Module 2: NUR 2214 Module 2 EA
What is Rheumatoid Arthritis? - ANSWER:An idiopathic, chronic, autoimmine disorder causing
inflammation of connective tissue in synovial tissue resulting in warm, swollen, and painful joint
What increases your risk for developing Rheumatoid Arthritis? - ANSWER:-Being a woman (2.5x more
likely)
-Genetics
-Smoking/pollution exposure
-Increasing age
-Bacterial/viral infections
What type of hypersensitive reaction is Rheumatoid Arthritis? - ANSWER:Type III
How does Rheumatoid Arthritis affect the body? - ANSWER:Synovial fluid breaks down, causing a break
down of collagen, increasing edema and proliferation of the synovial membrane. A pannus (vascular
fibrous tissue extends over the surface or organ) is then formed which destroys the cartilage and bone.
What are some s/s of Rheumatoid Arthritis? - ANSWER:-Joint pain/stiffness/swelling
-Limited ROM due to pain
-Contractures causing deformities
-Nodule formation near joints
-Neuropathy (peripheral nerve pain)
-Raynaud's phenomenon (poor circulation to appendages)
,-Splenomegaly
-Pericarditis (inflammation around the heart)
-Sjogrens syndrome. (dry eyes and mucous membranes)
(also fever, fatigue, weight loss, anorexia)
What are the extremity deformities associated with Rheumatoid Arthritis? - ANSWER:-Ulnar drift
(joints/fingers swell & move towards pinky)
-Boutonnière deformity (finger/knuckle joint bends towards the palm)
-Hallux valgus (bunion)
-Swan neck deformity (finger tip joint bends towards palm, finger/knuckle joint bends up/away from
palm)
What should you know about Rheumatoid Arthritis & perfusion? - ANSWER:-CVD
-Arterial wall stiffness
-Endothelial dysfunction
-Elevated lipid values
How can we diagnose Rheumatoid Arthritis? - ANSWER:-Increased Erythrocyte sedimentation rate (ESR)
and C0reactive protein (CRP)
-ANA Lab-autoantibodies produced by a person's immune system when it fails to adequately distinguish
between self and nonself.
-CBC-baseline prior to medication treatment (platelets may be elevated due to inflammation)
,-X-rays/US-can see joint damage with 6-12 months
What is the criteria in the scoring system of Rheumatoid Arthritis? - ANSWER:Scoring system (6 points or
higher):
-Number of joints impacted
-Serology (RF or ACPA)
-Abnormal ESR or CRP
-Symptoms >6 weeks
What are some treatments for Rheumatoid Arthritis? - ANSWER:-Pharmacology
-Physical therapy
-Occupational therapy
-Nutrition
What are some disease modifying anti-rheumatic drugs? - ANSWER:-Thotrexate (Rheumatrex)
-Leflanomide (Arava)
-Sulfasalazine (Azulfidine)
-Hydroxychloroquine (Plaquenil)
What are some of the classes of drugs used to treat Rheumatoid Arthritis? - ANSWER:-NSAIDS
-Corticosteroids
, -Antidepressants
(AVOID OPIOIDS)
What are some treatments available for *moderate erosive* rheumatoid arthritis? - ANSWER:-OT
-PT
-Cyclosporin (immunosuppressant added to enhance Methotrexate)
Combination Therapy
(Biologic DMARD
Non-biologic DMARD)
What are some treatments available for *persistent erosive* rheumatoid arthritis? - ANSWER:-
Corticosteroids
-Reconstructive Surgery:
•Synovectomy (excision of synovial joint)
•Tenorrhaphy (tendon suture)
•Arthodesis (joint fusion)
•Replacement of the joint
What are some treatments available for *advanced unremitting* rheumatoid arthritis? - ANSWER:-
Immunosuppressants
(methotrexate,
cytoxan,
Imuran)
-Medications for depressive symptoms
(elavil, paxil, zoloft)
What is Rheumatoid Arthritis? - ANSWER:An idiopathic, chronic, autoimmine disorder causing
inflammation of connective tissue in synovial tissue resulting in warm, swollen, and painful joint
What increases your risk for developing Rheumatoid Arthritis? - ANSWER:-Being a woman (2.5x more
likely)
-Genetics
-Smoking/pollution exposure
-Increasing age
-Bacterial/viral infections
What type of hypersensitive reaction is Rheumatoid Arthritis? - ANSWER:Type III
How does Rheumatoid Arthritis affect the body? - ANSWER:Synovial fluid breaks down, causing a break
down of collagen, increasing edema and proliferation of the synovial membrane. A pannus (vascular
fibrous tissue extends over the surface or organ) is then formed which destroys the cartilage and bone.
What are some s/s of Rheumatoid Arthritis? - ANSWER:-Joint pain/stiffness/swelling
-Limited ROM due to pain
-Contractures causing deformities
-Nodule formation near joints
-Neuropathy (peripheral nerve pain)
-Raynaud's phenomenon (poor circulation to appendages)
,-Splenomegaly
-Pericarditis (inflammation around the heart)
-Sjogrens syndrome. (dry eyes and mucous membranes)
(also fever, fatigue, weight loss, anorexia)
What are the extremity deformities associated with Rheumatoid Arthritis? - ANSWER:-Ulnar drift
(joints/fingers swell & move towards pinky)
-Boutonnière deformity (finger/knuckle joint bends towards the palm)
-Hallux valgus (bunion)
-Swan neck deformity (finger tip joint bends towards palm, finger/knuckle joint bends up/away from
palm)
What should you know about Rheumatoid Arthritis & perfusion? - ANSWER:-CVD
-Arterial wall stiffness
-Endothelial dysfunction
-Elevated lipid values
How can we diagnose Rheumatoid Arthritis? - ANSWER:-Increased Erythrocyte sedimentation rate (ESR)
and C0reactive protein (CRP)
-ANA Lab-autoantibodies produced by a person's immune system when it fails to adequately distinguish
between self and nonself.
-CBC-baseline prior to medication treatment (platelets may be elevated due to inflammation)
,-X-rays/US-can see joint damage with 6-12 months
What is the criteria in the scoring system of Rheumatoid Arthritis? - ANSWER:Scoring system (6 points or
higher):
-Number of joints impacted
-Serology (RF or ACPA)
-Abnormal ESR or CRP
-Symptoms >6 weeks
What are some treatments for Rheumatoid Arthritis? - ANSWER:-Pharmacology
-Physical therapy
-Occupational therapy
-Nutrition
What are some disease modifying anti-rheumatic drugs? - ANSWER:-Thotrexate (Rheumatrex)
-Leflanomide (Arava)
-Sulfasalazine (Azulfidine)
-Hydroxychloroquine (Plaquenil)
What are some of the classes of drugs used to treat Rheumatoid Arthritis? - ANSWER:-NSAIDS
-Corticosteroids
, -Antidepressants
(AVOID OPIOIDS)
What are some treatments available for *moderate erosive* rheumatoid arthritis? - ANSWER:-OT
-PT
-Cyclosporin (immunosuppressant added to enhance Methotrexate)
Combination Therapy
(Biologic DMARD
Non-biologic DMARD)
What are some treatments available for *persistent erosive* rheumatoid arthritis? - ANSWER:-
Corticosteroids
-Reconstructive Surgery:
•Synovectomy (excision of synovial joint)
•Tenorrhaphy (tendon suture)
•Arthodesis (joint fusion)
•Replacement of the joint
What are some treatments available for *advanced unremitting* rheumatoid arthritis? - ANSWER:-
Immunosuppressants
(methotrexate,
cytoxan,
Imuran)
-Medications for depressive symptoms
(elavil, paxil, zoloft)
