Rheumatologic Disorders Flashcards
rheumatic disease
nearly 100 disorders including
- rheumatoid arthritis
- osteoarthritis
- systemic lupus erythematosus
- scleroderma
- Sjogren syndrome
- gout
rheumatoid arthritis
autoimmune disease of unknown origin causes microvascular endothelial cell injurry
pathophysiology of RA
inflammation of synovium of joints leading to cartilage and subchondral bone destruction
complications of RA
new bone/fibrous tissue laid down resulting in loss of mobility
RA clinical presentation
- multiple SYMMETRIC joint involvement
- morning joint stiffness >1 hr
- systemic manifestations
which areas of the body does RA commonly affect?
- hands
- feet
- knees
- TMJ
T/F: men are affected by RA more often than women
false
*women:men 3:1
what are some systemic manifestations of RA?
- fatigue
- weakness
- malaise
med management of RA
control disease and limit joint damage
overall goal of med management of RA
disease remission and regain fxn
drugs used to manage RA
- antiinflammatory drugs
- disease-modifying antirheumatic drugs (DMARDs)
- biologics-highly targeted DMARDs
which anti-inflammatory drugs are used for long term management of RA?
NSAIDs
pts with RA are typically given what first for faster pain relief?
corticosteroids
what is used as a last resort to txt RA?
biologics-highly targeted DMARDs
why is biologics-highly targeted DMARDs used as a last resort to txt RA?
- a lot of adverse effects
- costly
- has to be injected
- significantly suppress immune system so good for controlling disease but bad for any surgeries
what is the end-stage disease of RA?
alloplastic joint replacement
dental management of RA pts
immunosuppressive agents can cause bone marrow suppression thus affecting WBCs and platelets
is elective or restorative dental care indicated for RA pts?
yes, won’t be a problem unless RA is in TMJ and possibly chair positioning (sore joints)
most common form of arthritis?
osteoarthritis
osteoarthritis
non-inflammatory degenerative disease that begins in cartilage
complications of OA
secondary to cartilage loss, subchondral new bone formation and marginal bony overgrowth
is RA or OA are more favorable prognosis?
OA
does RA or OA have less serious complications?
OA
clinical presentations of OA
- pain localized to one or two joints
- stiffness in the morning or after inactivity that subsides in less than 15 minutes
common areas affected by OA
- hips
- knees
- feet
- spine
- hands
- TMJ
med management of OA pts
- symptomatic relief
- drug therapy limited to analgesics
- intraarticular steroid injections intermittently to reduce acute pain and inflammation
- possible joint replacement
what is the first line of analgesics for OA pts?
acetaminophen
dental management of OA pts
pts can have limited, painful opening so have shorter appts (don’t fatigue joint which can cause acute flare up)
