T2 - Arthritis, SLE, Gout (Josh) Flashcards by Josh Miller

Rheumatology is the study of CTD. What is CTD?

Connective Tissue Disease (CTD)

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Arthritis can be inflammatory and non-inflammatory. Name which is which.

Osteoarthritis (non-inflammatory)

Rheumatoid (inflammatory)

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— — is any disease or condition that involves the musculoskeletal system.

Rheumatic Disease

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— is the inflammation of one or more joints.

NOTE: there is a type that is NOT inflammatory. Name it.

Arthritis

osteoarthritis is NOT inflammatory

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— is not systemic and not autoimmune.

— is an autoimmune disorder.

Osteoarthritis

Rheumatoid

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What is the most common arthritis type?

Osteoarthritis (OA)

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Features of OA:

Progressive loss of —
Bone spures (aka: —)
Cartilage — and bone and cartilage float into joint causing —

cartilage

osteophytes

disentegrates, crepitus

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What is another name of Osteoarthritis (OA)?

Degenerative Joint Disease (DJD)

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OA:

What are Heberden’s Nodes and Bouchard’s Nodes?

Heberden’s Nodes:
- only at distal portion

Bouchard’s Nodes:
- more proximal

B is closer to the beginning than H

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What are the Primary Risk Factors for OA?

Aging

Genetic Changes

FEMALE

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What are the SECONDARY Risk Factors for OA?

Joint Trauma

Joint Sepsis

Smoking

Obesity

Paget’s Disease

Sickle Cell Disease

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Labs for OA:

What will ESR look like?

What will hsCRP look like?

ESR - slightly elevated when you have associated effusion of joint but majority of time NOT elevated

hsCRP - ibid

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Meds for OA:

Why are Cox-2 Inhibitors NOT used?

they are associated with risk of cardiac death

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Meds for OA:

What is DOC?

What labs should we monitor?

Acetaminophen

monitor liver function

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Meds for OA:

If using NSAIDs, what do we monitor for?

GI bleeds

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Meds for OA:

What are some topical meds?

Lidocaine Patches

Trolamine Salicylate

Capsaicin (made from peppers)

Buspirone

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Meds for OA:

What are some injections?

Cortisone

Hyaluronic Acid (made from chicken comb)

Meds for OA:

What do we need to teach before injecting Hyaluronic Acid?

are they allergic to eggs, birds, or feathers?

Meds for OA:

What do we need to teach before applying a Capsaicin lotion?

wear gloves because it’s made from hot peppers

Meds for OA:

— does NOT provide anti-inflammatory benefits, so it’s only really good for OA.

Acetaminophen

Meds for OA:

What is Glucosamine

naturally occuring chemical involved in the makeup of cartilage and is believed to aid in the synthesis of synovial fluid and rebuild cartilage

May also decrease the cells that cause inflammation

Meds for OA:

What do we teach regarding Glucosamine?

causes mild GI upset (nausea, heartburn)

use with caution if allergic to SHELLFISH

question clients about use of chondroitin, NSAIDs, heparin and warfarin

Surgery for OA:

— is diagnostic joint examination and must be able to move the knee — degrees.

Antroscopy

Surgery for OA:

— is joint replacement

Arthoplasty

ex: TJA (Total Joint Arthoplasty) and THA (Total Hip Arthoplasty)

It is important to prevent infection before joint surgery because it's a hard infection to treat. What should we counsel client?

have dental procedures BEFORE surgery take antisceptic shower night before

To prevent anemia from blood loss related to surgery, what options does client have?

Autologous blood banked Epoetin Alfa for several weeks prior

Postoperative Care (OA): What is CFNB?

Continuous Femoral Nerve Blockade (CFNB) - involves a catheter in femoral vein with constant infusion of meds

Postoperative Care (OA): What can we do to prevent hip dislocation (subluxation)?

an abduction pillow to prevent INTERNAL ROTATION of leg

RA: In most cases, inflammation associated with RA will by ----, whereas OA is ---

symmetrical (both sides) non-symmetrical (on only one side)

RA: What is the patho of RA?

Transformed anutoantibodies (rheumatoid factors) form, attacking healthy tissue, causing inflammation

RA: What are the risk factors?

FEMALE (3:1 ratio) ages 20 - 50 Epstein-Barr Virus Stress Environmental Factors

What is a reason that RA may go undiagnosed for a while?

early signs of RA (fatigue, joint discomfort) are vague and may be attributed to other disorders in older adult clients

RA: What are the EARLY signs of RA? LATE?

Early: - joint stiffness - swelling - pain - fatigue - generalized weakness Late: - joints become progressively inflamed and painful

RA: What are some systemic complications of RA?

Weight loss, fever, and extreme fatigue Exacerbations of RA Subq Nodules Resp and Cardiac complications Eye Problems Vasculitis Periungual Lesions Parestesias Lymph Node enlargement

RA: What are the eye problems associated with RA?

Iritis Scleritis

RA: What are the Subq Nodules associated with RA?

nodules found on Ulnar surface of arm, fingers or Achilles Tendon

RA: What are the Periungual Lesions associated with RA?

small brownish spots around the fingernails

RA: What are some syndromes associated with RA?

Sjogren's Syndrome Secondary Osteoporosis Felty's Syndrome Caplan's Syndrome

RA: Which RA-associated Syndromes are the following: - Dry eyes, dry mouth, dry vagina - RA, hepatosplenomegaly, leukopenia - RA nodules in lungs and pneumoconiosis

Sjogren's Syndrome Felty's Syndrome Caplan's Syndrome

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