Rheumatology Tutorial Flashcards
What legal framework exists to enable access and provision of care for all? What does it do?
Equality act 2010
- Protect discrimination of the protected characteristics
- easier for someone to show their disability and receive financial aid as a result
- increases positive actions such as more disability training
Define the concept of reasonable adjustments
Give some examples of reasonable and non reasonable
Any public accessed building must make adjustments to their premises so that those with disability are not disadvantaged. The changes must be reasonable and practicable to the existing premises.
Reasonable
- small practice introducing disabled ramp
- disabled patients’ appts being on the ground floor
Not
- small practice having to install a lift
Why might someone with rheumatoid arthritis have a dry mouth?
RA is often associated with a risk of sjorgens syndrome
Sjorgens syndrome is an autoimmune disease that attacks glands that secrete fluid e.g. lacrimal or salivary glands
Give some symptoms of Sjögren’s syndrome
- ocular dryness, eyes feeling sandy or requiring tear substitutes
- dry mouth, requiring liquids to swallow food
- swollen salivary glands
Signs and Symptoms of RA?
Pain or aching in more than one joint
Stiffness in more than one joint
Tenderness and swelling in more than one joint
Bilateral symptoms
Weight loss
Denver
Fatigue
Weakness
Give some complications of rheumatoid arthritis
Premature heart disease and diabetes
Obesity causes RA treatment to be less effective. Also increases risk of conditions like CVD and diabetes even more
Employment can be an issue due to disability and deformity
What is osteoporosis?
Bone disease where mineral content is decreased, bone structure changes, bone mass decreases and thus bone strength decreases.
What are some risk factors of osteoporosis?
Low calcium intake & poor nutrition leading to deficiency
Smoking and alcohol intake
Cancer and glucocorticoid medications
Slender body size
Family history
Low oestrogen/testosterone
Illness - RA, HIV, anorexia, GIT disease
What medications can increase risk of osteoporosis?
Proton pump inhibitors - to decrease stomach acid
Glucocorticoids - asthma treatment
Cancer medications for breast and prostate
Selective serotonin reuptake inhibitors - for anxiety and depression
Thiazolidinediones - t2 diabetes
What may you ask a patient who has osteoporosis?
- Do you eat a proper balanced diet?
- what medications are you currently on (standard MH)
- smoke / exposed to second hand smoke?
- do you do any exercise, especially strength training?
What drugs can help someone with osteoporosis?
- bisphosphonates - preserve bone strength
- calcitonin - post menopausal women
- parathyroid hormone - increases bone mass
What legislation introduced the reasonable adjustment concept? What else did they do?
Equality act 2010
- RA
- prevent discrimination against protected characteristics
- employers no longer ask direct Q’s about disability unless with good reason
What is Rheumatoid arthritis?
Autoimmune inflammatory disease that attacks bodies healthy cells causing inflammation.
Commonly affects hands, wrists, knees
Lining of joint becomes inflamed
Risk factors for RA?
Old age
Women > men
Genetic influence
Smoking
Never giving birth = higher risk
Obesity
Complications of RA?
Premature heart disease - higher risk
Obesity - poor movement /cardiovascular issues too
Employment - less likely to be employed and long term employment is affected
