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Patho 1 > Joint stuff and SLE > Flashcards

Joint stuff and SLE Flashcards

1
Q

Synovial joints

A

moveable bc of synovial fluid
- outer fibrous joint capsule, internal synovial mem, articular cartilage, and synovial fluid
- joint capsule connects bone and inner membrane lining

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2
Q

Function of articular cartilage

A

Prevent friction btwn bones

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3
Q

Arthropathy

A

joint disorder of inflammation of at least one joint leading to arthritis

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4
Q

Osteoarthritis

A

Degeneration of the joints from aging and stress
- most common cause of disability in the US
- inc bc longer life and obesity
- localized inflam from wear and tear

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5
Q

Joints that OA affects more

A

often the back–cervical spine and lumbosacral, hip, knee, hands, BIG TOE

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6
Q

Risks for OA

A

age, obesity (strain, inc load, b/d cartilage), hx team sports, hx trauma or overuse of joints, misaligned pelvis, hip, knee, ankle, feet, men before 45 and women after 45

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7
Q

Causes of OA

A

Degen in articular cartilage from excess load of healthy or previously injured joints and stress applied
- chronic process

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8
Q

Patho of OA

A
  • pressure wears on cartilage and subchondral bone exposed–cyst develops
  • cyst moves thru cartilage and destroys more
  • local inflam causes more degradation
  • chondrocytes synthesize fluid called proteoglycans to try and repair–swelling
  • osteoblasts activate–bone spur and synovial fluid thickens
  • loss of cartilage causes narrow joint space
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9
Q

CM of OA

A

Deep aching joint pain esp with exertion and relieved with rest
- stiffness in the morning
- crepitus of joint with motion
- joints swell–hard swelling
- limited ROM
- altered joint gait
- deformities
- tenderness
- dec ROM
- Heberden’s nodes (distal) and Bouchard’s (proximal)

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10
Q

non-pharm for OA

A
  • dec risk and prevent
  • manage pain, mobility and disability
  • no pharm to improve sx
  • diet supps - chondroitin sulfate and glucosamine
  • artificial joint fluid with hyaluronic acid
  • joint replacement or arthropathy
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11
Q

Pharm for OA

A
  • tylenol or NSAIDs
  • mild-mod topical capsaicin
  • mod-severe NSAIDs w/ colchicine, acet and tramadol, opioids, steroid IJ in joint
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12
Q

Degenerative disc disease (DDD)

A

OA of the lumbar or cervical spine causing back pain with lifting or twisting

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13
Q

DDD Patho

A

Same as OA; intervertebral disc compression with age
- motor or sensory spinal nerves enter and exit spinal cord and travel thru vertical bone
- discs dehydrate with age and bone is compressed–impinge on nerves
- motor or sensory nerves impede mvt and sensation in extremes, cause weakness and paresthesia

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14
Q

Lumbar DDD CM

A
  • lower back pain that radiates down one leg “sciatica”
  • pain in butt or thighs
  • worse with twist, sit, bed lift
  • dec with walking, lying down, chx position
  • numb, tight, weak legs
  • foot drop
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15
Q

Cervical DDD CM

A
  • chronic neck pain that can radiate to shoulders and down arms
  • numb or tingle in arm/head
  • weak arm or hand
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16
Q

What can DDD lead to?

A

herniation or ruptured disc

17
Q

Rheumatoid arthitis

A
  • systematic autoimmune disease
  • type 3 hypersensitivity
  • poorly understood genetic, enviro factors, triggered by infx, injury
  • risks 40-60, fem, tobacco, FAM
18
Q

RA patho

A
  • autoimmune compounds deposit in synovial tissue
  • immune cells attach syn tissue (lympho and macros) and attract cytokines
  • make inc rheumatic factor
  • phagocytosis releases enzymes that damage tissue–chronic and destructive
  • cartilage destroyed by clasts forming scar tissue
  • pannus develops–inflam and prolif of synovium–leads to bone erosion, cysts, fissures dev that contain imm cells
19
Q

What is pannus

A

Vasc scar tissue

20
Q

RA CM

A
  • early–few joint pain/discomfort
  • symmetrical degen
  • general stiffness, dec ROM, pain
  • inflam–heat, swell, tender
  • bone loses potential contact with surface
  • deformity and disability, joint subluxation
  • systemic fatigue
  • can affect all body sys based on severity incl heart
  • Rheumatoid nodules–imm granulomas around joints, SQ and firm pain; LUNGS
  • Sjogren’s syndrome–lose moisture glands; eyes and mouth
21
Q

RA pharm

A
  • relieve pain and swelling
  • slow or stop disease
  • long term NSAIDs, glucocorts, DMARDs, slow or stop prog
  • steroids (often pred)
22
Q

Gouty arthritis

A

disruption in uric acid metabolism and deposits in joints (uric crystals)
- acute and painful
- DISEASE OF KING - wine and smoked stuff

23
Q

Gout patho

A

uric acid crystals from b/d of purines made by bod (b/c of nitrogenous waste)
- uric acid does not dissolve in blood and excrete thru kids like meant to
- causes hyperuricemia–inc uric acid prod and dec uric sec

24
Q

Sources of uric acid

A

organ meats, shellfish, anchovies, mushrooms, asparagus

25
Q

Risk fx for gout

A

men, obese, HTN, DM, renal, SCA, alc, diet rich in meat and seafood, diuretics, AfAm

26
Q

Phases of gout

A
  1. asymp - inc serum uric acid levels and deposits in tissue (crystals accum and damage tissue–acute inflam)
  2. acute flares of hyperuricemia
  3. clinically inactive, hyperuricemia (month to year before next flare; attacks may start to get closer)
  4. chronic arthritis - joint pain and other sx present most of the time
27
Q

CM of gout

A

PAIN - mild or awful, often in lower extremes and BIG TOE
- burn
- red
- swell, warmth
- fever

28
Q

Comps of gout

A
  • tophi - hard nodules of uric acid in soft tissue (risk kid stones)
  • may be below skin or around joints
  • local inflam, may drain chalky material
29
Q

gout pharm

A

dec sx and prevent recurrent attacks
- NSAIDs first line
- second line allo, clochine, probenecid

30
Q

Systemic lupus erythematosus (SLE) patho

A
  • autoimmune
  • b lymph are hyperactive and make antinuclear antibodies (ANA)–drain from plasma
  • type 3 that attach all major organ sys–kids most common (glom)
  • activated by own DNA
  • form immune complexes
  • inflammatory response destroys tissue
31
Q

Risk factors for SLE

A

female, genetics, 20-40, Black, enviro (sun exp), abx allergy, hors (estrogen), tobacco, women who menstruate before 10

32
Q

CM for SLE

A

Sx often flare at diff times
- FATIGUE
- butterfly rash
- photosensitive
- edema, fever, hair loss, Raynaud’s–restrict BF
- CNA–dizzy, HA, sz, stroke
- lungs–pleuritis and effusion
- myocarditis and endocarditis
- nephritis
- vasculitis
- arthritis

33
Q

SLE flares

A
  • exac and remiss
  • warning signs are fatigue, HA and pain
  • prevent by avoiding triggers like infx, stress, sun, abrupt stop meds
34
Q

Pharm for SLE

A
  • NSAIDs, steroids (high dose–kid and CNS) or low (athritis)
  • immunosupp–severe organ involve
  • hydroxychloroquine–skin, mscktl; prevent kid and CNS damage
35
Q

Sim btwn RA and SLE

A
  • autoimmune
  • systemic
  • pharm similarities
    RA of joints and SLE of all organs
36
Q

Which dx is soft and spongy

A

RA

37
Q

Which dx is firm

A

OA

38
Q

Which dx can lead to myocarditis and pericarditis?

A

RA

Patho 1 (37 decks)

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