231832577 86214449 Proiect Poliartrita Reumatoida

8/10/2019 231832577 86214449 Proiect Poliartrita Reumatoida

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UNIVERSITATEA ,,DUNREA DE JOS,, GALAI

FACULTATEA DE MEDICIN I FARMACIE

SPECIALIZAREA: ASISTEN MEDICAL GENERAL

COORDONATOR TIINIFIC: ABSOLVENT:

PROF. DR. RO CA TUDOR CRISTIAN ANTOHE GETA

2011

CUPRINS

Intro!"#r# .... pag $

PARTEA GENERAL ....... pag %C&'(to)!) I Et(o'&to*#n(& +n 'o)(&rtr(t& r#!&to(-...pag % I.1. Eti!gia ...... pag 10


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Antohe Geta Elemente de prognostic n poliartrita reumatoid (PAR)

I.". Patg#$ia ..... pag 10 I.%. A$at&i# pat!gi'( ...... pag 1.

C&'(to)!) II E)##nt# # (&*no/t(" ( 'ro*no/t(" +n 'o)(&rtr(t&

r#!&to(- .....................pag1

II.1. )a$i*#+t(,i '!i$i'# pag 1 II.". )-i*i'(,i pa,a'!i$i'# .... pag 2 II.%. Diag$+ti' piti/ .. pag $$ II.0. Diag$+ti' -i*#,#$ia! . pag 31 II.2. C&p!i'aii ..pag 3$

PARTEA SPECIAL.. pag 3CAPITOLUL III St!(! ")(n(" 'r(4(n 'ro*no/t("!) +n 'o)(&rtr(t&

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III.". O6i#'ti/3! '#,'#t(,ii . pag

III.%. )at#,ia! 4i t-( .. pag

III.0. A$a!ia g,a*i'a ........ pag

Con")!6((........................pag

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CAPITOLUL II

ELEMENTE DE DIAGNOSTIC I PROGNOSTIC


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*,#'/#$t '8$- +# p,-3'#7 #! apa,# &ai a!#+ !a 'pi!.

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+it,ia +3*#,i$#i a,ti'3!a,# 4i ,#+p#'ta,#a a,ti'3!aii!, i$t#,*a!a$gi#$# -i+ta!# =">.

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Articulaiile m%inii7 '#a ,a-i'a,pia$(7 g#$3$'


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-#+ i$t#,#+at#7 -a, p!ia,t,ita ,#3&ati-( pat# a*#'ta ,i'# a!t( a,ti'3!ai# -ia,t,-ia!(.

Fapt3! 'a +i$/ita #+t# '$+i-#,at( #!#$t3! '


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i$t#,#+at# &ai -#+.

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p,!i*#,ati/(. E,i3$i!# 'a,ti!agi$a+# 4i a!# +3!3i +3$t 5$+( &ai ta,-i/# 4i -# i$t#$+itat# &ai

&i'( ?*ig. $,. @.

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22/68


F(*5 nr5 % Mo(("-r( &)# &rt("!)&;(#( *#n!n"B(!)!( >/#"B#)#?

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A#"t&r#& articulaiilor coloanei vertebrale #+t# ,a,(. C8$- +# p,-3'#7 +#g$t3!

'#,/i'a! +3*#,( '#! &ai -#+. I$*!a&aia &i'ii 63,+# 'a,# +# ,#g(+#4t# 5$t,# ai+ 4i !iga$t3!

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p,'#+# /a+'3!iti'#.

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i$+3*i'i#$( ',$a,ia$(7 ,g8$- p8$( !a i$*a,t &i'a,-i' a'3t.

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p,i$ t,a$+pa,#$( a ',i-#i. A'#a+ta #+t# p+i6i! -at,it( +36i#,ii +'!#,#i p,i$ -i+t,3'ia t#t3,ii

+a!# 4i 34a,a

K 7 ia, !a '#!# ,#'ta!# !a 2 K -i$t,# 6!$a/i. C#! &ai -#+ #p,#+ia +a '!i$i'( #+t# -# ,-i$ ,#$a!.

II5 25 Mo(("-r( '&r&")(n("#

D#4i apa, &ai t8,i3 5$ #/!3ia 6!ii7 #!# pt a;3ta !a ,#!/a,#a 3$3i -iag$+ti'

-i*#,#$ia!.

E7AMENE DE LA8ORATOR

VS

Di$t,# a$&a!ii!#


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D#t#r(n&r#& VS

P,#!#/a,#a p,6#!, 9 +# ,#'!t#a( +8$g# /#$+ 5$ /a'3t(i$#,# +p#'ia!# p#$t,3 VSH:

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T,a$+p,t3! p8$( 5$ !a6,at, +# a+ig3,a 5$ t36 p,i&a, 5$ '#! &ai +'3,t ti&p.

I-iat 5$ai$t# -# t#+ta,# +# &i#a( t363! '3 at#$i# p,i$ ,(+t3,$a,# &i$i& -# 'i$'i ,i.

S# p!a+#a( t363! 5$ +tati/3! -# &a+3,a,# a+ig3,8$-39$# '( $i+'3! +3p#,i, #+t# !a

$i/#!3! #,. Di+ta$a -i$t,# $i+' 4i 6aa t363!3i t,#63i# +a *i# 22 && ?291 &&@. S# p!a+#a(

+tati/3! !a t#&p#,at3,a 'a,#i p# +3p,a*a( ,i$ta!a *(,( /i6,aii.

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X#+t#,g,#$ ?1 3$itat# X#+t#,g,##$1&& ,a@.

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5$t8!$it( 5$ p#,ia-#!# -# a'ti/itat# a 6!ii7 &ai a!#+ !a 6!$a/ii *#6,i!i +a3 !a '#i '3 ati$g#,i

p!ia,ti'3!a,# ?*ig. $,. J@.

A$#&ia ?-# tip $,&'ita,7 $,&',& +a3 .

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27/68


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28/68


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% -# ,i *a( -# $,&a!7 *ii$- p,##$t( 5$ +#, +a3 a!t# !i'


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T#+t3! -# *a't, ,#3&ati- &(+a,( 'a$titat#a -# a$ti',pi ai a'#+t3ia -i$ p!a+&(

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A$ti',pii +3$t p,-34i -# +i+t#&3! i&3$ita, p#$t,3 a a;3ta !a -i+t,3g#,#a 6a't#,ii!, 4i

/i,3+3,i!, '# pt 'a3a -i*#,it# a*#'i3$i.Fa't,3! ,#3&ati- #+t# 3$ a$ti',p7 '# +# pat# ata4a -# '#!3!#!# +($ata+# a!#

,ga$i+&3!3i7 ,#3!t8$- -i+t,3g#,#a a'#+t,a.

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ap,#'ia #t#$+ia !#i3$i!, 5$ /#-#,#a #/a!3(,ii 4i ap,#'i#,#a *#!3!3i p#,ai#i ?*ig. $,. 1@.

E=n# R&(o)o*("#

adiografia osteoarticulara,# p$-#,# -iag$+ti'( &a,#7 &ai a!#+ 5$t,93$ '$t#t '!i$i'+3g#+ti/. $ #a&i$a,#a 3$#i ,a-ig,a*ii +# 3,&(,#4t#:

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-# i$+#,i# a! +i$/ia!#i p# 'a,ti!a; 4i +3$t 3,&a,#a ,#+,6i#i +a+# p,-3+# +36

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+3*#,it# -# ap*ia -$ti-( a ai+3!3i.

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+t#+'!#,ti'( +36'$-,a!( #+t# &ai i$t#$+(.

T,#63i# +36!i$iat *apt3! '( -#4i &-i*i'(,i!# +t,3't3,a!# a!# 'a,ti!a;3!3i +# p,-3' ti&p3,i37

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+t#+'!#,ti'( +36'$-,a!( #+t# &ai i$t#$+(.

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3$#,i +36 3$ a$ -# !a -#63t3! 6!ii7 +#&$#!# ,a-i!gi'# -#/i$ /ii6i! &3!t &ai t8,i3 3$#,i

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$3'!#a,(.

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-iagnosticul de poliartrit reumatoid$#'#+it( '$*i,&a,#7 +!i'it( -i*#,#$i#,#a -# a!t#

+3*#,i$# '3 'a,# a, a/#a p3$'t# '&3$# 4i i&p3$# ap,#'i#,#a +ta-i3!3i -# #/!3i# 4i -# a'ti/itat#a! 6!ii ?*ig. $,. 1"@.

-iagnosticul pozitiv#+t# 34, -# *('3t 5$ +ta-ii!# a/a$+at# a!# 6!ii7 a+p#'t3! '!i$i' 4i '#!

,a-i!gi# *ii$- +3*i'i#$t -# +3g#+ti/.

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i,#/#,+i6i!#.

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g,a/( p!ia,t,ita a'3t(7 #p!i/( 4i &ig,at,i#7 *a,t# a+#&($(ta,# ,#3&ati+&3!3i a,ti'3!a, a'3t

B3i!!a3-

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5$ ti&p3! ;3/#$i!7 -#63t3! pat# *i pa3'ia,ti'3!a, 4i a+it,i'

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&i' -# a,ti'3!aii #+t# &ai *,#'/#$t(. S# +#&$a!#a( a*#'ta,#a 5$t,9 i$'i-#$( +3p#,ia,( a

a,ti'3!ai#i 3&(,3!3i

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-i$t,# a'#+t# ',it#,ii.

E7AMENE DE LA8ORATOR

P,i&3! #!#$t a3t,#a'ti/ i-#$ti*i'at 5$ +#,3! pa'i#$i!, '3 p!ia,t,it( ,#a'ti/( a *+t*a't,3! ,#3&ati- ?FR@7 3!t#,i, *ii$- -#*i$it 'a 3$ a3ta$ti',p +p#'i*i' a$ti9i&3$g!63!i$a G.

Di$ 107 '8$- E&i! Xaa!#, a -#+',i+ i$iia! FR7 5$ +#,3! pa'i#$i!, '3 PAR a3 *+t g(+ii

$3,4i a!i a3ta$ti',pi 'a,# a'i$#a( a+3p,a -i/#,+#!, '&p$#$t# ti+3!a,#9i$t( ?-# #.

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p,t#i$# $3'!#a,# 4i p,t#i$# 'it,3!i$at# '3& a, *i *i6,i$a +a3 /i$ti$a@.

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?ACPA@ a3 +p#'i*i'itat# &ai ,i-i't(7 5$ ti&p '# a!i a3ta$ti',pi7 i$'!3+i/ FR7 apa, &ai *,#'/#$t 4i

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a*#'i3$i ,#3&at!gi'#. Tt34i7 +p#'i*i'itat#a FR p#$t,3 PAR ',#4t# '$+i-#,a6i! -at( '3',#4t#,#a tit,3!3i7 3$ FR &ai &a,# 'a 2 UI&L7 *ii$- +p#'i*i' p#$t,3 p!ia,t,ita ,#3&ati-(.

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pt *i p,##$t# -#;a 5$ +ta-ii!# p,#''# -# 6a!(7 3$#,i p,#'#-8$- -#63t3! PAR '3 '8i/a a$i.

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+36tip3,i!# FRIg ) +i FR9Ig G. E+t# i&p,ta$t -# 4ti3t '( tit,3,i ,i-i'at# -# FR9Ig ) 4i FR9Ig A

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