Rheumatoid Arthritis
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Transcript of Rheumatoid Arthritis
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Jennifer Pratt
ENG 101
Prof. Kerr
Dec. 4, 2003
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I. Overview of the DiseaseA. What is it?B. What causes it?C. What are the symptoms?D. How is it diagnosed?E. Who is at risk?II. Effects on a JointA. Anatomy of a jointB. Effects of the diseaseC. Systemic effectsIII. EducationA. PlanningB. Emotions and stressC. QuackeryIV. TreatmentA. How to prevent disability and preserve joint functionB. CAM methodsC. Pharmacological optionsD. Surgical options
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●autoimmune disease
●affects 1% of population
●chronic, systemic, inflammatory
●adverse effects on joints
●psychological, social, and financial effects
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●Viral Infections
●Genetics
●Weakened Immune Systems
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●loss of appetite
● fever
● energy loss
● anemia
● side-effects in other parts of the body
● joint swelling and painful movement
● development of rheumatoid nodules on or close to the joints and other joint deformities
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Criteria
●morning stiffness
● arthritis in three or more joint areas
● symmetric arthritis
● presence of rheumatoid nodules and rheumatoid factor.
Doctors analyze all symptoms, medical history, and lab tests and do a physical examination and radiograph testing. Specialists consider a white-blood cell count and a complete blood-cell count
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●Usually found in adults between the ages of 40 and 60.
●Women are affected three times as much as men.
●Children can be affected in the most damaging ways.
●Rheumatoid arthritis has the potential to affect people of any age, and the severity of the disease varies among them.
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● joint capsule that separates the joint from surrounding tissue
● cavity formed by the capsule
● a synovial membrane that lines the inside of the cavity
● synovial fluid that lubricates the joint.
● bones and cartilage that are joined together.
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Effects on the Joint
●synovial lining cells begin to multiply and grow to form a diseased tissue called pannus
● synovial fluid that is supposed to lubricate the joints also undergoes a transformation
● Digestants form in the fluid, and they attack surrounding tissues as well
● the main components of the joints are altered, they are unable to perform their original joint-preserving functions
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● pathology of the nervous system - leads to sensory loss
● Eye lesions or dry eyes
● skin problems (fragile and bruise easily)
● Lung disease and other cardiopulmonary disorders
● Major body organs such as the spleen and lymph nodes may also be affected as a result of RA
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Planning
●Patients experience good and bad days.
● patients and family work closely with a physician to obtain a complete understanding of the disease and its nature.
● all activities and rest periods should be planned
● disease could flare at any time due to overworking the joints or extreme physical stress
● Rest cannot be overemphasized.
● Patients may find that they become fatigued easily
● After any period of vigorous activity, a rest period should be planned
● When sleeping, position changes should be in two hour intervals.
Emotions, Stress, and Quackery● relationship between emotions and exacerbations● stress, such as sporting events and driving in bad whether ● devices and gizmos that claim to cure arthritis ● vitamins and other pills will make a patient disease-free.
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Preventing disability and preserving joint function● plan exercise and develop a routine to help maintain joint function ● Range of motion (ROM) can be preserved through careful evaluation and a healthy exercise program. ● A common type of exercise, Isometric, targets specific muscle groups while avoiding joint motion. ● schedule regular check-ups with their doctor and discuss any concerns openly so that the doctor can best evaluate their condition.
Symptomatic treatment
● applying direct heat to an area of swelling or stiffness
● There is no evidence that these methods alter the progression of the disease in any way.
● hot packs, paraffin wax, heating pads, and whirlpool baths.
● cold packs as an alternative to heat therapy.
CAM Methods (Complementary and Alternative Medicine)
● herbal treatments
● vitamins
● minerals
● ointments
● magnets and copper bracelets
● Diets
● praying
● meditation and relaxing activity
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Pharmacological Options● NSAIDs (nonsteroidal anti-inflammatory drugs) reduce joint pain and swelling, but they do not affect the progression of the disease. ● relieve pain and inflammation. ● DMARDs (disease-modifying antirheumatic drugs) are the basis for most RA treatments due to their reputation for impeding joint destruction. These drugs should be implemented into a combination therapy immediately after diagnosis because joint deterioration begins early on. The patient and physician should make a decision about which DMARD to use based on the severity of the disease. Surgical Options● Tenosynovectomy will remove the tendon sheaths. ● Synovectomy is performed to remove diseased parts of the synovium before any cartilage destruction takes place. ● Joint arthoplasty involves the replacement of the joint end with man made parts called prosthesis. ● Arthrodesis, a surgical fusion of the bone, has proved very effective in patients with wrist pain.