Quiz #3

Question 1

Inflammatory vs Noninflammatory Joint Disease is differentiated by

Answer 1

Absence of synovial membrane inflammation, lack of systemic s/sx, normal synovial fluid analysis

Question 2

Degenerative joint disorder with a progressive loss of articular cartilage accompanied by new bone formation and capsular fibrosis, usually affects weight bearing joints (hands, elbow, feet) and variable degrees of synovitis and thickening of the joint capsule

Answer 2

Osteoarthritis

Question 3

Name some of the manifestations of OA

Answer 3

Pain, stiffness, enlargement of the joint, tenderness, limited motion, and deformity

Question 4

What are some of the goals of therapy for OA?

Answer 4

Early elimination of risk factors, early diagnosis, surveillance of the disease, appropriate treatment of pain and maximize/encourage mobility

Question 5

What is crepitus?

Answer 5

Continuous grating sensation caused by irregular cartilage, may be felt or heard as the joint is put through passive ROM

Question 6

What is the primary drug of choice for pain relief of OA? What are the risks?

Answer 6

Acetaminophen/Risk for liver damage if pt takes >4,000mg QD, have concurrent alcoholism, or have pre-existing liver disease

Question 7

This OTC topical salicylate is useful for some pts as a temporary pain reliever. How does it work?

Answer 7

Aspercreme. It works by blocking substance P, a neurotransmitter for pain

Question 8

If acetaminophen or topical agents are not successful, what else can be used?

Answer 8

NSAIDs, work by inhibiting COX-1 and COX-2. COX-2 manages pain and inflammation w/ fewer side effects of GI distress/bleeding

Question 9

What are some of the nursing issues for a pt with OA?

Answer 9

Mobility, pain, risk for injury (falls, surgical complications/medication toxicity), pre-op care and post-op care

Question 10

This connective tissue disease is one of the most common and is the most destructive to the joints. It is a chronic, progressive, systemic inflammatory AI disease that primarily affects the synovial joints

Answer 10

Rheumatoid arthritis

Question 11

Rheumatoid factors consist mainly of what two immunoglobulins?

Answer 11

IgG and IgM

Question 12

Early systemic clinical manifestations of RA include

Answer 12

Low grade fever, fatigue, weakness, anorexia, and paresthesias

Question 13

Treatment of RA includes

Answer 13

Salicylates, NSAIDS (COX-2), Ibuprofen and Celebrex

Question 14

These types of drugs can be prescribed to slow the progression of mild rheumatoid disease before it worsens

Answer 14

DMARDs (Disease modifying antirheumatic drugs)

Question 15

Name 3 DMARDS

Answer 15

Plaquenil an antimalarial drug, Azulfidine, and Minocycline

Question 16

Arthritis in older adults is not a normal part of the aging process. T/F

Answer 16

True.

Question 17

This inflammatory arthritis is caused by deposits of uric acid crystals in the joints

Answer 17

Gout

Question 18

Name five high purine rich foods that cause gout:

Answer 18

anchovies, asparagus, beef kidneys, game meats, liver

Question 19

Medications that can cause gout include:

Answer 19

Diuretics, salicylate containing drugs, niacin, cyclosporine, and levodopa

Question 20

Hyperuricemia, presence of uric acid crysals in joint fluid, more than one attack of acute arthritis, arthritis that develops in a day, attack only in one joint

Answer 20

S/Sx of gout

Question 21

Treatment for gout includes

Answer 21

NSAIDS, corticosteroids, colchicines, and allopurinal

Question 22

What is dislocation?

Answer 22

Temporary displacement of two bones, loss of contact between articular cartilage

Question 23

Contact between articular surfaces is only partially lost is called

Answer 23

Subluxation

Question 24

Dislocation and subluxation are associated with

Answer 24

Fractures, muscle imbalance, rheumatoid arthritis, or other forms or joint instability

Question 25

Muscle fiber shortening without an action potential and caused by failure of the sarcoplasmic reticulum even with available ATP is called

Answer 25

Contracture

Question 26

What is stress induced muscle tension?

Answer 26

Neck stiffness, back pain, clenching teeth, hand grip, headache, and is associated with chronic anxiety

Question 27

Reduction in the normal size of muscle cells d/t prolonged inactivity (bed rest, trauma, casting or nerve damage) is called

Answer 27

disuse atrophy

Question 28

Treatment of disuse atrophy is

Answer 28

Isometric movements and passive lengthening exercises

Question 29

Sudden, forced motion causing the muscle to become stretched beyond its normal capacity, local muscle damage, and can involve muscle tendons is

Answer 29

Muscle strain

Question 30

What treatment is used for muscle strains?

Answer 30

RICE - rest, ice, compression and elevation

Question 31

The most common cause of toxic myopathy is

Answer 31

Alcohol abuse

Question 32

What is myositis ossificans?

Answer 32

Complication of local muscle injury, inflammation of muscular tissue with subsequent calcification and ossification of the muscle

Question 33

This is an acute problem, life threatening complication of severe muscle trauma with muscle cell loss (crush/compartment syndrome)

Answer 33

Rhabdomyolosis

Question 34

The difference of RA and juvenile RA is

Answer 34

the mode of onset; arthritis in fewer than five joints, more than five joints, and systemic disease

Question 35

This is a collective group of inherited noninflammatory but progressive muscle disorders without a central or peripheral nerve abnormality; affects the muscles with definite fiber degeneration but without evidence of morphologic

Answer 35

Muscular dystrophies