Med Surg Chpt 65

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Med Surg Chpt 65
2011-10-25 15:13:30

Med Surg
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  1. osteoarthritis (OA)
    • the most common form of joint disease, its a slowly progressive noninflammatory disorder of the synovial joints.
    • Cartilage destruction
  2. Diff btw OA & RA
    systemic manifestations such as fatigue, fever and organ involvement are not present in OA.
  3. Crepitation
    a granting sensation caused by loose particles of cartilage in the joint cavity, can also contribute to stiffness. Indicates loss of cartilage integrity & is present in more than 90% of pts with knee OA.
  4. Orteoarthritis (Joints)
    Sitting down becomes difficult, as does rising from a chair when hips are lower than the knee. Early morning stiffness is common bt generally resolves within 30 mins.
  5. Osteoarthritis (Heberden nodes, Bouchards nodes)
    • (DIP)distal interphalangeal
    • (PIP)proximal interphalangeal
    • (MCP)metacarpopalangeal
    • (MTP)metatarsophalangeal
    • deformity or instability associated with OA is specific to the involved joint.
  6. Synovial fluid
    analysis allows differentiation btw OA and other forms of inflammatory arthritis. In the presence of OA, the fluid remains clear yellow with little or no sign of inflammation.
  7. Glucosamine
    Use caution in pts with diabetes, and pts with shellfish allergies, renal disease or peptic ulcer. Contraindicted during pregnancy & lactating.
  8. Gerontologic Consideration
    the older adult who takes NSAIDs has an increased risk for side effects, particularly GI bleeding and renal toxicity.
  9. Spondyloarthrothies
    are a group of interrelated multisstem inflammatory disorders that affect the spine, peripheral joints, and periarticular stuctures.
  10. Ankylosing Spondylitis
    is a chronic inflammatory disease that rimarily affects the axial skeleton, including the sacroiliac joints, intervertebral disk spaces, and costovertebral articulaitons.
  11. Psoriatic Arthritis
    a common bening, inflammatory skin disorder that appears to have a genentic predisposition. PsA in now recognized as a progressive inflammatory disease that can cause signigicant disability.
  12. Azulfidine (sulfasalazine)
    Therapeutic effect: reduction in the symptoms of inflammatory bowel disease. Used for Ankylosing Spondylitis and Psoriatic Arthritis
  13. HLA-B27
    • HLA-B27 is a blood test to look for a protein that is found on the surface of white blood cells. The protein is called human leukocyte antigen B27 (HLA-B27).
    • Human leukocyte antigens (HLAs) are proteins that help the body's immune system tell the difference between its own cells and foreign, harmful substances.
  14. Reactive Arthritis (Reiter's syndrome)
    appeart to occur after a genitourinary o GI tract infection. Clamydia trachomatis is most often inplicated in sexually transmitted reactive arthritis.
  15. Septic Arthritis
    is caused by invasion of the joint cavity with microorganisms. Large joints such as the knee and hip are the most frequently involved.
  16. Lyme disease
    transmitted by the bite of an infected deer tick. Doxycycline has alos shown to be effective in preventing Lyme disease when given within 3days after the bite of a deer tick.