Chapter 18 Flashcards by laura Blakeney

Osteophytes

Bone spurs

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Crepitus

Grating sound caused by the loosened bone and cartilage

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Primary OA

Caused by aging and genetic factors

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Secondary OA

Joint injury or obesity

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Heberdens nodes

Nodules on the distal interphalangeal joints

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Bouchards nodes

Nodules at the proximal interphalangeal joints

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Labs for OA

ESR

hsCRP

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Drugs for OA

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

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Cox2

Causes cardiovascular disease (MI)

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Glucosamine

Decrease inflammation

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Chondroitin

Strengthen cartilage

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Osteonecrosis

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

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Subluxation

Dislocation

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Pannus (RA)

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

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Vasculitis (RA)

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

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Gel phenomenon (RA)

Late manifestations. Morning stiffness of joint

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Periungeal lesions

Ischemic skin lesions that indicate vasculitis

Sjögren’s syndrome (RA)

Dry eye
Xerostomia
Dry vagina

Felty’s syndrome

Enlarged liver and spleen

Leukopenia

Caplans syndrome

Rheumatoid nodules in the lungs

Tests for RA

Rheumatoid factor >1:80

Antinuclear antibody (ANA) > 1:40

Arthrocentesis

Aspiration of effusion from the joint to decrease pressure

Disease modifying antirheumatic drugs DMARD

Methotrexate

4-6 weeks to start working

Methotrexate no-no’s

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

Plaquenil

May cause retinal damage

BRM biological response modifiers

Enbrel, humira, Remicaide

Plasmapheresis

Not common | Filter plasma for disease causing antibodies

Non pharm interventions for RA

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

SLE

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

Raynaud's phenomenon

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

Primary gout

Errors of purine metabolism Inherited Middle aged &a older men Postmenopausal

Secondary gout

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

Labs for gout

Consistent level of 6.5 is abnormal Uric acid production of 750mg per 24 hours Athrocentensis of synovial joint

Tophi

Deposit is of sodium irate crystals

Manifestations of gout

Renal calculus Renal dysfunction Changes in urinary output

Acute gout treatment

Colchicine NSAID 4-7 days

Chronic gout treatment

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

Nutrition in gout

``` Limit protein Starvation diets Alcohol Diuretics Aspirin Increase fluid Stress ```

Stage one Lyme disease

Flu like symptoms Doxycycline Amoxicillin

Stage two Lyme disease

Cardiac problems CNS disorder IV antibiotics 30 days Ceftriaxone

Fibromyalgia

Chronic pain syndrome NOT inflammatory Burning, gnawing!!!!

Fibromyalgia treatment

Lyrica, cymbalta, SSRIs (neuropathy) ``` Tricyclics -sleep, spasm Tramadol NSAIDs PT Exercise Avoid triggers ```