3.4.1 Treatment of Arthritis Flashcards
What type of pharmalogics are possible for OA?
Acetaminophen: under 3 mg
NSAIDS
COX-2 Inhibitors
Glucosamine, Chondroitin, Opiates
Capsaicin (modest benefit)
Intraarticular (IA) injections
What characteristics are checking in each joint?
Warmth?
Swelling?
Tenderness?
Limitation of motion?
What are some of the biologic disease-modifying options for rheumatoid arthritis?
What are some of the nonpharmacologic approaches to treating RA?
physical therapy, occupational therapy, reconstructive surgery
How long must patients be off rheumatoid medications prior to surgery and after?
Off medication 6 wks prior
Off medication 4 wks after
What are two markers for rheumatoid arthritis?
Rheumatoid factor and anti-CCP Ab (patients can be seronegative then progress to seropositive, these can also act as prognostic markers)
Worse with activity, frequently in hands in knees. What type of joint pain?
Non-inflammatory joint pain
What type of nodes are labeled 1? 2?
1 = herberden’s nodes
2 = bouchard’s nodes
What are the two lab values that act as inflammatory markers?
C reactive protein and creatinine
What are some non-biologic disease-modifying drugs for arthritis?
What is the most common crystal-induced form of arthritis?
Gout (urate crystals)
These are features of what imaging modality?
MSK ultrasound
What are some of the nonpharmacologic treatments for OA?
Exercise, unloading, realignment, and acupuncture
Which joints are involved in this RA patient?
PIPs of LIF and LMF
What is one of the more important criteria for RA?
Number of joints involved
What are some common characteristics of joints affected by RA?
Swelling!
Not as common - tenderness, warmth, and limitation of movement (LOM)
What are some imaging techniques that can be used to catch changes in joints prior to changes being seen on x-ray? (more sensitive)
ultrasound
MRI (w/ or w/out) gadolinium contrast
These are features of what imaging modality?
MRI
What are some of the systemic symptoms of RA?
fatigue and malaise
How hard do you press when checking a joint?
Maximum - Until blanching of your distal nail
What is the genetic marker of ankylosing spondylitis?
HLA-B27
When is joint stiffness most commonly noted in RA patients?
Morning stiffness
What is the difference b/t primary and secondary failures in regards to remicade treatment?
Primary: never respond to the drug
Secondary: Respond to drug, then have to get off drug for some reason. The drug isn’t efficacious once they start taking drug again.
What is the genetic factor that predisposes for rheumatoid arthritis?
HLA-DR4
