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MedPsych Exam 3 > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

1
Q

what type of disease is rheumatoid arthritis?

A

Systemic inflammatory disease

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2
Q

what does RA primarily affect?

A

synovial lining of joints but can affect other organs

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3
Q

what is characteristic of RA?

A

Persistent symmetric polyarthritis of hands & feet which is hallmark feature
Progressive articular deterioration
May lead to difficulty with ADLs

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4
Q

What does the build up of synovial cells cause?

A

damage of underlying cartilage

Products of this destruction stimulate inflammation New phagocytes clean up debris

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5
Q

what are the cardinal signs of RA?

A 
Heat
Swelling 
Redness 
Pain
Eventual loss of fx
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6
Q

how does permanent inflammation occur?

A

swells up and back down

eventually soft tissue doesnt reshape itself

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7
Q

what is the diagnostic criteria for RA?

A 
at least 4
Morning stiffness
Arthritis of 3 or more joints
Arthritis of hand joints
Symmetric arthritis
Rheumatoid nodules
Serum rheumatoid factor
Radiological changes
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8
Q

what is the monocyclic course of RA?

A

1 episode ending in 2-5 years after initial diagnosis May result from early and/or aggressive tx

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9
Q

what is polycyclic course of RA?

A

Levels of disease fluctuates over course of condition

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10
Q

what is progressive course of RA?

A

Continues to increase in severity, is unremitting

leading to Radiographic damage, Decline in fx, Work disability, Premature mortality by 10 – 15 years

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11
Q

what is the onset of RA?

A

Usually insidious, can be episodic, acute

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12
Q

what are systemic manifestations of RA?

A

Fever, malaise, fatigue, anorexia

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13
Q

what are Extra-articular Symptoms of RA?

A

rheumatoid nodules
affected respiratory and vascular systems
eye dryness
enlarged spleen

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14
Q

what are the comorbidities of RA?

A 
Cardiovascular disease 
TB infection
Anxiety
Depression
Leukemia, multiple myeloma
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15
Q

what can be physically seen in RA pts?

A 
Stiffness,tenderness
Pain w/ motion
Deformity
Decreased motion
Rheumatoid nodules
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16
Q

what can be found on radiographs of RA pts?

A

not helpful early b/c cartilages arent destroyed yet

17
Q

what can be found on lab reports of RA pts?

A 
CBC
blood count (Erythrocyte Sedimentation)
Antibodytest, 
Rheumatoid Factor
RA latex rate
18
Q

what is RA progression and prognosis?

A

30% of all cases so mild, no MD involvement

10% severely disabled: WC, bed bound

19
Q

what is the order of joint involvement frequency of RA?

A
  1. Hands
  2. Wrists
  3. Knees
  4. Elbows
  5. Feet
  6. Shoulders
  7. Hips
20
Q

how does RA affect joints?

A

symmetrically

21
Q

what is swan neck deformity? who is it more common for?

A

hyper extension of PIP with flexion of DIP. more common in rheumatoid arthritis than trauma.

22
Q

what is Boutonniere deformity? who is it more common for?

A

flexion of PIP with extension of DIP. more common in trauma but can be seen in rheumatoid

23
Q

what is Ulnar drift at MCP joints?

A

stretched out of place over time. hand goes radial, fingers go ulnarly. swelling over time causing slip of extensor tendons

24
Q

what are early changes in RA?

A

soft tissue swelling, joint space narrowing, and erosions of the proximal interphalangeal (PIP) joints

25
Q

what are later changes in RA?

A

joint subluxation and malalignment

fusion or joint ankylosis may occur

26
Q

what are goals tx?

A 
Help pt. understand disease
Psychological support
Alleviate pain, suppress inflammatory process Maintain joint function & prevent deformity
Correct existing deformity
Improve fx
27
Q

what are methods to tx RA comprehensively?

A

Team approach
Early intervention
Patient & family involvement
Concern for patient & environment

28
Q

what is the drug therapy guideline for RA?

A

Non-biologic disease- modifying antirheumatic drugs (DMARDS) within 3 months of dx.
Biologic DMARDs if necessary
OT PT

29
Q

how does OT tx RA during acute and subacute phase?

A

Reduce pain & inflammation (Splinting, positioning)
Maintain ROM and joint integrity
Maintain strength & endurance (viaADL)

30
Q

how does OT tx RA during the chronic active stage?

A

Problem solve with patient

Post surgical rehab

31
Q

how does OT provide pt education?

A

Work simplification

Joint protection techniques

32
Q

what is scleroderma?

A

Progressive Systemic Sclerosis

Generalized connective tissue disorder characterized by inflammatory, fibrotic, and degenerative changes

33
Q

what organs does scleroderma affect?

A 
Skin
Synovia
Esophagus 
GI tract
Heart
Lungs
Kidneys
34
Q

what is a key sign of scleroderma?

A

facial rash

35
Q

what is Ankylosing Spondylitis?

A

Inflammatory disease that affects spine

Symptoms at first are mild but grow progressively worse

36
Q

how does Ankylosing Spondylitis present in pts?

A

In the hips, ankylosing spondylitis presents with joint space loss, axial migration of the femoral head, and osteophyte formation

MedPsych Exam 3 (7 decks)

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