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PathoPharm > lewis ch 64 - arthritis and connective tissue disease > Flashcards

lewis ch 64 - arthritis and connective tissue disease Flashcards

1
Q

Slowly progressive noninflammatory disorder of the synovial joints
-more common in women

A

osteoarthritis

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2
Q

type osteoarthritis: caused by direct damage or

joint instability

A

secondary osteoarthritis

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3
Q

risk factors osteoarthritis (5)

A
  • age
  • decreased estrogen
  • obesity
  • ACL injury
  • frequent kneeling/stooping
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4
Q

S+S osteoarthritis (4)

A
  • joint pain
  • early morning stiffness 30 mins
  • asymmetric affect
  • deformity
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5
Q

varus deformity

A

bowlegged

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6
Q

valgus deformity

A

knock kneed

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7
Q

Deformity on DIP joints d/t osteophyte formation

and loss of joint space (in osteoporosis)

A

heberdens nodules

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8
Q

deformity on PIP joints of the fingers and the MCP

joint of thumb (in osteoporosis)

A

bouchards nodules

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9
Q

drug therapy osteoarthritis (4)

A
  • NSAIDs
  • topical salicylates
  • COX2 inhibitor
  • intraarticular corticosteroid injections
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10
Q

what med can be given if pt is at high risk for GI side effects (osteoarthritis patient taking NSAIDs)

A

misoprostol (cytotec)

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11
Q

complications rheumatoid arthritis (4)

A
  • deformities, stress fractures
  • anemia
  • pericarditis
  • fibrosis, pneumonitis
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12
Q

3 stages RA

A
  • synovitis
  • pannus
  • fibrous ankylosis
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13
Q

S+S RA (4)

A
  • morning stiffness 1 hr+
  • low fever
  • anorexia
  • fatigue
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14
Q

treatment RA (3)

A
  • NSAIDs
  • COX1 and 2 inhibitors
  • disease modifying antirheumatic drugs (plaquenil, gold salts)
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15
Q

Chronic, systemic autoimmune
disease; inflammation of connective
tissue in diarthrodial (synovial) joints

A

rheumatoid arthritis

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16
Q

2 complications RA

A

heart attack

stroke

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17
Q

risk factors RA (3)

A
  • older age
  • sedentary lifestyle
  • pollution
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18
Q

muscle atrophy and tendon destruction

A

subluxation

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19
Q

4 extraarticular manifestations RA

A
  • sjogrens syndrome
  • felty syndrome
  • flexion contractures
  • depression
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20
Q

extraarticular manifestation RA: Enlarged spleen and low WBCs result in increased risk of infection and lymphoma

A

felty syndrome

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21
Q

4 stages RA

A
  • pre-clinical
  • synovitis
  • destruction
  • deformity
22
Q

2 side effects methotrexate

A
  • bone marrow suppression

- hepatotoxicity

23
Q

3 examples DMARDs for RA

A
  • methotrexate
  • sulfasalazine
  • hydroxychloroquine
24
Q

3 nursing considerations for pts taking DMARDs

A
  • drink fluids
  • wear sunscreen
  • eye exam
25
Q

what drug therapy can pts with RA take when they dont respond to DMARDs

A

biologic response modifiers (BRMs)

26
Q

nursing considerations for tumor necrosis factor inhibitor (BRMs) (4)

A
  • TB test and chest xray before starting
  • monitor for infection
  • avoid live vaccinations
  • report bruising, bleeding, persistent fever
27
Q

complications intraarticular injections for RA (2)

A
  • osteoporosis

- avascular necrosis

28
Q

Type of arthritis characterized by hyperuricemia and deposition of uric acid crystals in one or more
joints, periods of flare-ups

A

gout

29
Q

what can cause secondary gout (2)

A
  • more uric acid in body

- immunosuppressants

30
Q

what causes gout (5)

A
  • too much uric acid in body: kidneys can’t excrete enough or too much is being made
  • metabolic syndrome
  • increased intake high purine foods
  • prolonged fasting
  • excessive alcohol
31
Q

examples high purine foods (3)

A
  • red and organ meat
  • shellfish
  • fructose
32
Q

2 processes of gout

A
  • crystallization

- inflammation

33
Q

S+S gout (4)

A
  • dusky/cyanotic
  • very tender
  • symptom onset at night
  • low grade fever
34
Q

most common site gout

A

big toe

35
Q

Painless nodules filled with uric

acid crystals

A

tophi of chronic gout

36
Q

best diagnostic study for gout

A

synovial fluid aspiration

37
Q

drug therapy for acute gout attack

A
  • colchicine
  • NSAIDs
  • corticosteroids
38
Q

what med used for acute gout attack can cause leukopenia

A

colchicine

39
Q

drug therapy for longer management gout

A

-xanthine oxidase inhibitor (allopurinol): decrease production uric acid

40
Q

adverse effects allopurinol (3)

A
  • hypersensitivity syndrome
  • GI effects
  • neurologic effects
41
Q

drug of choice for chronic tophaceous gout

A

allopurinol

42
Q

characteristic sign lyme disease

A

bulls eye rash

43
Q

probable causes lupus (3)

A
  • genetic
  • hormones (contraceptives, pregnancy)
  • environmental factors (sun, UV light, stress, toxins)
44
Q

S+S lupus (7)

A
  • fever
  • weight loss
  • joint pain
  • butterfly rash
  • excessive fatigue
  • alopecia
  • vascular skin lesions
45
Q

most common infection developed by pts with lupus

A

pneumonia

46
Q

what should patients taking corticosteroids or cytotoxic drugs avoid

A

live vaccines

47
Q

drug therapy for lupus (4)

A
  • NSAIDs
  • corticosteroids
  • antimalarial drugs
  • immunosuppressive drugs
48
Q 
 Chronic central pain syndrome 
 Widespread, bilateral, 
burning musculoskeletal pain 
and fatigue
 Multiple tender points
A

fibromyalgia

49
Q

S+S fibromyalgia (5)

A
  • pain
  • fatigue
  • nonrestorative sleep
  • IBS
  • anxiety
50
Q

what cells are released in RA that can cause damage to cartilage and thicken synovial lining

A

neutrophils

51
Q

2 criteria that must be met to diagnose fibromyalgia

A
  • pain experienced atleast 11/18 tender points upon palpation
  • history of widespread pain atleast 3 months
52
Q

drug therapy fibromyalgia (7)

A
  • pregabalin (lyrica)
  • duloxetine (cymbalta)
  • milnacipin (savella)
  • antidepressants
  • muscle relaxants
  • OTC and nonopioid analgesics
  • zolpidem (ambien)

PathoPharm (42 decks)

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