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Adult Health 2 Test 4 > Arthritis and Connective Tissue Diseases > Flashcards

Arthritis and Connective Tissue Diseases Flashcards

1
Q

What is osteoarthritis?

A

Most common form of joint disease in North America
Progresses slowly
Noninflammatory/synovial joints
Formation of new joint tissue in response to cartilage destruction
women affected more than men
joint pain/stiffness
decreases after rest/intensifies after activity
as disease progresses pain with rest also
pain due to soft tissue involvement
crepitation (grating sensation)

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2
Q

What are clinical manifestations of osteoarthritis?

A

deformity: specific to involved joint
appears as early as 40
tends to be seen in family members
Knee OA often leads to joint malalignment
altered gait
Advanced hip OA may cause one leg to be shorter

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3
Q

What diagnostic studies are used for patients with osteoarthritis?

A

X-rays are helpful in confirming disease and staging the progression of joint damage
Bone density
Bone scan
CT, MRI

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4
Q

How do you treat osteoarthritis?

A 
manage pain-Analgesic-Tylenol, topical salicylates 
NSAIDS
Rest but also positioning and exercises 
Weight reduction if needed 
TENS unit 
Surgery
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5
Q

What does SLE typically affect?

A 
skin
muscle 
lining of lungs 
heart 
nervous tissue 
kidneys
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6
Q

What happens with SLE?

A

multi-system autoimmune inflammatory disease
production of large variety of autoantibodies
multiple influences
genetic
hormonal
environmental
immunologic
can be mild to severe
accumulation of circulating immune complexes
chronic unpredictable course
waxes and wanes

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7
Q

What are the dermatologic manifestations of SLE?

A 
alopecia 
butterfly rash
discoid erythema 
palmar erythema 
mucosal ulcers
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8
Q

What are manifestations in the central nervous system of SLE?

A 
stroke 
seizures 
peripheral neuropathy 
psychosis 
organic brain syndrome
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9
Q

What are manifestations in the cardiopulmonary system of SLE?

A 
endocarditis 
myocarditis 
pericarditis 
pleural effusion
pneumonitis 
Raynaud's phenomenon
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10
Q

What are manifestations in the hematopoietic system of SLE?

A 
anemia 
leukopenia 
lymphadenopathy 
splenomegaly 
thrombocytopenia
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11
Q

What are manifestations in the urinary system of SLE?

A

glomerulonephritis
hematuria
proteinuria

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12
Q

What are manifestations in the gastrointestinal system of SLE?

A

abdominal pain
diarrhea
dysphagia
nausea and vomiting

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13
Q

What are manifestations in the musculoskeletal system of SLE?

A

arthritis
myositis
synovitis

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14
Q

What are manifestations in the reproductive system of SLE?

A

menstrual abnormalities

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15
Q

How do you diagnose SLE?

A 
History 
Physical exam
Laboratory studies 
  ANA 
  anti-Sm
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16
Q

What criteria do you need for a diagnosis of SLE?

A

malar rash
discoid rash
photosensitivity
oral ulcers
arthritis: nonerosive, involvement of two or more joints characterized by tenderness, swelling and effusion
Serositis: pleuritis or pericarditis
Renal disorder: persistent proteinuria or cellular casts in urine
Neurologic disorder: seizures or psychosis
Hematologic disorder: hemolytic anemia, leukopenia, lymphopenia, or thrombocytopenia
Immunologic disorder: positive LE preparation; anti-DNA antibody or antibody to Sm nuclear antigen or false-positive serologic tests for syphilis
Antinuclear antibody

17
Q

What collaborative care do you have for SLE?

A

Early diagnosis
Prompt recognition of serious organ involvement
Manage active phase
Prevent complications

18
Q

What is the pharmacological treatment of SLE

A 
NSAIDS
Anticoagulants 
  Warfarin (Coumadin)
Anti-malarial medications 
  Hydroxychloroquine (Plaquenil)
Corticosteroids 
  Prednisone 
  Solumedrol 
Immunosuppressive medications 
  Azathiopine (Imuran)
  Cyclophosphamide (Cytoxan)
19
Q

What are goals for patients with SLE?

A

Provide pain relief
Comply with therapeutic regimen to achieve Maximal symptom management
Demonstrate awareness of and avoid activities that exacerbate condition
Maintain optimal role function and positive image

20
Q

What is Rheumatoid Arthritis

A

Chronic systemic autoimmune disease
Characterized by inflammation of the connective tissue of synovial joints
Periods of remission and exacerbations
Extra-articular manifestations

21
Q

What are clinical manifestations of Rheumatoid Arthritis?

A 
Joints 
 insidious onset 
 pain 
 stiffness 
 limitation of motion 
 inflammation 
 symmetrical 
 affects small joints of hands and feet
22
Q

What are extrarticular manifestations of Rheumatoid Arthritis?

A

rheumatoid nodules
Sjogren’s syndrome - targets moisture producing glands - leads to dry mouth and eyes
Felty syndrome - swollen and elevated WBC

23
Q

What are complications of Rheumatoid Arthritis?

A 
Joint destruction 
  Flexion contractures 
  Joint deformities 
Cataract development 
Bone destruction 
Ulcerations 
Progressive hoarseness
24
Q

How do you diagnose Rheumatoid Arthritis?

A

History and physical findings
Laboratory tests
Synovial fluid analysis
X-rays

25
Q

What is the pharmacologic treatment of Rheumatoid Arthritis?

A 
Immunosuppressants 
  Methotrexate (Rheumatrex)
Sulfasaline (Asulfidine)
Antimalarial 
  Hydroxychloroquine (Plaquenil)
Biologic/targeted therapy
  Etanercept (Enbrel)
  Infliximab (Remecade)
26
Q

What are acute interventions for patient with Rheumatoid Arthritis?

A

Pain management

Help them to be as independent as possible

27
Q

What are goals for patients with Rheumatoid Arthritis?

A

Have satisfactory pain relief
Minimal loss of functional ability of affected joints
Participating in and carrying out the therapeutic regimen
Maintain a positive self image
Perform self-care activities to great potential

28
Q

What are clinical manifestations of systemic sclerosis?

A

Raynaud’s phenomenon

Skin and joint changes

29
Q

What are skin changes with systemic sclerosis?

A

sweat glands become compressed
loses hair
fat goes away
blood vessels are being compressed (decrease in circulation)

30
Q

What are three soft tissue rheumatic syndromes?

A

myofascial pain syndrome
fibromyalgia syndrome
chronic fatigue syndrome

31
Q

What is fibromyalgia syndrome?

A

It is questionable if it is genetic
s/s: Pain, sleep issues, fatigue
Diagnostic studies: nothing specific
Treatment: treat symptoms and psychologic issues, yoga, better nutrition
disease is life-long; may only be able to decrease or alleviate symptoms

32
Q

Wat is chronic fatigue syndrome?

A

debilitating fatigue
diagnosis is of exclusion
nursing care: supportive management
Drugs: NSAIDS, antihistamines, tricyclic antidepressants, sleep meds

Adult Health 2 Test 4 (5 decks)

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