Arthritis Flashcards
1
Q
Features of rheumatoid arthritis`
A
> 4 features for at least 6 weeks
- morning stiffness
- arthritis in >3 joint areas
- arthritis of hand joints
- symmetric arthritis
- rheumatoid nodules
- serum rheumatoid factor
- radiographic changes
2
Q
Features of osteoarthritis
A
- advanced age
- different joints affected
- synovial fluid less active
- radiological features
- typical patterns of presentation
3
Q
Features of acute gouty arthritis
A
- painful inflamed single joint
- synovial fluid analysis shows negative bifringement needles
- complete resolution of symptoms between attacks
4
Q
How to choose therapy for RA
A
- level of disease
- stage of therapy
- regulatory restricrtions
- patient preference
5
Q
Non-selective NSAIDS for symptomatic relief
A
- Ibuprofen
- Indomethacin
- Naproxen
6
Q
Cox-2 selective NSAID
A
Celecoxib
7
Q
Weak opioids
A
- codeine phosphate
- tramadol
8
Q
Strong opioids
A
- pethidine
- morphine
9
Q
How do glucocorticosteroids work as anti-inflammatories?
A
- increase neutrophils
- decrease lymphs, monos, eosino, and basos
- inhibit tissue macrophages
- inhibit phospholipase A2
- suppress mast cell degranulation
- decrease histamine release
10
Q
Adverse effects of steroids
A
- neuropathy
- hypertension
- osteoporosis
- diabetes
- immunosuppression
- cataracts
- mood disturbance
11
Q
How many intra-articular steroid injections per year max?
A
4
12
Q
Intra-articular steroid preparations
A
- methylprednisone
- betamethasone
- dexamethasone
13
Q
DMARDS for RA
A
- methotrexate
- chloroquine
- sulfasalazine
- azathioprine
- cyclosporine
- TNF a blocking agents
14
Q
MOA of methotrexate
A
Inhibitrs the activity of key enzymes
- interferes with carbon metabolism, purine and pyrimidine synthesis
- leads to increased adenosine release
15
Q
Contraindications for methotrexate
A
- pre-existing blood dyscrasias
- existing renal or hepatic disease
- previous or existing herpes/varicella
- serous effusion
- pregnancy or lactation
