Chapter 34: Assessment and management of inflammatroy rheumatic disorders Flashcards
What are the three distinct characteristics of rheumatologic disorders?
- I____________
- D_____________
- A_____________
Inflammation - complex process resulting in pan u.s.
Degeneration. -secondary process for inflammation
Autoimmunity - Hallmark of rheumatologic disease; Body recognizes own tissue as foreign antigen
-
-
-
-
-
pain
joint swelling
limited movement
stiffness
weakness
fatigue
When using medications for rheumatic diseases, they are used to _________ symptoms, control ______________, and sometimes ________ the disease
control
inflammation
modify
Disease modifying anti rheumatic drugs can (DMARDs) can:
- Suppress the ____________ response
- Alter __________ progression
- Stop or decrease further tissue damage on _______, ________, and __________
autoimmune
disease
joints, cartilage, organs
NONPHARMACOLOGIC PAIN THERAPY FOR RHEUMATIC DISEASE
- __________ application
- Assistive devices — _________/__________
heat
braces/splints
Rheumatoid arthritis has evidence of __________ predisposition and development of immunologically mediated join _____________
genetic
inflammation
RA is classified by the number of _______ involved, positive rheumatoid factor test, abnormal C-reactive protein or erythrocyte sedimentation rate (ESR) and duration of symptoms greater than ___ weeks
joints
6
RA is initially symmetric joint pain and __________ joint stiffness lasting longer than ___ hour
morning
1
Classic symptoms of RA include :
symmetric joint pain, swelling, warmth, erythema, and lack of function
With patients with RA, ______ can be aspirated from inflamed joints
fluid
In RA, patient often guards __________ joints and immobilizes them; too much immobilization can lead to _____________
affected
contractures
Systemic symptoms of RA include:
Fever
weight loss
fatigue
anemia
lymph node enlargement
Raynaud’s phenomenon
Treatment of early RA includes ________ like (MTX) to prevent inflammation and joint damage; benefit usually seen within ___ weeks and tolerate med well; can use ________________ as a bridge in early treatment but shouldn’t use long term. JAK inhibitors can also be used.
DMARDs
6
corticosteroids
Treatment for established RA can include ___ and ____, pace activities, muscle strengthening, ROM; may need to ________ medication regimen and take multiple meds; may need surgery to help with ________________; corticosteroids can be used but for shortest time possible; can do ___________ injections to joint but only sparingly
OT, PT
adjust
functionality
cortisone
Systemic Lupus Erythematous (SLE) is when the ___________ system inaccurately recognizes one or more components of cell’s __________ as foreign and creates antibodies to the nuclear “antigen”; over production of multiple __________ by B cells
immune
nucleus
cytokines
Common manifestations of systemic lupus erythematous
- ___________ rash
- Lupus _________________
- Osteoporosis
- Myositis and _____________
butterfly
glomerulonephritis
poly arthritis
Treatment / management of systemic lupus erythematosis
- M___________ antibodies (Rituxan)
- C______________
- A___________ agents
- NSAIDs
- I______________ drugs
Monoclonal
Corticosteroids
Antimalarial
Immunosuppressant
Primary Sjögren’s Syndrome is when lymphocytic infiltration leading to failure of ________ and ____________ glands
lacrimal
salivary
Manifestations of Primary Sjögren’s syndrome :
- Dry ______
- X__________ (dry mouth)
- Pain and fatigue
eyes
Xerostomia
Treatment / management of Primary Sjögren’s syndrome
- Symptom management and improving QOL — ( __ _____)
- Use of artificial ______, biotene_______ rinse
- No smoking, no anticholinergic medications, no spicy / salty / irritating foods
- Small frequent ______
- Monitor for depression and sleep disturbances
- Education may be challenging due to pain, fatigue, and depression
- Education on self management techniques
no cure
tears, oral
meals
Ankylosing Spondylitis (AS) if an inflammatory disease of the ________; cartilaginous ______ and surrounding tissues become rigid
spine
joints
Manifestations of Ankylosing Spondylitis include:
- ______ pain
- _____________ mobility
- K___________ (stooped position)
back
decreased
Kyphosis
Treatment / Management of Ankylosing Spondylitis include:
- NSAIDs
- M______________ can help with skin and peripheral joint disease, but not spine changes
- C_____________ injections periodically
- Surgery — with advanced cases, osteotomy can improve QoL
- Staying ______ and good _________
- Monitor for and address d___________ and _____________ stress
Methotrexate
Corticosteroids
active, posture
depression, emotional
Gout is caused by hyper___________ due to increased purines which is usual found in meat products. An attack happens when _____________ in joint space phagocytize urate crystals
Hyperuricemia
Macrophages
