Arthritis Flashcards
patho osteoarthritis
most common joint disease
- cause idiopathic or related to trauma to cartilage
- obesity affects knees and hips
S/S osteoarthritis
- joint pain after use relieved by rest
- crepitus grating of the joint w/motion
- achiness during changes in weather
Diagnosis of osteoarthritis
- s/s
- xray
- mri
- synovial fluid analysis rules out inflammatory arthritis
treatment of osteoarthritis
- promote rest, pace activities
- ROM exercises
- for hands warm baths/paraffin dips
- lumbar spine firm mattress
- crutches,braces,canes, or walker
treatment medications for osteoarthritis
- treat pain w/tylenol or nsaids
- viscosupplementation(synvisc, gelone)
- corticosteroid injection
patho rheumatoid arthritis
- cause is thought to be autoimmune
- affects all ages
- women 3x more than men
- pannus forms (fibrovascular granular tissue)
S/S of rheumatoid arthritis
initial:
fatigue, weight loss, anorexia, generalized stiffness
-wks to months
stiffness becomes more localized, pain, limitation of movement, & signs of inflammation (heat, swelling, tenderness)
-affects mainly the smaller joints
-fingers may become spindle shaped
-joint stiffness w/inactivity
Further progression:
-joint passes over joint
-hand/foot deformities swan neck,bunions, ulnar drift, boutonniere deformities
extraarticular manifestions
rheumatiod nodules(can be in sclera/lungs) -sjorgen's syndrome(affects lacrimal/ salivary glands, photosensitivity) Felty syndrome: RA affects nearly every system spleen blood etc
diagnosis of rheumatoid arthritis
usually diagnosed H&P
- RF rheumatoid factor
- ESR & CRP
- ANA may be elevated/blood test
- Anti-CCP cyclic citrolean protein
- synovial fluid analysis elevated WBC, elevated MMP-3
RA Treatment primary goals
reduce inflammation
manage pain
maintain joint function
prevent or minimize joint deformities
Medications for tx of RA
-aspirin
-nsaids
-corticosteroids(overuse can cause moon face/ buffalo hump)
-
DMARDS drug for tx of RA
-decrease inflammation methotrexate (rheumatrex) sulflasalazine(azulfidine) leflunomide (arava) these drugs are teratogenic/can affect fetus
drugs for RA antimalarial
hydroxychloroquine (plaquenil)
SE: retinopathy report visual disturbances immediately, see eye doctor yearly
immunosuppressants for RA Tx
Azathiopine Imuran
Cyclophosamide cytoxan
mycophenolate mofetil cellcept
biologic targeted therapies for RA
slows the disease progression
Enbrel/entanercept SE: increased risk of serious infection & heart failure report fever,bruising, bleeding,or other signs of infection
Infliximab/remicade must administer TB skin test& chest x-ray before start of med. monitor for signs of infection, stop drugs if infection occurs
