Chapter 18 Flashcards Preview

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Flashcards in Chapter 18 Deck (42):
1

Osteophytes

Bone spurs

2

Crepitus

Grating sound caused by the loosened bone and cartilage

3

Primary OA

Caused by aging and genetic factors

4

Secondary OA

Joint injury or obesity

5

Heberdens nodes

Nodules on the distal interphalangeal joints

6

Bouchards nodes

Nodules at the proximal interphalangeal joints

7

Labs for OA

ESR
hsCRP

8

Drugs for OA

Tylenol (not a primary inflammatory disease)
Lidocaine topical
Buspirone
Cox 2
NSAID
Steroid injections
Muscle relax & weak opioids

9

Cox2

Causes cardiovascular disease (MI)

10

Glucosamine

Decrease inflammation

11

Chondroitin

Strengthen cartilage

12

Osteonecrosis

Secondary to lack of blood flow. Trauma or chronic steroid therapy

13

Subluxation

Dislocation

14

Pannus (RA)

Vascular granulation tissue of inflammatory cells that erode articulate cartilage and eventually destroy bone

15

Vasculitis (RA)

The organ supplied by the vessel can be affected, leading to organ failure

16

Gel phenomenon (RA)

Late manifestations. Morning stiffness of joint

17

Periungeal lesions

Ischemic skin lesions that indicate vasculitis

18

Sjögren's syndrome (RA)

Dry eye
Xerostomia
Dry vagina

19

Felty's syndrome

Enlarged liver and spleen
Leukopenia

20

Caplans syndrome

Rheumatoid nodules in the lungs

21

Tests for RA

Rheumatoid factor >1:80

Antinuclear antibody (ANA) > 1:40

22

Arthrocentesis

Aspiration of effusion from the joint to decrease pressure

23

Disease modifying antirheumatic drugs DMARD

Methotrexate
4-6 weeks to start working

24

Methotrexate no-no's

Alcohol -liver
Birth control- must have!!!!!!!!!!!!!!
Infection risk

25

Plaquenil

May cause retinal damage

26

BRM biological response modifiers

Enbrel, humira, Remicaide

27

Plasmapheresis

Not common
Filter plasma for disease causing antibodies

28

Non pharm interventions for RA

Rest, position, ice/heat, plasmapheresis, alternative therapy, enhance body image, manage fatigue

29

SLE

Vasculitis is a big concern, kidneys seem to be attacked.
Autoimmune, connective tissue disorder
Butterfly rash*

30

Raynaud's phenomenon

Cold or stress- red white or blue with extreme pain. SLE

31

Primary gout

Errors of purine metabolism

Inherited
Middle aged &a older men
Postmenopausal

32

Secondary gout

All ages
Renal insufficiency
Diuretic (dehydration)
Crash diets
Chemotherapy
Obese
Cardiovascular problems

33

Labs for gout

Consistent level of 6.5 is abnormal

Uric acid production of 750mg per 24 hours

Athrocentensis of synovial joint

34

Tophi

Deposit is of sodium irate crystals

35

Manifestations of gout

Renal calculus
Renal dysfunction
Changes in urinary output

36

Acute gout treatment

Colchicine
NSAID

4-7 days

37

Chronic gout treatment

Allopurinol
8 glasses of H2O
Periodic follow up
CBC w/ diff

38

Nutrition in gout

Limit protein
Starvation diets
Alcohol
Diuretics
Aspirin
Increase fluid
Stress

39

Stage one Lyme disease

Flu like symptoms


Doxycycline
Amoxicillin

40

Stage two Lyme disease

Cardiac problems
CNS disorder

IV antibiotics 30 days
Ceftriaxone

41

Fibromyalgia

Chronic pain syndrome
NOT inflammatory


Burning, gnawing!!!!

42

Fibromyalgia treatment

Lyrica, cymbalta, SSRIs (neuropathy)

Tricyclics -sleep, spasm
Tramadol
NSAIDs
PT
Exercise
Avoid triggers