Term
| Rheumatoid Arthritis (RA) |
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Definition
a chronic systemic disease that involves articular inflammation of the joints. Is insidious, symmetrical involvement of joints. interphalangeal joints of the fingers, thumbs, elbows, shoulders, ankles, knees, and toes.
not limited to joints. anemia, pleuropericarditis, neuropathy, myopathy,splenomegaly, Sjogren's syndrome, scleritis, vasulitis, and renal disease.
at increased risk for: carpal tunnel syndrome, stroke, osteoporotic fracture, and renal disease. |
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Term
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Definition
five of the seven symptoms are required. The first 4 symptoms must be continious for 6 weeks.
1. morning stiffness lasts longer than 1 hour, for more than 6 weeks
2. arthritis of at least 3 joint groups, with soft tissue swelling or fluid, for more than 6 weeks
3. one of the following joints must be swollen for longer than 6 weeks. proximal interphalangeal, metacarpophalangeal, wrists
4. symmetrical joint swelling for more than 6 weeks
5. positive RH factor
6. Xray changes consistent with RA |
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Term
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Definition
stage 1. no S&S, normal activity, antigen present
stage 2 morning stiffness, warmth at joint, extraarticular manifastations, normal in activity, increased T cells B cells antibody production, and synovial cells
stage 3 same as above except marked limitations of activity
stage 4 same as above except, proliferating synovial membrane involment causing injury to the bone, tendons, and cartilage. incapacitated or confined to a wheelchair. |
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Term
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Definition
| cause unknown, articular inflammaton that results in joint damage. antibody formation in the joint area results in inflammation in the joint area |
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Term
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Definition
family history
gender - female
age - 20 -50
recent systemic illness or trauma |
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Term
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Definition
joint pain
stiffness
swelling and warmth of joints, especialy the fingers, hands, wrists, elbows, shoulders, ankles and knees |
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Term
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Definition
| fatigue, malaise, subcutaneous nodules, depression, low grade fever, weight loss, myalgia, anemia, carpal tunnel syndrome |
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Term
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Definition
proximal interphalangeal - boutonniere deformities
fingers - swan neck
wrist - loss of extension
hips - loss of internal rotation, then flexion contratures
knees - suprapateller pouch distention
elbows - decreased extention, olecranon bursitis
shoulders - reduced ROM
cervical spine - subluxation (late and rare)
temporomandibular joint - pain with biting |
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Term
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Definition
CBC and platelets
ESR
RH factor
ANA
uric acid level
CRP
(optional) synovial fluid
plain film x ray to assess progression |
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Term
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Definition
RA
osteo
psoriati arthritis
gout and pseudogout
polyarthritis
reiter's syndrome
acute viral infection: lyme disease, hepatitis B, Hepatitis C, Parvo
SLE
Sjogrens: keratoconjunctivits, splenomegaly, and lymphadenopathy
sarcoidosis
polymyositis
felty's syndrom: RA, splenomegaly, and neutropenia |
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Term
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Definition
Referr to rhumatology
exercise and joint mobility
encourage smoking cessation and no ETOH
discuss vaccines |
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Term
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Definition
early disease: anti-inflammatory medication - ibuprofen, naproxen, Piroxican (consider comorbidies before staring NSAIDS)
be aware of all other medications and the interactions
moderate to severe: oral glucocorticoids, intra-articular glucocorticoid, gold salt therapy, DMARDS, and bisphosphonate |
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