13. RA and OA

Question 1

pevalence of OA

Answer 1

Question 2

characteristics of OA

Answer 2

lots of golgi, unwound active nucleus, protein synth.

sclerosis and new bone, subchondral osteoporosis,

muscle weakness

fibrocartilage and ligaments

angiogenesis

neural ingrowth

CNS adaptation

new bursae

• Degenerative joint disease
• Non-inflammatory
• Loss of articular cartilage
• New bone formation at joint margins

Question 3

surgery for OA

Answer 3

• Arthroplasty very effective
• Problems of selecting patients
• Resources for arthroplasty
• Longevity of replaced joints
• Timing of surgery pre retirement
• Worse outcome if you re do an operation

Question 4

contraindication with NSAIDs

Answer 4

can cause peptic ulcers

but corticosteroids can worsen outcome

GI toxicity

Block COX 2 block protective mechanisms for heart can cause MI

Question 5

how can NSAIDs cause GI toxicity

Answer 5

topical irritant effect on the epithelium

impairment of the barrier properties of the mucosa, suppression of gastric prostaglandin synthesis, reduction of gastric mucosal blood flow and interference with the repair of superficial injury.

Question 6

what is paracetomal associated with

Answer 6

increased risk of hospitalisation

Question 7

Rheumatoid arthritis

Answer 7

• Uncommon (relatively)
• Overall prevalence of 0.8% and decreasing
• Paradigm of inflammatory disease
• Inflammatory/destructive tissue response
• Immunological and non-immunological mechanisms

Question 8

Epidemiology risk factors of RA

Answer 8

• Age peak age now 65-75 years
• Gender peak in fertile women
• Post-partum
• Stress
• Genetic
• Smoking
• Low education
• Deprivation
• Periodontal disease
• Microbiome?