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PTRS 746 Exam 2 > Rheumatoid & Similar Diseases > Flashcards

Rheumatoid & Similar Diseases Flashcards

1
Q

Q: How many rheumatoid diseases exist?

A

More than 100 have been identified

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2
Q

Q: What is the prevalence of rheumatoid disease in the US?

A

46 million

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3
Q

Defn: Complex Regional Pain Syndrome

A

Continuous severe pain out of proportion to injury and which worsens over time due to CNS/PNS dysfunction

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4
Q

Q: What is the difference between CRPS 1 and CRPS 2?

A

1 = no underlying nerve injury

2 = known nerve injury

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5
Q

Q: Who is CRPS more common in?

A

Young women

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6
Q

Symptoms: CRPS (6)

A
  1. Intense burning or hot pain
  2. Joint stiffness/inflammation
  3. Motor dysfunction
  4. Skin hypersenstivity
  5. Altered skin temp, color, texture
  6. Changes in nail/hair growth
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7
Q

Content: CRPS Stage 1 (5)

A
  1. 1-3 months
  2. Severe pain
  3. Muscle spasm and joint stiffness
  4. Excessive hair growth
  5. Skin color and temperature changes
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8
Q

Content: CRPS Stage 2 (6)

A
  1. 3-6 months
  2. Pain intensifies
  3. Swelling
  4. Decreased hair growth
  5. Nail Changes
  6. Osteomalacia and hypotonia
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9
Q

Content: CRPS Stage 3 (5)

A
  1. > 6 months
  2. Changes in skin and bone become irreversible
  3. Intractable pain
  4. Atrophy
  5. Joint Deformity
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10
Q

Content: Juvenile Rheumatoid Arthritis (3)

A
  1. Unusual but most common form of arthritis in children
  2. Onset prior to age 16
  3. Unknown etiology (genetic vs. environmental factors)
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11
Q

Content: 3 Types of JRA

A
  1. Pauciarticular (40-50%)
  2. Polyarticular (30%)
  3. Systemic or Still’s disease (20%)
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12
Q

Q: _________ and ___________ forms of JRA are commonly associated with ___________ which is asymptomatic but can cause permanent ________ loss if untreated.

A

Pauciarticular, polyarticular, iridocyclitis, visual

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13
Q

Q: How is the treatment course of JRA determined?

A

By disease activity in the first 6 months

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14
Q

Defn: Pauciarticular

A

Four or few joints affected, usually leg or jaw

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15
Q

Defn: Polyarticular

A

Five or more joints affected (can be as many as 40)

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16
Q

Defn: Systemic or Still’s Disease

A

Inflammation outside the joints (pericarditis, pleuritis, etc), usually accompanied by fever and rash

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17
Q

Content: Diagnosis of JRA (4)

A
  1. No single test, based on symptomology/clinical findings
  2. Symptoms can include arthritis, fever, rash, fatigue, anemia, loss appetite, irritability, reduced mobility
  3. RF and ANA may be negative or positive
  4. All forms can interfere with physical growth and cause joint deformity
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18
Q

T/F: Treatment and prognosis of JRA mirror adult disease.

A

True

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19
Q

Q: What percent of those JRA have complete remission.

A

50%

20
Q

Defn: Ankylosing spondylitis

A

Inflammatory disease of the axial skeleton

21
Q

Q: How does ankylosing spondylitis progress?

A

Onset at SI joint with ascending pattern

Inflammation > Erosion > Healing = bony fusion of fibrous ligaments

22
Q

Q: What prevalence of ankylosing spondylitis?

A

1 in 1000, male > female

23
Q

Symptoms: Ankylosing Spondylitis (4)

A
  1. Mild to Moderate flares and remissions
  2. Back pain and morning stiffness
  3. May be accompained by fever, fatigue, anemia, and/or weight loss
  4. Uveitis, valvular deficiencies, spinal cord compression are less common
24
Q

Content: Treatment focus for Ankylosing Spondylitis (4)

A
  1. Pain relief
  2. Preservation of ROM
  3. Prevention
  4. Correction of deformity
25
Q

Q: What other body system can ankylosing spondylitis effect?

A

Respiratory system

26
Q

Defn: Systemic Lupus Erythematosus

A

Chronic autoimmune connective tissue disorder with cycling exacerbation and remission

27
Q

Q: Who is Lupus most prevelant in?

A

Women of childbearing age

28
Q

Symptoms: Lupus (6)

A
  1. Butterfly rash
  2. Arthritis
  3. Cortical and trabecular bone loss
  4. Anemia, leukopenia, thrombocytopenia
  5. Nephropathy
  6. Neuropsychiatric disorders
29
Q

Content: Treatment of Lupus (3)

A
  1. Identify flares and reversal of inflammation
  2. Prevention of organ complications
  3. Aggressive treatment of HTN, renal dysfunction
30
Q

Defn: Scleroderma

A

Inflammation, degernation, and fibrosis of skin, vasculature, joints and tendons, muscle, GI tract, lung, heart, and kidney

31
Q

Q: Who is scleroderma more prevalent in?

A

females > males (4:1)

32
Q

Symptoms: Scleroderma (5)

A
  1. Swelling and cyanosis of fingers
  2. Raynaud’s
  3. Heartburn
  4. Myositis
  5. Arthritis
33
Q

T/F: Scleroderma and Lupus can be fatal

A

True

34
Q

Q: What is the skin like in scleroderma? (3)

A

Fibrose, taut, and inflexible

35
Q

T/F: Reactive or infectious arthritis is 80-90% polyarticular.

A

False, monoarticular

36
Q

Q: What agents typically cause reactive/infection arthritis?

A

Gram positive aerobes

37
Q

Content: Risk Factors for Reactive/Infectious Arthritis (6)

A
  1. Very old or young
  2. Presence of another systemic disease
  3. Recent invasive procedure
  4. Prosthetic joint
  5. Immunosuppression
  6. IV drug use
38
Q

Q: How is reactive/infectious arthritis diagnosed (3)

A
  1. Arthrocentesis to rule out/in
  2. Blood culture
  3. Radiograph or joint scans
39
Q

Content: Treatment of Reactive/Infectious Arthritis (4)

A
  1. Joint aspiration
  2. Antibiotic coverage
  3. Surgical drainage
  4. Maintain/preserve ROM and strength
40
Q

Q: Who is gout more prevalent in?

A

Men (4:1)

41
Q

Content: Causes of Gout (2)

A
  1. Elevated uric acid levels
  2. Depositions of monosodium urate (MSU) crystals
42
Q

Content: Gout may result from… (5)

A
  1. Diuretic, aspirin, or cyclosporine use
  2. Renal insufficiency
  3. Enzymatic abnormalities
  4. Alcoholism
  5. Malnutrition
43
Q

Q: What joint is most commonly affected by gout?

A

MTP of great toe

44
Q

Content: Treatment of Gout (3)

A

Rest, NSAIDs, corticosteriods

45
Q

Defn: Polymyalgia Rheumatica

A

Systemic inflammatory disease in those > 50 years

46
Q

Symptoms: Polymyalgia Rheumatica (6)

A
  1. Malaise and fatigue
  2. Fever
  3. Anorexia
  4. Weight loss
  5. Chronic, symmetrical aching of proximal muscles and joints
  6. Prominent in neck, shoulders, and pelvis - worst in morning
47
Q

Content: Diagnosis of Polymyalgia Rheumatica (4)

A
  1. Elevated ESR
  2. Exclusion of neoplasm
  3. Infection
  4. Muscle disease

PTRS 746 Exam 2 (9 decks)

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