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Rheumatoid Arthritis and Systemic Lupus Erythematosus

Rheumatoid Arthritis and Systemic Lupus Erythematosus. RA - Predisposing Factors. Gender. Infection. Genetic. Hormonal. RA. SLE - Predisposing Factors. Gender. Race. Genetic. Toxins UV light. SLE. Pathophysiology - RA. Antigenic Stimulus (virus?). IGg formed.

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Rheumatoid Arthritis and Systemic Lupus Erythematosus

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  1. Rheumatoid Arthritis and Systemic Lupus Erythematosus

  2. RA - Predisposing Factors Gender Infection Genetic Hormonal RA

  3. SLE - Predisposing Factors Gender Race Genetic Toxins UV light SLE

  4. Pathophysiology - RA Antigenic Stimulus (virus?) IGg formed Rheumatoid Factor (RF) Autoantibody IGg + RF = Immune Complexes Deposited in joints, vessels and pleura

  5. RA - Pathophysiology Microvascularinjury = synovial inflammation Pannus formation = invades joint and bone Fibrous tissue replaces pannus= deformity and dysfunction Calcification + ankylosis = immobility

  6. SLE - Pathophysiology or

  7. SLE - Pathophysiology Antigen - Antibody Complex Complement Activation Immune Complex Buildup = Lupus Vasculitis Ischemia

  8. SLE - Pathophysiology ISCHEMIA Thickened lining Fibrinoid degeneration Thrombus

  9. Complications of RA

  10. Complications of RA -Cysts

  11. Complications of RA - Cysts - Infection

  12. Complications of RA - Cysts - Infection - Osteoporosis

  13. Complications of RA - Cysts - Infection - Osteoporosis - Amyloidosis

  14. Complications of RA - Cysts - Infection - Osteoporosis - Amyloidosis - Spinal Cord Compression

  15. Complications of SLE INFECTION

  16. Clinical Manifestations of RA and SLE

  17. DiagnosticTests

  18. Diagnostic Tests - RA - ESR - Elevated in 85% - Used to monitor response to TX - RF - Greater than 1:160 in 80% - WBC - Greater than 30,000 in synovial fluid

  19. Diagnostic Tests - RA - Synovial Fluid - Increased volume and turbidity - Decreased viscosity - X-ray - Early - Bone Demineralization - Soft tissue swelling - Late - Narrowed joint space - Erosion - Deformity

  20. Diagnostic Tests - SLE - ESR - Increased - Gamma Globulin - Increased - Hct - WBC - Platelets Decreased

  21. Diagnostic Tests - SLE - EKG - X-ray - Pericarditis - Pleural effusion

  22. Diagnostic Tests - SLE - Antinuclear Antibody (ANA) - Present in 99% of cases - Not specific for SLE - RPR - False positives - UA - Cellular casts - Proteinuria

  23. Diet Therapy RA and SLE Depression Steroids H20 Retention

  24. LIFESTYLE INTERVENTIONS

  25. Lifestyle Interventions - RA PAIN !!!!! - Thermal Treatment - Heat up to 20 minutes - Cold up to 15 minutes - Decrease stress to joints (modify tasks) - Pain meds before activities

  26. Lifestyle Interventions - RA MOBILITY - ROM - in water and out - Moist heat - Rest joints - splints and modify tasks - More strenuous activities later

  27. Lifestyle Interventions - RA INCREASE ENERGY - Schedule and space activities - Rest periods - Regular exercise to tolerance - Energy conservation - Joint protective devices

  28. Lifestyle Interventions - RA SELF-CARE DEFICIT - Assistive devices - Sequence activities

  29. Lifestyle Interventions - SLE EFFICIENT ENERGY EXPENDITURE - Spacing - Scheduling - Sequencing

  30. Lifestyle Interventions - SLE SKIN INTEGRITY - Mild soap and water - Avoid sun - Only Rx. skin lotions

  31. Lifestyle Interventions - SLE INCREASE ACTIVITY - Pacing - Relaxation techniques - Pain management - Recreational activities

  32. Lifestyle Interventions - SLE ADEQUATE NUTRITION - Manage depression - Food preferences - Small frequent meals - Monitor lab values

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