Obesity Concept Map: An Overview

The aim of this concept map is to clarify the approach for evaluating and managing overweight/obesity patients.

Definition

The map starts with the definition of Obesity "obesity is excess body fat. It is defined as a body mass index (BMI) ≥ 30 kg/m2." and the epidemiology. On the left side of the map, you'll find obesity etiology and risk factors stated and represented using a funny image that will help you memorize this part easily.

Etiology and Risk Factors

Factors that contribute to obesity include:

· Genetic factors; cause primary obesity

· Environmental factors

· Secondary causes; medications and medical conditions that may cause secondary obesity

· Psychiatric disorders

· Physiological factors

· Other risk factors

Obesity Etiology and Risk Factors - part of the map
Click to enlarge

Classification

According to the etiology:

· Primary obesity

· Secondary obesity

According to body mass index (BMI)

Classification of obesity according to BMI

According to waist-to-hip ratio (fat distribution):

· Apple obesity

· Pear obesity

Diagnosis and Clinical Presentation

Diagnosis of obesity is based on

1- History; it is important to assess patient's dietary habit, physical activity level, whether obesity is due to one of the secondary causes or not, and if the patient have any of obesity comorbid conditions that should be managed besides to obesity.

2- Physical Examination, includes:

· Body mass index (BMI) = weight / height² (kg/m²); it is used to assess the severity of obesity; see previous table

· Body composition analysis; assesses percentage of body fat and muscle.

· Waist circumference; estimates visceral fat

· Waist-to-hip ratio; measures fat distribution; accordingly obesity is classified into: Pear obesity (gynoid obesity) and Apple obesity (Android obesity)

3- Laboratory Test that assess secondary causes and/or comorbid condition, examples:

· Fasting lipid profile

· Fasting plasma glucose, hemoglobin A1c, and electrolyte measurements

· Serum thyroid stimulation hormone and free T4 measurement

Complications and Comorbidities

They are stated in the map using a simple figure showing sites of organs exposed to obesity complications. Overall they can be: psychosocial, neurological, cardiovascular, endocrinal, musculoskeletal, renal, gastrointestinal, and/ or pulmonary.

Using the previously mentioned aspects of obesity – risk factors, secondary causes and information got from diagnosis and clinical presentation - individualized treatment goals and plan are to be set.

Treatment of Obesity

The map includes treatment goals and approach.

First line therapy for obesity is Non-Pharmacological Treatment including: Low-calorie diet (LCD), Exercise, and Behavioral Modification – benefits of each and more details are stated in the map.

Pharmacotherapy – presented in the form of comparison; comparing:

- Centrally acting anorexiant medications (impair dietary intake)

First, Agents Approved for Long-Term Use (Lorcaserin - Phentermine/Topiramate ER)

Second, Agents Approved for Short-Term Use (Phentermine – Diethylpropion)

- Peripherally acting medications (impair dietary absorption): Orlistat

Bariatric Surgery – the map explains its indications, benefits, most common procedures (Adjustable gastric banding - Roux-en-Y gastric bypass (RYGB)), and post-operative maintenance and supplementation.

This map will help you link between obesity etiology and/or risk factors and diagnosis for the aim of individualizing therapy.

Obesity Folded Map

We hope you find Obesity concept map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Map's Format	Delivery	Printing
Folded Poster The maps is printed out on ordinary A1 size paper and it is folded to be nearly sized as A4 paper.	Physical. To be sent to your address through the Egyptian Registered Postal Mail. Delivery in Egypt takes few days, Other countries: 2-3 weeks; you can upgrade to express mail. Please contact us for details.	Already printed out.	Buy Now
Whole Map It's the map's soft copy. You will have the map as a whole on your computer screen.	Electornic; Download link. A .pdf file for the whole map will be available for download immediately after payment received.	Printing the .pdf file of the map is not allowed.	Buy Now
Printable Version The map is split into pages to be printed on six A4 papers. After printing them, you have to tape the edges together to make a folded poster.	Electornic; Download link. A .pdf file for the printable version of the map will be available for download immediately after payment received.	Printing is allowed. The map is to be printed out on several pages.	Buy Now

Obesity concept map is written by: Hagar M. Abdel AA'l, B Pharm.

Reviewed and edited by Maha Atef, B Pharm.
Last updated on: 7 February 2013

Back to Diseases and Conditions

Obesity Concept Map | Etiology and Risk Factors | Diagnosis | Complications | Comorbidities | Treatment

Dyslipidemia Concept Map
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Dyslipidemia (Hyperlipidemia) Concept Map: An Overview

The aim of this map is to cover the pharmacotherapy of dyslipidemia in an easy and an interesting way that will help you understand the topic and link it with the other related cardiovascular diseases as atherosclerosis. Look inside the map and understand it through this video.

EXPLANATION VIDEO

DEFINITION

The concept map of Dyslipidemia (Hyperlipidemia) starts with the definition. Dyslipidemia is a disorder of elevated or abnormal levels of lipids and/or lipoproteins in the blood, characterized by high cholesterol, triglycerides (TGs), or both, or low High-density lipoprotein (HDL) level.

From this definition branches out the normal physiology of lipid metabolism including what is meant by lipoproteins, function of lipoproteins, and their classification. Low-density lipoproteins (LDL); carry cholesterol from the liver to cells of the body; it is referred to as the "bad cholesterol" lipoprotein. LDL has a role in initiating the atherosclerosis process; this is how dyslipidemia is a risk factor for atherosclerosis and consequently cardiovascular diseases (a small map for cardiovascular diseases categories is included).

LIPID METABOLISM (Normal Physiology)

In this map lipid metabolism is explained briefly through the following diagram:

Lipid Metabolism - Normal Physiology
Click to enlarge

The intestine absorbs dietary fat and packages it into chylomicrons, which are transported to peripheral tissues through the blood. The enzyme lipoprotein lipase breaks down chylomicrons; and fatty acids enter muscle and adipose tissues. The chylomicron remnants are subsequently taken up by the liver to start the process of very-low-density lipoproteins (VLDLs) synthesis. The liver secretes VLDL, which undergo lipolysis by lipoprotein lipase to form LDLs. LDLs are then taken up by the liver and by the peripheral tissues. HDL is produced by the liver. Its function is to transport cholesterol from the body back to the liver. That is why it is called “good cholesterol” lipoprotien.

CLINICAL PRESENTATION

Most patients are asymptomatic for many years prior to the appearance of physical findings.

Physical findings can include:

corneal arcus of the eye and
tuberous xanthomas in the Achilles tendon, hands, feet, elbows, and/or knees.

And symptoms of dyslipidemia can include: paresthesias, dypsnea, and confusion.

CLASSIFICATION

Primary Dyslipidemia; occurs due to genetic mutations; it affects lipoprotein synthesis and metabolism causing the following lipid disorders:

Isolated hypercholesterolemia (increase in cholesterol only)

- Familial hypercholesterolemia (FH)

- Familial defective apoB-100 (FDB)

- Polygenic hypercholesterolemia

Isolated hypertriglyceridemia (increase in TGs only)

- Familial hypertriglyceridemia (FHTG)

- Lipoprotein lipase (LPL) deficiency

- Familial apoC-II deficiency

Mixed or combined hyperlipidemias (increase in both cholesterol and TGs)

- Familial combined hyperlipidemia (FCHL)

- Familial dysbetalipoproteinemia (FDBL)

Watch the video to know when Primary Dyslipidemia is suspected in a patient.

On the other hand, Secondary Dyslipidemia can be caused by the following:

- Diseases: diabetes, hypothyrodism, obstructive liver disease/ biliary cirrhosis, renal disease, nephrotic syndrome/ chronic renal failure, or obesity.

- Drugs: estrogen, progestins, protease inhibitors, anabolic steroids, corticosteroids, isotretinoin, cyclosporine, atypical antipsychotics, thiazide diuretics, or β-Blockers.

These causes should be considered in the diagnosis and the management of dyslipidemia.

RISK FACTORS

Dyslipidemia risk factors are classified as:

Positive Risk Factors
Negative Risk Factors
Emerging Risk Factors

Details are available in the video above.

DIAGNOSIS

Diagnosis of dyslipidemia is based on the Fasting Lipid Profile of the patient; accompanied by the assessment of cardiovascular risk factors using Framingham Risk Score for patients with ≥2 risk factors.

Three Categories of Risk that Modify LDL-Cholesterol Goals (details are included in the map/video):

1- CHD and CHD Risk Equivalents.

2- For patients with ≥2 risk factors, perform Framingham 10-year CHD risk assessment.

3- For patients with ≤1 risk factor, 10-year risk assessment is not required.

These risk categories are linked to (treatment goals) part in the map.

TREATMENT

This part of the map starts with dyslipidemia treatment goals (classified according to the risk category) and targets (primary target for therapy is LDL).

Therapeutic Lifestyle Changes (TLC) and dietary recommendations are stated under the part of non-pharmacological treatment of dyslipidemia.

Pharmacological treatment of dyslipidemia includes:

Four classes of lipid-lowering drugs:

the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (the "statins"), including; atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin

the fibrates (gemfibrozil and fenofibrate),

niacin/nicotinic acid, and
the bile acid binding resins (colestipol, colesevelam, and cholestyramine)

In addition to;

the cholesterol absorption inhibitor, Ezetimibe, and

Omega-3 fatty acids (fish oils)

Each drug / drug class has its own map that covers: the mechanism of action, indications, adverse effects, drug interactions, contraindications, and precautions if any. The map also shows you how to manage certain adverse effects and drug interactions for these drugs. See the following example for Bile acid sequestrants.

Bile Acid Sequestrants
Click to enlarge

Dyslipidemia (Hyperlipidemia) Concept Map Folded Poster

Dyslipidemia Folded Poster

We hope you find Dyslipidemia Concept Map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Map's Format	Delivery	Printing
Folded Poster The maps is printed out on ordinary A1 size paper and it is folded to be nearly sized as A4 paper.	Physical. To be sent to your address through the Egyptian Registered Postal Mail. Delivery in Egypt takes few days, Other countries: 2-3 weeks; you can upgrade to express mail. Please contact us for details.	Already printed out.	Buy Now
Whole Map It's the map's soft copy. You will have the map as a whole on your computer screen.	Electornic; Download link. A .pdf file for the whole map will be available for download immediately after payment received.	Printing the .pdf file of the map is not allowed.	Buy Now
Printable Version The map is split into pages to be printed on nine A4 papers. After printing them, you have to tape the edges together to make a folded poster.	Electornic; Download link. A .pdf file for the printable version of the map will be available for download immediately after payment received.	Printing is allowed. The map is to be printed out on several pages.	Buy Now

Dyslipidemia concept map is written by: May Mehanna, BCPS

Reviewed and edited by Maha Atef, B Pharm.
Last updated on: 11 January 2013

Back to Diseases and Conditions

Dyslipidemia Concept Map | Pathophysiology | Etiology | Treatment | Cholesterol Lowering Drugs

Ischemic Stroke Concept Map: An Overview

Explanation Video

To know about map's content, take few minutes to watch this video. The video shows you how to read the map and how information is linked to each other.

Clinical Presentation and Diagnosis of Stroke

The map starts by the warning signs of stroke which result from sudden loss of blood circulation to an area of the brain. Once the patient reaches the emergency department, diagnostic procedures are done to exclude other causes of neurologic deficit and to establish type of stroke whether it is ischemic or hemorrhagic. An essential part of diagnosis is to identify time of onset of stroke, for deciding if the patient is eligible for thrombolytic therapy. And to identify the risk factors in order to determine secondary preventive measures.

Visit also Imaging and Diagnostic Procedures for Stroke Mind Map

Pathophysiology and Risk Factors

Ischemic stroke is caused mainly by cerebral artery occlusion, which occurs due to one of the following three mechanisms, either, thrombotic occlusion, embolism, or systemic hypoperfusion. You’ll find links between the modifiable risk factors and these mechanisms. For example, atherosclerosis as a risk factor for ischemic stroke may cause atherosclerotic thrombosis or embolism which lead to cerebral artery occlusion.

Modifiable risk factors of stroke should be considered for primary as well as secondary prevention of Ischemic stroke.

Treatment and Secondary Prevention

Treatment of ischemic stroke includes: supportive care, pharmacological treatment, and nonpharmacological treatment.

Regarding pharmacological treatment, it includes mainly, thrombolysis using the fibrinolytic agent alteplase, then antithrombotic therapy using tnti-platelet drugs and anticoagulants.

For patients with acute stroke without cerebral venous sinus thrombosis who are presented within 4.5 hours and have no contraindication to thrombolysis, alteplase is the first choice. However, for those who are presented after 4.5 hours or have contraindications to thrombolysis, aspirin is the first choice therapy.

And for acute stroke with cerebral venous sinus thrombosis, full-dose anticoagulation treatment with heparin then warfarin is recommended.

Antithrombotic therapy also plays a role in secondary prevention of ischemic stroke. In case of Noncardioembolic stroke or transient ischemic attack (TIA), antiplatelet therapy is recommended for secondary prevention. But in case of cardioembolic stroke, warfarin is used instead.

Low-dose subcutaneous unfractionated or low molecular weight heparin has a role in prophylaxis against deep pain thrombosis and pulmonary embolism that usually threaten immobilized stroke patients. Anticoagulants should be used with high consideration to the potential risk of bleeding as an adverse effect of these agents.

Non pharmacological therapy including Carotid Endarterectomy or Carotid Angioplasty and Stenting are considered for secondary prevention for selected patients with carotid artery stenosis.

Back to alteplase for further details. Alteplase is a fibrinolytic agent that causes breakdown of blood clot and restoration of blood supply to the brain, resulting in resolution of neurologic deficits. However, hyperfibrinolysis effect of alteplase may cause hemorrhage which is manifested as systemic hemorrhage or intracranial hemorrhage. Accordingly, ischemic stroke patient should be monitored for the signs of hemorrhage and managed as needed. The patient should also undergo neurological assessment, blood pressure measurement and computed tomography (CT) scanning in case of suspected hemorrhage and 24 hours before starting anticoagulants or antiplatelet agents, in order to avoid risk of bleeding.

Ischemic Stroke Concept Map Folded Poster

We hope you find Ischemic Stroke Concept Map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Map's Format	Delivery	Printing
Folded Poster The maps is printed out on ordinary A1 size paper and it is folded to be nearly sized as A4 paper.	Physical. To be sent to your address through the Egyptian Registered Postal Mail. Delivery in Egypt takes few days, Other countries: 2-3 weeks; you can upgrade to express mail. Please contact us for details.	Already printed out.	Buy Now
Whole Map It's the map's soft copy. You will have the map as a whole on your computer screen.	Electornic; Download link. A .pdf file for the whole map will be available for download immediately after payment received.	Printing the .pdf file of the map is not allowed.	Buy Now
Printable Version The map is split into pages to be printed on nine A4 papers. After printing them, you have to tape the edges together to make a folded poster.	Electornic; Download link. A .pdf file for the printable version of the map will be available for download immediately after payment received.	Printing is allowed. The map is to be printed out on several pages.	Buy Now

Ischemic Stroke Concept Map by Maha Atef, B Pharm
Last updated on: 25 January 2012

Back to Diseases and Conditions

Ischemic Stroke Concept Map | Diagnosis | Pathophysiology | Risk Factors | Treatment | Prevention

Rheumatoid Arthritis Concept Map - Click to enlarge image

Rheumatoid Arthritis Concept Map: An Overview

You can access this map for free. But if you want it as a printable version or a folded poster, please order here.

Definition

Rheumatoid Arthritis is a chronic inflammatory autoimmune disease that involves the joints and may cause systemic manifestations.

Etiology

It is an autoimmune disease with unknown cause and contributing factors (genetic & environmental factors). Environmental factors like: viral infections and cigarette smoking; trigger and maintain joint inflammation.

Epidemiology

- Prevalence; 1% worldwide

- Gender; Women : Men = 3:1 (after 50 years old, gender difference is less marked)

- Age; peaks at 35-45 years old, although it can occur at any age - when it occurs in childhood, it is called "Juvenile Idiopathic Arthritis"

- Limitations of activities:

* 33% have major activities limited

* 29% cannot perform major activities

Pathophysiology

Rheumatoid arthritis pathophysiology is shown in the map in the form of a cascade process that starts by an "Autoimmune Reaction" and ends by "Joint Destruction."

Etiology and Pathophysiology of Rheumatoid Arthritis

Clinical Presentation

Nonspecific signs & symptoms (for weeks/months): fever,malaise,arthralgias, and weakness

Specific signs and symptoms that take weeks to months to appear

Joint symptoms are characteristically symmetric, include:

- Stiffness lasts > 60 minutes after rising in the morning but may occur after any prolonged inactivity (called gelling).

- Erythema, warmth, swelling, and limitation of motion.

Joints involved in rheumatoid arthritis, include

The most common joints involved are;

- Wrists, feet (MTP), and the index (2nd) and middle (3rd) metacarpophalangeal (MCP) joints

Other joints include;

- Proximal interphalangeal (PIP) joints, shoulders, elbows, hips, knees, and ankles.

Any joint, except the distal interphalangeal (DIP) joints

Irreversible Joint Deformities may occur due to disease progression

Ulnar deviation of the fingers
Boutonniere Deformity (hyperextension of the DIP & flexion of the PIP joint)
Swan Neck Deformity (hyperextension of the PIP & flexion of the DIP joint)
Hammer toe deformity

Progression

Disease progresses most rapidly during the first 6 years, particularly the first year; 80% of patients develop some permanent joint abnormalities within 10 years.

Extra-articular Manifestations

Most of rheumatoid arthritis extra-articular manifestations are collected in this image:

Rheumatoid arthritis extra-articular manifestations

Diagnosis

This part of the map includes: History and Examination - Laboratory tests - Radiographic test
(x-ray) - ACR Rheumatoid Arthritis Diagnostic Criteria (2010). In addition, a comparison between rheumatoid arthritis and osteoarthritis is included.

Rheumatoid Arthritis vs Osteoarthritis

Treatment

Treatment goals for rheumatoid arthritis are linked to medications used in managing the diseases.

Medications to Reduce Pain and Inflammation

1) Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

e.g., ibuprofen, naproxen, ketoprofen, piroxicam, and diclofenac

- adjunctive therapy

- treat symptoms and decrease inflammation but do not affect disease progression.

- dose can be decreased or discontinued with successful Disease-modifying antirheumatic drugs (DMARDs) therapy.

- adverse effects: GI toxicity, headache, confusion and other CNS symptoms, increased BP, worsening of hypertension, edema, and decreased platelet function. NSAIDs increase cardiovascular risk.
Non-steroidal anti-inflammatory drug drugs mechanism of action is shown in this diagram:

Non-steroidal Anti-inflammatory Drugs - Mechanism of Action

2) COX-2 inhibitor (only celecoxib)

See the map.

3) Low-dose systemic corticosteroids (CS)

adjunctive therapy
decrease inflammation and other symptoms rapidly and efficiently
slow bone erosion

When to use low-dose systemic CS in RA?

In early RA, low-dose oral prednisone (<10 mg/day) in combination with DMARDs for up to 6 months, as symptomatic effects ↓ with time
In established RA, CS may be used as 'bridging' therapy when DMARDs are initiated, and should be withdrawn once DMARDs have controlled the disease
May be used for severe joint or systemic manifestations of RA (eg, vasculitis, pleurisy, pericarditis)

Contraindications

Relative contraindications include PUD, HTN, untreated infections, DM, and glaucoma
The risk of latent TB should be considered before CS therapy is begun

4) Intraarticular depot corticosteroids

- Temporarily control severe monarticular or even oligoarticular symptoms

- Triamcinolone hexacetonide may suppress inflammation for the longest time

- Triamcinolone acetonide and methylprednisolone acetate are also effective

- No single joint should be injected with a corticosteroid more than 3 to 4 times a year, as too-frequent injections may accelerate joint destruction

- Because injectable corticosteroid esters are crystalline, local inflammation transiently increases within a few hours in < 2% of patients receiving injections

- Although infection occurs in only < 1:40,000 patients, it must be considered if pain occurs > 24 h after injection

Medications to Prevent Disease Progression & loss of joint function

1) Disease-modifying antirheumatic drugs (DMARDs)

Also called "nonbiologic DMARDs," include: methotrexate (MTX), hydroxychloroquine (HCQ), azathioprine (AZA), sulfasalazine (SSZ), and leflunomide.

Other available but rarely used DMARDs include minocycline, azathioprine, cyclosporine, and tacrolimus.

Early treatment of RA (< 6 months after the onset of symptoms) with DMARDs retard disease progression more efficiently and induce more remissions.
Until the full action of DMARDs takes effect, anti-inflammatory or analgesic medications may be required as bridging therapy to reduce pain and swelling.
They differ from each other chemically and pharmacologically.
Patients should be informed about the risks of DMARDs and monitored closely for evidence of toxicity.
Combinations of DMARDs may be more effective than single drugs. Also, combining a DMARD with another drug, such as methotrexate plus a TNF-α antagonist or an IL-1 receptor antagonist or a rapidly tapered corticosteroid, may be more effective than using DMARDs alone.

A comparison between DMARDs is available in the map. The comparison is showing: mechanisms of actions, indications, doses, adverse effects, monitoring parameters, and contraindications.

Disease Modifying Anti-Rheumatic Drugs (DMARDs) - Table Comparison

2) Biologic Agents

Also called "biologic DMARDs"
They are not given in combination with each other due to increased frequency of infections.
Approved by the FDA to treat moderate to severe RA not responded to an one or more of the traditional DMARDs
They may be used alone, but are often in combination with other DMARDs, to increase the efficacy and decrease AE
Start biologic agents while patients remain on NSAID and/or corticosteroid

A comparison between biologic agents is available in the map. The comparison is showing: mechanisms of actions, indications, doses, onset of action, adverse effects, contraindications, and warnings/cautions.

Biologic DMARDs - Table Comparison

3) Other immunomodulatory, cytotoxic, and immunosuppressive drugs

e.g., Azathioprine, and cyclosporin A. Rarely cyclophosphamide and d-Penicillamine

Efficacy is similar to DMARDs but more toxic.
Used in case of treatment failure with DMARDs or to ↓ the need for CSs.
Used infrequently unless there are extra-articular complications.

And here is a comparison between them:

Other immunomodulatory, cytotoxic, and immunosuppressive drugs - Table Comparison

We hope you find Rheumatoid Arthritis Concept Map helpful. Please let us know your opinion in a comment below. You can access this map for free. But if you want it as printable version or a folded poster please order below.

Map's Format	Delivery	Printing
Folded Poster The maps is printed out on ordinary A1 size paper and it is folded to be nearly sized as A4 paper.	Physical. To be sent to your address through the Egyptian Registered Postal Mail. Delivery in Egypt takes few days, Other countries: 2-3 weeks; you can upgrade to express mail. Please contact us for details.	Already printed out.	Buy Now

Printable Version The map is split into pages to be printed on nine A4 papers. After printing them, you have to tape the edges together to make a folded poster.	Electornic; Download link. A .pdf file for the printable version of the map will be available for download immediately after payment received.	Printing is allowed. The map is to be printed out on several pages.	Buy Now

See also (Osteoarthritis Concept Map)

Rheumatoid Arthritis concept map by Maha Atef, B Pharm.

Version: 2.0
Last updated in: 10 June 2014

References

1- Altman, Roy D., MD. "Rheumatoid Arthritis (RA)." Merck Manual Professional. Merck Sharp & Dohme Corp., Nov. 2012. Web. <http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/joint_disorders/rheumatoid_arthritis_ra.html>.

2- Temprano, Katherine K., MD. "Rheumatoid Arthritis ." Rheumatoid Arthritis. Medscape, n.d. Web. 08 June 2014. <http://emedicine.medscape.com/article/331715-overview>.

3- DiPiro, Joseph T. "Rheumatoid Arthritis." Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York: McGraw-Hill Medical, 2011. N. pag. Print.

4- Trombetta, D. (2014). Geriatrics - Rheumatoid Arthritis. In ACCP Updates in Therapeutics® 2014: Pharmacotherapy Preparatory Review and Recertification Course (pp. 68-73).

5- Moses, Scott, MD. "Rheumatoid Arthritis Diagnosis." Family Practice Notebook. N.p., 17 May 2014. Web. <http://www.fpnotebook.com/Rheum/R_2/RhmtdArthrtsDgns.htm>.

6- RINDFLEISCH, J. ADAM, and Daniel MULLER. Diagnosis and Management of Rheumatoid Arthritis. Digital image. American Family Physician. 15 Sept. 2005. Web.

7- Hodkinson, B., E. Van Duuren, C. Pettipher, and A. A. Kalla. "SAMJ: South African Medical Journal - South African Recommendations for the Management of Rheumatoid Arthritis: An Algorithm for the Standard of Care in 2013 - Part 2." SAMJ: South African Medical Journal - South African Recommendations for the Management of Rheumatoid Arthritis: Table 4. Synthetic DMARDs. N.p., n.d. Web. 11 June 2014.

8- Lipton, Sarah, MD, and Atul Deodhar, MD. "Managing RA in 2011: An Update." Rheumatology Network. UBM Medica, 9 Jan. 2011. Web. 17 Nov. 2013. <http://www.rheumatologynetwork.com/rheumatoid-arthritis/managing-ra-2011-update>.

9- Cush, John J., MD. "Biologic Treatments for Rheumatoid Arthritis." American College of Rheumatology. American College of Rheumatology, Dec. 2004. Web. <http://www.rheumatology.org/Practice/Clinical/Patients/Medications/Biologic_Treatments_for_Rheumatoid_Arthritis/>.

10- Hodkinson, B., E. Van Duuren, C. Pettipher, and A. A. Kalla. "SAMJ: South African Medical Journal - South African Recommendations for the Management of Rheumatoid Arthritis: An Algorithm for the Standard of Care in 2013 - Part 2." SAMJ: South African Medical Journal - South African Recommendations for the Management of Rheumatoid Arthritis: An Algorithm for the Standard of Care in 2013 - Part 2. N.p., n.d. Web. 11 June 2014. <http://www.scielo.org.za/scielo.php?pid=S0256-95742013000800030&script=sci_arttext>.

11- Celecoxib (Rx) - Celebrex. (n.d.). Retrieved from http://reference.medscape.com/drug/celebrex-celecoxib-343282

12- RINDFLEISCH, J., & MULLER, D. (2005, September 15). Diagnosis and Management of Rheumatoid Arthritis. Retrieved from http://www.aafp.org/afp/2005/0915/p1037.html

13- Abatacept - Drug Information Provided by Lexi-Comp. (2014, May). Retrieved from http://www.merckmanuals.com/professional/lexicomp/abatacept.html#N213B7F

14- Tocilizumab (Rx) - Actemra. (n.d.). Retrieved from http://reference.medscape.com/drug/actemra-tocilizumab-999419#4

15- Keystone, E., Smolen, J., & Riel, P. (2012, March 30). Developing an effective treatment algorithm for rheumatoid arthritis. Retrieved from http://rheumatology.oxfordjournals.org/content/51/suppl_5/v48.long

16- Bingham, Clifton, and Victoria Ruffing. "Rheumatoid Arthritis Treatment." Johns Hopkins Arthritis Center. Johns Hopkins Arthritis Center, 24 Sept. 2013. Web. <http://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/>.

17- "Osteoarthritis vs. Rheumatoid Arthritis." Diffen. Diffen. Web. <http://www.diffen.com/difference/Osteoarthritis_vs_Rheumatoid_Arthritis>.

18- "Comparing Rheumatoid Arthritis and Osteoarthritis - Topic Overview." Rheumatoid Arthritis Health Center. Healthwise, 5 June 2012. Web. <http://www.webmd.com/rheumatoid-arthritis/tc/comparing-rheumatoid-arthritis-and-osteoarthritis-topic-overview>.

19- Table 4. The Updated ACR/EULAR 2010 Criteria for the Diagnosis of Rheumatoid Arthritis Patients Who Have at Least 1 Joint with Definite Clinical Synovitis (swelling) with the Synovitis Not Better Explained by Another Disease. Digital image. Journal of the Korean Medical Association. Web.

20- Pannus. Digital image. The Free Dictionary by Rarlex. Web.

Related Maps:
Osteoarthritis Concept Map

Back to Diseases and Conditions

Obesity Concept Map: An Overview

Definition

Etiology and Risk Factors

Classification

Diagnosis and Clinical Presentation

Complications and Comorbidities

Treatment of Obesity

We hope you find Obesity concept map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Obesity Concept Map | Etiology and Risk Factors | Diagnosis | Complications | Comorbidities | Treatment

Dyslipidemia (Hyperlipidemia) Concept Map: An Overview

EXPLANATION VIDEO

DEFINITION

LIPID METABOLISM (Normal Physiology)

CLINICAL PRESENTATION

CLASSIFICATION

RISK FACTORS

DIAGNOSIS

TREATMENT

Pharmacological treatment of dyslipidemia includes:

Four classes of lipid-lowering drugs:

We hope you find Dyslipidemia Concept Map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Dyslipidemia Concept Map | Pathophysiology | Etiology | Treatment | Cholesterol Lowering Drugs

Ischemic Stroke Concept Map: An Overview

Explanation Video

Clinical Presentation and Diagnosis of Stroke

Pathophysiology and Risk Factors

Treatment and Secondary Prevention

We hope you find Ischemic Stroke Concept Map helpful and we are looking forward to hearing your opinion. This map is available in the following formats:

Ischemic Stroke Concept Map | Diagnosis | Pathophysiology | Risk Factors | Treatment | Prevention

Rheumatoid Arthritis Concept Map: An Overview

Definition

Etiology

Epidemiology

Pathophysiology

Clinical Presentation

Extra-articular Manifestations

Diagnosis

Treatment

Medications to Reduce Pain and Inflammation

1) Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

2) COX-2 inhibitor (only celecoxib)

3) Low-dose systemic corticosteroids (CS)

4) Intraarticular depot corticosteroids

Medications to Prevent Disease Progression & loss of joint function

1) Disease-modifying antirheumatic drugs (DMARDs)

2) Biologic Agents

3) Other immunomodulatory, cytotoxic, and immunosuppressive drugs

We hope you find Rheumatoid Arthritis Concept Map helpful. Please let us know your opinion in a comment below. You can access this map for free. But if you want it as printable version or a folded poster please order below.

Rheumatoid Arthritis Concept Map | Pathophysiology | Signs and symptoms | Medications for RA

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