RHMTIC DS Flashcards
(33 cards)
What are the common sites of RHEUMATIC DISEASE?
● Skeletal muscles,
● Bones,
● Cartilage,
● Ligaments,
● Tendons, and
● Joints
What are the classifications of RHEUMATIC DISEASE?
-MONOARTICULAR
-POLYARTICULAR
CLASSIFICATION OF RHEUMATIC DISEASE:
- only one joint is affected
MONOARTICULAR
CLASSIFICATION OF RHEUMATIC DISEASE:
- multiple joints are affected
POLYARTICULAR
WHAT ARE THE FURTHER CLASSIFICATION OF RHEUMATIC DISEASE?
-INFLAMMATORY
-NONINFLAMMATORY
FURTHER CLASSIFICATION OF RHEUMATIC DISEASE:
- there is a formation of
pannus.
-INFLAMMATORY
Additional Notes:
● Deformity is caused by the
pannus - destructive granulation
tissue that extends from
synovium to synovial cavity.
● ____________ is the most common rheumatic disease
● Autoimmune; real cause is unknown
● Chronic systemic inflammatory disease
RHEUMATOID ARTHRITIS
T OR F: Women affected 2x to 3x than men,
TRUE
○ Peak: 40 to 60
○ Onset: 30 to 50
Destructive granulation tissue that extends from synovium to synovial cavity
PANNUS
MANIFESTATIONS OF RHEUMATOID ARTHRITIS:
● Fatigue
● Anorexia
● Weight loss
● Generalized aching and stiffness
● Subluxation of joints - a condition that occurs when
a joint begins to dislocate
● Swan neck deformity - hyperextension of PIP joint
and partial flexion of DIP
● Boutonniere deformity
● Bulge skin
● Genus valgus
● Joints contractures
● Baker’s cyst
● Increase ESR or Erythrocytes Sedimentation Rate -
matagal mag settle meaning there is inflammatory
response happening to the patient
● Rheumatoid nodules: ulna
● Ulcerations of lower extremities
MANIFESTATIONS OF RHEUMATOID ARTHRITIS:
-a condition that occurs when
a joint begins to dislocate
SUBLUXATION OF JOINTS
MANIFESTATIONS OF RHEUMATOID ARTHRITIS:
-hyperextension of PIP joint
and partial flexion of DIP
SWAN NECK DEFORMITY
CRITERIA FOR CLASSIFICATION OF RHEUMATOID ARTHRITIS
Four or more of the following conditions must be present to
establish a diagnosis of rheumatoid arthritis:
1. Morning stiffness for at least 1 hour and present for
at least 6 weeks
2. Simultaneous swelling of three or more joints for at
least 6 weeks
3. Swelling of wrist, metacarpophalangeal, or proximal
interphalangeal joints for 6 or more weeks
4. Symmetric joint swelling for 6 or more weeks
5. Rheumatoid nodules
6. Serum rheumatoid factor identified by a method that
is positive in less than 5% of normal subjects
7. Radiographic changes typical or rheumatoid arthritis
on hand or wrist radiographs
DIAGNOSTICS OF RHEUMATOID ARTHRITIS:
● Physical examination
● Rf test
● Presence of 4 major criteria
● Anti-cyclic citrullinated peptide (CCP)
● Antibodies - antibodies attacking normal antibody
● Synovial fluid analysis - done to check if there is
problem in the synovial fluid of the patient
STAGES OF RHEUMATOID ARTHRITIS:
-● There is inflammation of the joint but no bone
damage.
STAGE 1/ Early Stage
STAGES OF RHEUMATOID ARTHRITIS:
● Synovium’s inflammation causes damage to the
joint cartilage.
● Limited ROM or Range of Movement
STAGE 2/ Moderate Stage
STAGES OF RHEUMATOID ARTHRITIS:
● Damage extends from the joint to the
bones
● Joint to the bones
STAGE 3/ Severe Stage
STAGES OF RHEUMATOID ARTHRITIS:
● Joints become destroyed and the bones fused
together (ankylosis)
STAGE 4/ End stage
TREATMENT OF RHEUMATOID ARTHRITIS:
○ Regulating activity by pacing, establishing
priorities, and setting realistic goals - since
there is limitations in the EDM of the
patient or the ROM or Range of motion
○ Long-term adherence to the prescribed
treatment modalities - if there is an
available therapy, encourage the patient to
adhere or have the said therapy
○ Proper posture, positioning, body
mechanics, and the use of supportive
shoes
- SYMPTOM CONTROL
TREATMENT OF RHEUMATOID ARTHRITIS:
■ range of motion exercises
- ROM
TREATMENT OF RHEUMATOID ARTHRITIS:
○ Reduce pain, decrease inflammation,
maintain or restore joint function, and
prevent bone and cartilage destruction.
- GOALS OF PHARMACOLOGICAL THERAPY
TREATMENT OF RHEUMATOID ARTHRITIS:
○ Coxib,
○ Ibuprofen
○ Naproxen
○ Celecoxib, rofecoxib, and valdecoxib
● NSAID and ASA (nonsteroidal pain medication)
Additional Notes:
● Coxib is very common (once na mag
aggressive, automatic mag order na si
doctor)
TREATMENT OF RHEUMATOID ARTHRITIS:
○ Gold salts, hydroxychloroquine,
sulfasalazine, methotrexate, and azathioprine
- DISEASE MODIFYING ANTIRHEUMATIC DRUGS (DMARD’s)
TREATMENT OF RHEUMATOID ARTHRITIS:
○ Interfere with purine metabolism, leading
to the release of adenosine, a potent anti-inflammatory compound
METHOTREXATE
