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GI/Rheumatology Module > Case Questions Exam One > Flashcards

Case Questions Exam One Flashcards

1
Q

Physical Exam for FM

A

Hyperanalgesia
Allodynia

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2
Q

2016 Update to ACR Criteria 2010/2011

A
  1. Generalized pain > 4 body regions
  2. Symptoms >3 months
  3. WPI and SSS
  4. No other disorder explains pain
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3
Q

What is the non-pharmacologic treatment most recommended?

A

Aerobic Exercise

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4
Q

FDA Approved FM Drugs

A
  1. Lyrica
  2. Cymbalta
  3. Savella
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5
Q

Inexpensive drugs to recommend to patient?

A

Recommend Pregablin to help with sleep

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6
Q

What anti depressive drugs are recommended to patient for sleep?

A

Amitriptyline

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7
Q

If the patient cannot tolerate amitriptyline, what else should be recommended that has a similar structure?

A

Cyclobenzaprine

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8
Q

What drug has an enhanced benefit when added to amitriptyline or cyclobenzaprine?

A

Fluoxetine

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9
Q

What are the risk factors of OA?

A
  1. Prior injury
  2. Female
  3. Age 65 and older
  4. Overweight/Obese
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10
Q

What are the S/S of OA?

A
  1. Gelling
  2. Pain
  3. Herbdens Notes
  4. Limit to daily activities
  5. Bilateral Deformity
  6. Osteophyte
  7. Joint Space Narrowing
  8. Crepitus
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11
Q

What are considerations to selecting OA therapy?

A
  1. Diabetes
  2. CrCl
  3. Uncontrolled HTN
  4. Age
  5. GI ULCER, CV, Renal RISKS
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12
Q

Does she have primary or secondary OA?

A

Secondary, because injury to her knee
Primary in other areas maybe

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13
Q

How should she be treated for OA?

A
  1. Topical NSAIDs Voltaren
  2. APAP
    Do not use NSAIDs due to the risk factors
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14
Q

What is the education provided for OA patients?

A
  1. Diet
  2. Exercise/Weight Loss
  3. Stop NSAIDs
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15
Q

What do you monitor in the follow up of OA patients?

A
  1. Pain
  2. Weight Loss
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16
Q

Does treatment with NSAIDs alter the course of osteoarthritis?

A

NO

17
Q

4 Categories that fall under the ACR for RA?

A
  1. Small/Large Joints involved
  2. Duration of symptoms
  3. Serology
  4. Acute Phase Reactant
18
Q

What oral disease-modifying anti-rheumatic drug would you recommend?

A

Methotrexate

19
Q

What is the dosing frequency of Methotrexate?

A

Q WEEK

20
Q

What are the 3 lab tests monitored with on Methotrexate?

A
  1. LFTs- ALT/AST/Albumin
  2. CBC
  3. Chest X-Ray
  4. CrCl Creatinine
21
Q

What can be done to decrease the risk of A/E with methotrexate?

A

Folic Acid

22
Q

If the patient does not respond to Methotrexate, what is recommended to have increased efficacy when added with Methotrexate?

A
  1. Biologics
  2. JAK
  3. SAS
  4. Leflunomide
  5. HCQ
  6. Enbrel
23
Q

What should be done prior to starting JAK inhibitors/biologics?

A

TB Screening
Hep B/C

24
Q

What is the agent’s main MOA?

A

Biologics/Jak Inhibitors

GI/Rheumatology Module (18 decks)

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