NURS 6501 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders The case study concerns a 60-year-old man with complaints of urinary frequency and incontinence that started after having chemo and radiotherapy three years ago to treat prostate cancer

Question:

The pt. had various symptoms, explain how these factors are associated with RA and what is the difference between RA and OA? 

Your Answer:

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by inflammation of the synovial joints, which can lead to joint destruction and functional disability. 

The patient’s symptoms are quite characteristic of RA. The generalized joint pain, stiffness, and swelling, particularly in the hands, are common early symptoms. The stiffness tends to be worst in the morning and after periods of inactivity, improving with physical activity. RA often affects joints symmetrically, meaning the same joints are affected on both sides of the body, as seen in this patient’s bilateral hand involvement.

The observed ulnar deviation of the hands and swollen, boggy proximal interphalangeal joints are also characteristic signs of RA, indicating ongoing joint inflammation and damage. Additionally, RA can cause systemic symptoms, such as fatigue, which the patient attributed to her stressful job. This is because RA is a systemic inflammatory condition that can affect more than just the joints.

Now, to compare Rheumatoid Arthritis (RA) with Osteoarthritis (OA):

OA is a degenerative joint disease characterized by the breakdown of the joint’s cartilage. The primary risk factors for OA include age, obesity, joint injury, overuse of the joint, and genetics. The main symptoms of OA are pain and stiffness in the affected joint, typically worsening with activity and improving with rest. OA often affects a single joint or is asymmetrical, affecting one side of the body more than the other. OA is most common in weight-bearing joints like the knees, hips, and spine, but it can also affect the fingers.

In contrast, RA is an autoimmune disease where the body’s immune system mistakenly attacks its tissues, including the joints, causing inflammation. RA typically affects multiple joints symmetrically and causes more systemic symptoms, like fatigue and occasional fever. Unlike OA, RA can occur at any age, though it is most common in middle age.

In summary, the key differences are that RA is an inflammatory, autoimmune disease, often causing symmetrical joint involvement and systemic symptoms, while OA is a degenerative disease that primarily affects high-use or weight-bearing joints, with symptoms typically worsening with activity.

Sample Answer 5 for NURS 6501 NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4

Gout refers to chronic inflammatory arthritis characterized by the deposition of monosodium urate monohydrate crystals in tissues. Gout is relatively common with an estimated global prevalence of 1 to 4% (Dehlin et al., 2020). In the United States, gout affects more than 2 million adults (Dehlin et al., 2020). The incidence of gout increases with age as well as a family history of gout. Additionally, gout is slightly male preponderance with up to 2 to 6 times higher in males than females. The pathophysiology of gout is considered complex and multifactorial. Factors implicated in the development of gout include alcohol, medications, hypertension, hyperlipidemia, obesity, diabetes mellitus, cardiovascular disease, diet, chronic kidney disease, advanced age, ethnicity, family history, and male gender (Dehlin et al., 2020). Gout is contemplated as a disorder of metabolism resulting in the accumulation of urate and uric acid in blood and tissues. Consequently, tissues become supersaturated leading to the precipitation of urate salts forming monosodium urate crystals. The deposition of these crystals occurs in an array of tissues although the synovium, kidney, bone, ligament, skin, tendon, and cartilage are among the most common sites. Uric acid is less soluble under low temperatures and acidic conditions. Finally, microcrystals may be shed from preexisting tophi initiating an inflammatory response.