Infection and Inflammation Flashcards
N201
What is osteoarthritis (OA)?
Slow progressive noninflammatory disorder of the diarthrodial (synovial) joints.
Think wear and tear
Etiology & Pathophysiology of OA
-gradual loss or destruction of articular cartilage.
-Cartilage become weak & dull.
-Formation of osteophytes occur.
Main cause of OA?
-No single cause.
-Caused by an event or condition which leads to joint instability.
What can cause OA?
-Drugs (e.g. indomethacin & corticosteroids)
-Hematologic/ endocrine (e.g. chronic hemarthrosis)
-Joint instability
-Mechanical stress (e.g. sports)
-Neuro problems (e.g. diabetic neuropathy)
-Skeletal deformities (e.g. broken hip)
-Trauma
Risk factors for OA?
-Age
-Decreased estrogen increases the risk in women.
-Obesity
-Anterior cruciate ligament (ACL) , injury from sports.
-Work (constant kneeling & stooping)
Regular moderate exercise decreases risk
Clinical manifestation of joint pain (OA).
-NO SYSTEMIC MANIFESTATIONS!
-Joint pain (main symptom)
-Joint stiffness
-Crepitation
-Affects asymmetrically
-Deformities
Joint pain with OA typically goes away with rest? true or false?
-True
-Typically occurs in the morning, but resolves in 30 mins.
-This is what distinguishes it from RA.
What can happen with OA affecting joints asymmetrically?
-One limb will initially be affected.
-Strong limb will over compensate.
-The strong limb becomes more susceptible.
Cold therapy pt. teaching…
-For inflammation
-Cover source w/ towel or cloth.
-Keep off areas w/ radiation, open wounds, & poor circulation.
- If it’s not possible to apply directly to site, try above or below or opposite side of body on corresponding site.
Heat therapy pt. teaching…
-For stiffness
-Cover source w/ towel or cloth.
-Keep off areas w/ radiation, decreased sensation, or injury within 24 hrs.
-Don’t use w/ menthol products.
What are the deformities with OA?
-HEBEDEN NODES: “distal” (DIP Joint)
-BOUCHARD’S NODES: “Proximal” (PIP Joint)
-Knee: bowleg, knock- kneed
-Hip: One leg shorter
What does care of OA focus on?
-PAIN MANAGEMENT
-PAIN MEDS
-No cure
-NSAIDS ARE 1ST LINE OF DEFENSE
What’s one MAJOR safety measure for a pt. with OA?
-FALL RISK
-TEACH STAIR SAFETY, USE HANDRAILS OF LIVE IN ONE STORY.
What is Rheumatoid Arthritis?
-Chronic, systemic autoimmune disease.
-CHARACTERIZED BY INFLAMMATION OF CONNECTIVE TISSUE in the diarthrodial (synovial joints).
What test is primarily looked at for RA?
-ERYTHROCYTE SEDIMENTATION RATE (ESR)
What are the clinical manifestations of RA?
-Pain
-Stiffness
-Limited motion
-Signs of inflammation
-OCCURS SYMMETRICALLY
What does synovial fluid look like in RA?
-CLOUDY, STRAW-COLORED FLUID, W/ FIBRIN FLECUS, & INCREASED WBCs IN THE FLUID.
What’s the preferred drug for early treatment with RA?
METHOTREXATE
What should we monitor when using Methotrexate?
-HEAPATOTOXICITY, ALT/AST before and during treatment!
-INFECTION, MONITOR CBC!
-PREGNACY! MUST HAVE NEGATIVE PREGNACY TEST!
what’s the normal ALT & AST for the liver?
ALT: 7 - 56 (u/l)
AST: 5 - 40 (u/l)
What is systemic lupus erythematosus (Lupus)?
Autoimmune disease that effects multiple systems & organs.
2 Cardio complications with lupus.
-Pericarditis = inflammation of the pericardium.
-Myocarditis = inflammation of the heart muscle.
One MAJOR complication of Lupus?
ANTIPHOSPHOLIPID SYNDROME (causes blood clots)!!!
What’s the MOST SERIOUS from an upper GI bleed?
SUDDEN ONSET OF SEVERE ABDOMINAL PAIN!!!!
