23/24: Arthrits - Burdt

Question 1

radiographic findings for osteoarthritis **

Answer 1

• joint space narrowing
• subchondral sclerosis
• osteophyte formation

Question 2

NSAIDs **

Answer 2

• good analgesics
• good for fever
• watch for comorbidities
• good for OA pain; no disease modifying effect for RA

Question 3

true or false: RA is a benign joint disease ***

Answer 3

FALSE

• multisystem, autoimmune disease
• high rates of disability
• increased early mortality

Question 4

NSAIDs are often chosen as initial therapy for RA why? (not generally a good idea)

Answer 4

• effective for pain and stiffness
• NO disease modifying acitivy
• multiple bad effects: GI ulceration, perforation dyspepsia; renal hypetension, decreased GFR; cardiovascular CHF, anti-platelet effect

Question 5

gold standard for treatment of RA

Answer 5

methotrexate

• long track record for safety, tolerability and efficacy
• potential hepatic fibrosis, bone marrow toxicity, pulmonary toxicity, nuisance side effects
• proven for monotherapy as well as combination therapies

Question 6

biggest downside anti-TNFalpha therapies

Answer 6

infectious complications (TB and histoplasmosis) and also cost

Question 7

erosions on x-ray =

Answer 7

RA

don’t have to be rheumatoid factor +, etc to have the diagnosis

Question 8

HLA B27 **

Answer 8

ankylosing spondylitis and other seronegative arthritis

Question 9

can’t see, can’t pee and can’t climb a tree

Answer 9

reactive arthritis

Question 10

symmetric polyarthritis, wrist, CMP ***

Answer 10

not OA

yes RA