Felty's syndrome is a complication of

KPSC Staff Nurse - 2021

Medical & Surgical Nursing

Easy

Appeared in: KPSC Staff Nurse - 2021

Explanation

Felty's syndrome is a specific, recognized complication associated with rheumatoid arthritis (RA).
It is defined by a classic triad of conditions: long-standing RA, an enlarged spleen (splenomegaly), and a low white blood cell count (neutropenia).
This syndrome typically occurs in individuals who have had seropositive RA for many years.
The presence of neutropenia is the most serious feature, as it significantly increases the patient's risk for severe and recurrent bacterial infections.

Option A: Osteoarthritis is a degenerative 'wear-and-tear' joint disease. It is not a systemic autoimmune condition and is not associated with the systemic features of Felty's syndrome like splenomegaly and neutropenia.
Option C: Systemic Lupus Erythematosus (SLE) is another systemic autoimmune disease that can cause hematological issues like low blood cell counts. However, the specific triad of rheumatoid arthritis, splenomegaly, and neutropenia is the defining characteristic of Felty's syndrome, which is classically linked to RA.
Option D: Osteochondritis is a localized condition involving inflammation of bone and cartilage, often seen in children and adolescents (e.g., Osgood-Schlatter disease). It is not a systemic autoimmune disease and has no association with Felty's syndrome.

Clinical Relevance

Nursing practice connection: Knowing Extra-articular manifestations of Rheumatoid Arthritis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The primary clinical significance of Felty's syndrome for a nurse is the patient's extremely high risk for life-threatening infections due to neutropenia.
Nursing priorities include meticulous infection control, vigilant monitoring for early signs of infection (which may be subtle), and comprehensive patient education on self-protection.
What if? If the patient's Absolute Neutrophil Count (ANC) drops below 500/µL (severe neutropenia), the patient requires immediate neutropenic precautions, possible hospitalization for protective isolation, and potential administration of granulocyte colony-stimulating factor (G-CSF) to boost neutrophil production.

How to Approach the Question

First, identify the key term in the question stem, which is 'Felty's syndrome'.
This is a factual recall question that requires knowledge of a specific medical syndrome.
Recall the definition of Felty's syndrome. The definition includes the underlying disease it complicates.
The classic definition is the triad of rheumatoid arthritis, splenomegaly, and neutropenia.
Scan the options to find the disease that is part of this classic definition.
Select 'Rheumatoid arthritis' as it is the foundational disease in the triad of Felty's syndrome.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 1044-1046