Walden-NRNP 6560 verified 2022/2023

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Difference between RA and OA RA Treatments Acetaminophen, NSAIDs, Corticosteroids, DMARDS, Biologics, Targeted DMARDs ... ... ... other than ASA, NSAIDs increase risk of having... a heart attack or stroke. Can cause UGI bleed. May need to take with a PPI Corticosteroids Gives quick pain and inflammation relief. Also slows down your immune system helping control autoimmune diseases Risks: Glaucoma, cataracts, fluid retention, mood and behavioral changes, hyperlipidemia, hyperglycemia, increased appetite, osteoporosis, thin skin Traditional DMARDs suppress the immune system, decreases inflammation, slows down joint damage DMARDs: Risks Harder to fight infections, increase chance of CA low blood cell counts, diarrhea, HA, hair loss, fatigue, weight loss, stomach upset. Can take several weeks to work. May be prescribed an NSAID DMARDS: biologic (TNF a antagonist) EIA Etanercept Infliximab Adalimumab DMARDs-biologic Risks not available PO, only IV infusions. Weakens the immune system. (if exposed) TB or Hep B may come back. May cause HF or MS DMARDs-biologic Side Effects HA injection site reaction infusion reaction ... starts with transmission followed by retroviral infection by one of the strains of the HIV-1 and HIV-2 Finally progression of the disease HIV infects cells that express the CD4 receptor and include: Macrophages cD4 T lymphocytes Langerhans cell of the skill Macrophages in the CNS other protected reservoirs, including the intestinal wall HIV infection is chronic and progressive 1. initially a rapid increase occurs in viral particles in the blood 2. During clinical latency (can be prolonged 10yrs) is low yet still detectable 3. During initial symptoms the viral load increases and the number of CD4s lymphocytes measurable in the blood stream Therapy Against HIV 1. Combining ART with appropriate management decreases mortality and opportunistic diseases that characterize AIDs HIV Symptoms a. flu-like symptoms: fever. chills, fatigue, diffuse erythematous rash b. serologic tests for HIV may be indeterminant c. HIV viral load measures are clearly elevated and the CD4 count is within normal range or reduced d. Often missed clinically because of rapid resolution without the need for acute medical care Symptomatic HIV Disease a. often presents similar to acute infection b. fever, chills, diarrhea, unintended weight loss c. appearance of non-AIDS-defining infections: shingles, thrush (oral, mucocutaneous, vaginal) d. Laboratory evidence of HIV viral load AIDs a. Measurable immunodeficiency, with the appearance of one AIDs indicator illnesses or opportunistic infections (OIs): 1. pneumocystis Carini 2. cryptosporidium parvum 3. Candidiasis: esophageal bronchial, tracheal, or pulmonary 4. Chronic herpes simplex >1mo b. CD4 count,200 c. diagnosed in the absence of opportunistic disease HIV Staging -Stage 0: inferred from a negative or indeterminate HIV test result w/i 6 months of a confirmed positive result -Stage 1: CD4 count >500 -Stage 2: CD4 count between 200-500 -Stage 3: CD4 count <200 or a percentage of 14%, or an AIDS defining illness -Stage unknown: Lab confirmation, no info on CD4 count, percentage, or AIDs defining conditions - HIV Infection: Clinical Evaluation 1. Serologic testing a. Screening tests: *Prefered testing algorithm is an antigen/antibody combo HIV-i/2 immunoassay -Negative =HIV uninfected - if the antigen/antibody combo assay is positive, an HIV-1/HIV-2 differentiation is done. If the differentiation immunoassay is negative a qualitative HIV RNA PCR is done B: lab-based antigen/antibody is done in less than 20 min, has high accuracy, sensitivity and specificity. Most useful in urgent care, community-based hospitals, ER, after exposure in a health care setting, pts not likely to return for results HIV Viral Detection An alternative approach to dx HIV. The virus is present in blood samples before the HIV abs are detected. Only detects HIV-1 Low levels may be false-positive [Show More]

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