrist

A

volar subluxation and ulnar displacement of carpals in relation to radius

  • flexion contractures
  • De Quervain’s and carpal tunnel common (due to synovitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is often the first clinical feature of RA?

A

symmetric MCP and PIP joint involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

RA hand involvement

  • MCPs
  • PIPs
  • Thumb
  • DIPs
A
  • volar subluxation and ulnar drift
  • swan neck and boutonniere deformity with osteophytes, bouchard’s nodes
  • IP hyperextension and MCP flexion, with progressive CMC involvement
  • usually uninvolved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

mutilans deformity

A

severe deformity with profound instability and functional impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

RA of the hip joint

A
  • not as common as in RA
  • characteristic joint space narrowing with intact articular cortex
  • consider treatments that reduce risk of hip joint degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

RA of the knee joint

A

commonly involved, large amount of synovium

-flexion contractures due to pain and muscle guarding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

RA of the foot/ankle

  • ____ hindfoot
  • collapse of _____
  • hallux valgus
  • MTP ____
  • ______ toes
A
  • pronated
  • longitudinal and transverse arches
  • subluxation
  • hammer/claw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

RA muscle involvement contributions

A

disuse atrophy, myositis, steroid-induced myopathy/peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

RA involvement of tendon/ligament

A

tenosynovitis: interrupts gliding at tendon sheath, causing damage and potential for rupture
- flexor tenosynovitis is a poor prognostic factor

28
Q 
radiographic features of RA
(stages I-IV)
-early
-moderate
-severe
A
  • no radiographic evidence, possible OP
  • OP with slight cartilage destruction, muscle atrophy, no joint deformity
  • OP and destruction of cartilage and bone, jt. deformity without ankylosis, extensive atrophy
  • stage III+ fibrous or bony ankylosis
29
Q
  • sensitivity

- specificty

A
  • ability to avoid a false negative

- ability to avoid a false positive

30
Q

lab tests (RA)

  • RF
  • erythrocyte sedimentation rate (ESR)
  • C-reactive protein
A
  • negative in up to 30% of those with RA, can be positive without RA
  • often elevated
  • elevation indicates acute inflammation
31
Q

lab tests (RA)

  • CBC
  • synovial fluid analysis
A
  • decreased RBCs (anemia or chronic disease), normal WBCs, platelets may be elevated
  • usually turbid with neutrophils, culture to rule out infection
32
Q

Complications/Impairments with RA

A

functional impairments, deconditioning, rheumatoid nodules, vascular complications, neuro complications, cardiopulm, ocular (sjogren’s syndrome)

33
Q

Pharm for RA

A

NSAIDS, DMARD (disease modifying anti-rheumatic drugs), BRM (biological response modifiers)

34
Q

Pharm for RA

A

NSAIDS, DMARD (disease modifying anti-rheumatic drugs), BRM (biological response modifiers)

35
Q

OA is a ____ that is confined to ______

A

localized process

affected joints

36
Q

2 pathologic features of RA

A
  • progressive destruction of articular cartilage

- formation of bone (osteophytes) at the margins of the joint

37
Q

Diagnostic criteria for OA

A

asymmetrical involvement, lack of generalized symptoms, morning or post-activity stiffness (shorter than RA), pain is variable, radiographic tests?

38
Q

Epidemiology of OA

-knee ___ hip

A

knee >hip 13.8%-3.1%

39
Q

Primary OA

A

idiopathic, unknown etiology

40
Q

Secondary OA

A

identifiable trauma, congenital malformation, or other musculoskeletal disease
-increased age (not normal aging though), trauma, occupational/functional tasks, obesity, infection

41
Q

Pathophys of OA

A

initial increase in articular cartilage H2O, proteoglycan/collagen increase, later, proteoglycan loss reduces compressive stiffness and elasticity

42
Q

Radiographic criteria for OA

A

osteophytes, joint space narrowing, deformity

43
Q

Radiographic findings for OA vs. RA

A

OA- bone formation

RA- bone erosion

44
Q

Radiographic findings for OA vs. RA

A

OA- bone formation

RA- bone erosion

45
Q

UE joint involvement for OA

A

DIPs, PIPs, thumb, CMC

46
Q

heberden’s nodes

A

osteophyte formation at the DIP (may also occur in RA, but more common in OA)

47
Q

protective position of the hip in OA

A

hip flexion, abduction, external rotation

48
Q

decreased hip ROM relates to _______

A

decreased walking speed and functional limitations

49
Q

Knee OA

  • most prevalent
  • functional impact
A

-similar to CHF, COPD

50
Q

Kellgren and Lawrence Grading system for OA

  • grade 0
  • grade 1
  • grade 2
  • grade 3
  • grade 4
A
  • normal
  • possible osteophytes, questionable joint narrowing
  • definite osteophyte formation
  • moderate osteophytes, narrowing, possible deformity
  • large osteophytes, marked narrowing, sclerosis, deformity
51
Q

OA pharmacologic therapy

A 
goal is pain control
-medication, patient education
-joint protection
exercise
-NSAIDS
-Corticosteroid injection
-viscosupplementation (hyalouronic acid)
-topical analgesics
52
Q

neutraceuticals

A

glucosamine sulfate

chondroitin sulfate

53
Q

3 primary indications for sugery

A

intractable pain
loss of function
progression of deformity

54
Q

soft tissue procedures

A

synovectomy
soft tissue release
tendon transfer

55
Q

bone and joint procedures

A

osteotomy
arthroplasty
arthodesis

56
Q

caution with _____

A

MMT, use or modify functional tests

57
Q

Goals of rehab

A

decrease pain, increase or maintain ROM, increase or maintain strength, improve joint stability, decrease mechanical joint stress, increase functional endurance, maximize ADLs, improve gait gait efficacy and safety, establish conditioning programs

58
Q

Goals of rehab

A

decrease pain, increase or maintain ROM, increase or maintain strength, improve joint stability, decrease mechanical joint stress, increase functional endurance, maximize ADLs, improve gait gait efficacy and safety, establish conditioning programs

59
Q

Acute rehab mgmt

A

reduce pain and inflammation, rest affected joints, modalities, maintain ROM, strength, endurance, functional independence

60
Q

subacute rehab mgmt

A

progress ROM, strength, endurance and functional training, improve performance and range of ADLs, joint protection

61
Q

chronic rehab mgmt

A

independence in ADLs, return to vocation, recreation, patient education

62
Q

Modalities for arthritis

A

superficial heat, deep heat (questionable), cold modalities, TENS

63
Q

strengthening interventions

A

isometric or sub-max, add dynamic, concentric, and eccentric, use resistance with caution, exercise-induced discomfort should subside within one hour

64
Q

gait/functional training

  • improve ____
  • cane
A
  • walking speed, and normalize gait

- may unload hip up to 60%

65
Q

Education

A

disease process, joint protection, pain mgmt, resources

RS PTRS 746 Musculoskeletal Conditions (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions