PHCP LAB - RA, DM, HLPD Flashcards
1
Q
It is an autoimmune and inflammatory disease in
which your immune system mistakenly attacks
healthy cells, causing painful swelling
A
RHEUMATOID ARTHRITIS
2
Q
HPI
A
History of Present Illness
3
Q
WDWN
A
Well Developed, Well Nourished
4
Q
DIP
A
Distal Interphalangeal
5
Q
RRR
A
Regular Rate and Rhythm
6
Q
PMH
A
Past Medication History
7
Q
DMARDS
A
Disease modifying anti-rheumatic
drugs
8
Q
MCP
A
Metacarpophalangeal
9
Q
MRG
A
Murmur, Rubs, and Gallops
10
Q
ALL
A
Allergies
11
Q
ROS
A
Review of Systems
12
Q
RA
A
Rheumatoid Arthritis
13
Q
ROM
A
Range of Motion
14
Q
JVD
A
Jugular vein distention
15
Q
Rheumatoid Arthritis
Patient Name
Complaint
A
Jannet Hobbs
Generalized arthralgias, a swollen left knee,
and morning stiffness.
16
Q
Past Medical History of Patient
A
Rheumatoid Arthritis x 6 years
Hysterectomy - 4 years ago
Hypertension x 10 years
17
Q
A surgical procedure to remove the womb (uterus)
A
Hysterectomy
18
Q
Jannet Hobs Allergy
A
Penicillin (25 years)
19
Q
HEENT
A
head, ears, eyes, nose, and throat examination
20
Q
PERRLA
A
Pupils Equal, Round, Reactive to Light and Accommodation
21
Q
EOMI
A
Extra-ocular eye movements intact.
22
Q
JVG
A
Jugular vein distention
23
Q
CTA
A
Computed Tomography Angiography
24
Q
RRR
A
Relative risk reduction (RRR)
25
RRR
Relative risk reduction (RRR)
26
RRR
Relative risk reduction (RRR)
27
NT/ND
Non-Tender, Non-Distended
28
DIP
Distal Interphalangeal
29
PIP
Proximal Interphalangeal
30
MCP
Metacarpophalangeal
31
Hydrochlorothiazide |
Dosage Strength
Use/Indications
S/E
25mg
Hypertension
Dizziness, Chest Pain
32
Norvasc|
Dosage Strength
Use/Indications
S/E
10mg
Hypertension
Headache, Dizziness
33
Nabumetone |
Dosage Strength
Use/Indications
S/E
750mg
NSAID
HA, Diz, Diarrhea
34
Prednisone |
Dosage Strength
Use/Indications
S/E
5mg
Anti-Inflammatory
Immunospressive
Weight gain, Indigestion, Insomnia
35
Methotrexate|
Dosage Strength
Use/Indications
S/E
2.5mg
RA
Stomach pain, Black tarry tools
36
Hydroxychloroquine|
Dosage Strength
Use/Indications
S/E
200mg
RA
Dizziness, Fainting
37
Sulfasalazine EC|
Dosage Strength
Use/Indications
S/E
500mg
RA
HA, Diz, N/V
38
DI | HCTZ and Norvasc
dizziness, or feeling like you might pass out
39
DI | HCTZ and Folic acid
decreases the levels of FA by increasing renal clearance
40
Di | Norvasc and Nabumetone
- increase risk of heart attack
41
DI | Prednisone and Methotrexate
can cause a decrease in blood cell counts
42
DI | Sulfasalazine EC and Methotrexate
increase risk of liver problems
43
inflammation of a synovial (joint-lining) membrane.
Causes pain and swelling of the joints forming
pannus.
Synovial Inflammation (Synovitis)
44
- an abnormal tissue that develops because of
excess inflammation. It is composed of inflammatory
cells
Pannus
45
source of the Rheumatoid factors and Anti–cyclic citrullinated peptide
antibodies, which contribute to immune complex formation leading to
inflammation
B-lymphocyte (humoral mediated inflammation)
46
produce cytotoxins, cytokines and macrophage, which stimulate further
activation of inflammatory processes.
Cytokines: TNF-α, interleukin-1, and IL-6
T-lymphocyte (cell-mediated inflammation)
47
expressed on the surface of T-cell, leads to osteoclastmediated synovial inflammation and joint
destruction
RANK Ligand
48
SIGNS AND SYM OF RA
Multi-joint pain
Stiffness in more than one joint
Multi-joint tenderness and swelling
49
RISK FACTORS OF RA
Age
Gender
Genetics
Smoking
Obesity
Hysterectomy
50
May help diagnose rheumatoid
arthritis in the early stages of the
disease. In addition, these imaging
tests can help evaluate the amount of
damage in the joints and the severity
of the disease
Magnetic resonance imaging (MRI)
51
uses electromagnetic radiation to
produce images of the body to assess the
severity of joint destruction. Although this
test is not useful in the early stages of
rheumatoid arthritis, it can be used to
monitor the progression of the disease
X-rays
52
This blood test checks for anti-CCP
antibodies, which appear in many people
with rheumatoid arthritis. In addition, antiCCP can appear before RA symptoms
develop, which can help doctors diagnose
the disease early.
Anti-cyclic citrullinated peptide (anti-CCP) test
53
This blood test measures different
blood cell counts and can help
diagnose anemia, which is
common in people with RA.
Complete blood count
54
This test measures inflammation in the
body and monitors disease activity and
response to treatments.
Erythrocyte sedimentation
rate (sed rate)
55
RA | PT
This medication reduces pain and inflammation.
(NSAIDs), (Ibuprofen, Naproxen, Aspirin )
56
RA | PT
Another category of NSAIDs, with less
common stomach bleeding side effects than those of standard NSAIDs.
COX-2 inhibitors (Celecoxib, Etoricoxib, Lumiracoxib )
57
RA | PT
- Have both anti-inflammatory and
immunoregulatory effects. This may be administered orally, intravenously, intramuscularly, or via joint injection. While a disease is still in its early stage, _______ can be used as a temporary adjunct therapy while waiting for DMARDs to start acting as an anti-inflammatory.
Corticosteroids (Prednisone, Methylprednisolone ) -
58
RA | PT
__________ have been demonstrated to change the course of the disease and enhance
radiographic results. When rheumatoid arthritis is officially diagnosed, most patients should begin
taking ________.
Disease Modifying Anti-rheumatic Drugs (DMARDs)
(Methotrexate, Hydroxychloroquine, Sulfasalazine, etc)
59
RA | PT
Another class of DMARDs are _______
When a patient's condition doesn't improve when taking methotrexate alone, rheumatologists
frequently prescribe ____inhibitors.
Janus Kinase (JAK) Inhibitors (Tofacitinib, Baracitinib)
60
RA | PT
Your healthcare practitioner may
prescribe _____ response agents if you don't respond well to DMARDs. The molecules that induce
inflammation in your joints are the target of them. They target the cells more precisely,
according to providers, making them more effective.
Biologics
61
Non-Pharmacologic Intervention for RA
EXERCISE
DIET
MASSAGE
COUNSELING
STRESS REDUCTION
PHYSICAL THERAPY
SURGERY
62
Diabetes Mellitus
Patient name
Complaint
Sarah Martin
Headache
63
Sarah Martin
Allergies
Morphine - Urticaria/Hives
64
the need for patients to get up at
night on a regular basis to urinate
Nocturia
65
when your body makes too much
Polyuria
66
-excessive or abnormal thirst.
Polydipsia
67
Polyuria |
Urine output (Adults, Children)
exceeding 3 L/day in adults and 2
L/m2 in children
68
An abnormal touch sensation, such as burning or
prickling, that occurs without an outside
stimulus.
Paresthesia
69
DM | Glyburide
Dosage
Ind
5mg
High blood
70
DM | Lisinopril
Dosage
Ind
20mg
ACEi for HTN
71
DM | Zyprexa
Dosage
Ind
5mg
Acute manic
72
DM | Carbamazepine
Dosage
Ind
200mg
Epilepsy, Bipolar Disorder
73
DM | Lorazepam
Dosage
Ind
1mg
Anxiety
74
DM | Fluoxetine
Dosage
Ind
20mg
Selective serotonin inh, depressive illness symp
75
DM - EC ASA
Dosage
Ind
80mg
NSAID, reduces CHD
76
DM | Prevastatin
Dosage
Ind
40mg
statin, lower cholesterol and triglyceride
77
DI | Lorazepam and Olanzapine
Low BP, weak pulse, muscle weakness
78
DI | Carbamazepine and Lorazepam
Dizziness, drowsiness, confusion
79
DI | Aspirin/Fluoxetine and Glyburide
Increase the risk of hypoglycemia
80
DI | Glyburide and Lisinopril
May increase the risk of hypoglycemia, or low
blood sugar.
81
autoimmune destruction of the insulinproducing β-cells in the pancreas, which is
thought to be triggered by environmental
factors, such as viruses or toxins, in
genetically susceptible individuals.
Type 1 DM
82
characterized by impaired insulin
secretion and resistance to insulin action.
In the presence of insulin resistance,
glucose utilization by tissues is impaired,
hepatic glucose production is increased,
and excess glucose accumulates in the
circulation.
This hyperglycemia stimulates the
pancreas to produce more insulin in an
attempt to overcome insulin resistance
Type II DM
83
DM 1 or DM 2
Insulin-dependent or Juvenile-Onset
DM 1
84
DM 1 or DM 2
Non-insulin-dependent
DM 2
85
DM 1 or DM 2
Usually none, although some residual C-peptides can sometimes be detected at diagnosis, especially in adults
DM 1
86
DM 1 OR DM 2
Insulin presents in low, "normal", or high amounts
DM 2
87
DM 1 OR DM 2
Associated with certain HLA types
DM 1
88
DM 1 OR DM 2
Defect in insulin secretion, tissue resistance to insulin; INC hepatic glucose output
DM 2
89
DM 1 OR DM 2
CP: Moderate to severe symptoms that generally progress rapidly
DM 1
90
DM 1 OR DM 2
CP: Rare except in circumstances of unusual stress
DM 2
91
DM 1 OR DM 2
TX: Insulin, MNT, PA, Amylin mimetic (pramlintide)
DM 1
92
DM 1 OR DM 2
TX: MNT, PA, Antidiabetic agents, Insulin, Amylin mimetic (pramlintide)
DM 2
93
Signs & Symptoms Diabetes (5)
Polyuria, Polydipsia, Polyphagia, Blurry Vision, Wounds
94
Risk Factors for Type 2 Diabetes
-High blood/HTN
-High-fat and carb diet
-Obesity
95
DM | Diagnostic
The average blood sugar level over the previous two
to three months is determined.
A1C test
96
DM | Diagnostic
Test your blood sugar on an empty stomach and after an overnight fast.
Fasting Blood Sugar test
97
DM | Diagnostic
Measures your blood sugar before and after you drink a liquid that contains
glucose.
Glucose Tolerance Test
98
DM | Diagnostic
This measures your blood sugar level at the moment of testing. This
test can be taken whenever you want
Random Blood Sugar Test
99
Amylin Analogue
Pramlintide
100
Rapid-acting insulin
Insulin Lispro
101
Short-acting insulin
Humulin-R®
102
Intermediate-acting insulin
Humulin-N®
103
Long-acting insulin
(Insulin Glargine)
104
1st line initial tx of Type II DM among obese
patients
Metformin
105
should only be used in type II diabetics who
are stable, free of liver, kidney, or cardiovascular issues
Phenformin
106
can be used in combination with metformin
or a sulfonylurea as dual oral therapy in patients with type 2
diabetes whose blood glucose levels are not well controlled.
Rosiglitazone
107
indicated as an adjunct to diet and exercise
to improve glycemic control in adults with type 2 diabetes mellitus.
Pioglitazone
108
is an insulin secretagogue that lowers blood
glucose levels in patients with T2DM.
Repaglinide
109
the only treatment for type 1 diabetes mellitus that
induces an insulin-independent, the normoglycemic
condition is pancreas transplantation, either using the entire pancreas or just the pancreatic islet cells. Benefits
can include improvements in retinopathy, nephropathy,
and quality of life.
Pancreas and Islet Cell Transplants
110
Non-Pharmacologic TX for DM
Caloric restriction
Low-fat or low-carb diets
Reduce weight (especially if overweight)
Physical activities (aerobic exercise)
Avoid bedtime and between-meal snacks
