Connective Tissue Disorders Flashcards
Osteoarthritis
-most common joint disease, flexible tissue at end of bones (cartilage) starts to wear down
-risk factor is aging but this is not a normal process of aging
-african american women
-progressice pain over time, boney swelling, crepitus, morning stiffness less than 30 min
-nothing can be done to stop progression, goal is to decrease pain and improve or maintain joint mobility
-heat or cold compress, aerobic exercise, PT
-mild to moderate: tylenol or NSAID, intraarticular injection
What to monitor for patients taking tylenol or NSAID’s?
tylenol: monitor liver
NSAID’s: monitor for bleeding and kidney issues
`Rheumatoid Arthritis
-autoimmune, inflammatory process that affects freely moving joints usually bilateral wrist, ankles, knees
-affects females 3 times as much as men
-peripheral joint pain & swelling w/erythema, morning stiffness > 30 min
-symmetrical joint involvement, synovitis is objective MD can tell on exam w/palpation
-swan neck deformity, osteopenia, episcleritis, scleritis, symptoms longer than 6 weeks
-labs: RA factors, CRP, ESR
-pharm: analgesics, NSAID’s, glucocorticosteroids, DMARD’s, joint replacement
-goal is to control inflammation that leads to joint destruction
Reactive Arthritis
-After GI or GU infection
-young males
-conjunctivitis, urethritis, arthritis (cant see, cant pee, cant climb tree)
-treat underlying cause, NSAID, steroids for serious cases
Psoriatic Arthritis
-inflammatory arthritis associated with psoriasis, 7% of psoriasis patients will get it
-onset 30-50 y/o
-synovitis, polyarthritis, spondylitis
-NSAID’s, steroids oral or injections
Lupus
-chronic inflammatory disease that can affect any organ
-female to male ratio in children 3:1 and 15:1 in child bearing years
-african american women
-symptoms will vary from person to person
-most common sign is butterfly rash on face
-NSAID’s, Antimalarial (hydroxychloroquine), steroids (glucocorticoids), immunosuppresive agents (methotrexate)
-patients go through periods of flare ups and remission
-MUST USE SUNSCREEN, NO LIVE VACCINES, NO ORAL CONTRACEPTIVES
-complications: kidney, renal, heart disease, nephrectomies
Gout
-inflammatory arthritis characterized by recurrent attacks of painful, red, swollen joint caused by monosodium urate crystals
-risk factors: obesity, HTN, large amount of meat and seafood and alcohol
-signs are intense pain, gout nodules, tophi, redness & swelling of joint, dont want bed sheet because of extreme pain
-labs: high uric acid levels (hyperuricemia)
-examination of synovial fluid is only definitive diagnosis
-low purine diet
-FOR ACUTE: NSAID’s, colchicine, steroids, NO ALLOPURINOL
-FOR CHRONIC: uric acid lowering agents (allopurinol)
-STAGES: acute, intercritical (asymptomatic period), chronic
-repeated attacks lead to production of tophi (uric acid deposits)
-podagra is term used to identify gout in that first metatarsal phalangeal joint
Fibromyalgia
-chronic pain disorder of soft connective tissues
-normal pain signals amplified
-patients with RA, Lupus
-widespread pain, insomnia, fatigue, cognitive dysfunction (brain fog)
-feeling of pain more intense than others, patient reports hurting all over and flu symptoms, no inflammatory markers
pharm: anti depressants, anti seizure (lyrica)
-can be triggered by infection or physical or emotional trauma (anniversary, deaths), stress
Ankylosing spondylitis
-chronic inflammation of the spine, stiffening of the joints of the spine causing decreased mobility leading to kyphosis
-more common and severe in males, patients with GI issues
-signs are low stability and balance, primarily severe back pain, can also spread to knees, hips, shoulders, heart and lungs can be constricted
-can cause respiratory compromise, pulmonary fibrosis
Scleroderma
-autoimmune caused by external triggers, eventually the tissue degenerates and becomes nonfunctional
-more common in women ratio 3:1, african american
-localized= skin only
-systemic=lungs, heart, kidneys
-limited= insidious, raynauds before diagnosis
-diffuse= rapid onset, affects internal organs, raynauds concurrently or after
-lab test: ANA
-3 important signs: raynauds, renal crisis, pulmonary artery hypertension
-pulmonary disease leading cause of death
