Module 3 extras Flashcards
Which of the following is strongly recommended AGAINST in Osteoarthritis?
a. KT tape
b. TENS
c. Tai Chi
d. Acupuncture
b. TENS
per 2019 American College of Rheumatology/Arthritis article
https://www.rheumatology.org/Portals/0/Files/Osteoarthritis-Guideline-Early-View-2019.pdf
Which of the following m is strongly recommended AGAINST in Osteoarthritis?
a. NSAID
b. Methotrexate
c. Bisphosphonates
d. Tramadol
e. B and C
b. Methotrexate
c. Bisphosphonates
per 2019 American College of Rheumatology/Arthritis article
https://www.rheumatology.org/Portals/0/Files/Osteoarthritis-Guideline-Early-View-2019.pdf
Which of the following is NOT recommended for osteoarthritis? A. NSAIDs B. Balance training C. Cognitive behavioral therapy D. Non-tramadol Opioids
D. Non-tramadol Opioids
According to Ottawa Ankle rules, An Ankle X-ray is only required if:
There is any pain in the malleolar zone; AND
Any one of the following:
Bone tenderness along the distal 6 cm of the posterior edge of the TIBia or tip of the MEDial
malleolus, OR
Bone tenderness along the distal 6 cm of the posterior edge of the FIBula or tip of the LATeral
malleolus, OR
_________________
An inability to bear weight both immediately and in the emergency department for four steps.
Ottawa Ankle Rules include necessity to palpate the entire distal 6 cm of the _____ and _____
tibia and fibula
- *Note: It also says:
2. Do Not neglect the importance of medial malleolar tenderness
3. Use the rules only on those over the age of 18
Pittsburgh Knee Rules Recommends XR IF mechanism:\_\_\_\_\_\_\_\_ AND any one of the following: -Age <12 -Age>50 -Unable to bear weight in ED (4 steps, limping is allowed)
mechanism: blunt trauma or fall
* all patients with an acute knee injury in the past 1 week old (without surg or ED eval)
True or False:
NSAIDS, corticosteroids by mouth and/or an injection into the joint are all appropriate means of controlling inflammation and pain in osteoarthritis
TRUE
Are steroids and NSAIDs often effective for fibromyalgia?
No
Are antidepressants and anticonvulsants often effective to treat fibromyalgia?
yes
What non-medication treatments can you recommend to a patient with fibromyalgia?
-Exercise relaxation therapy -Cognitive behavioral therapy -Tai Chi and Yoga -Acupuncture -Multidisciplinary care
A _____ flare is typically monoarticular and intensely inflammatory
GOUT
True or False:
Alcohol consumption can trigger a gout flare?
True
This includes beer, spirit, wine
At least 80 % of gout flares involve a single joint, most often the ______
base of the great toe (first metatarsophalangeal joint, known as podagra)
or the knee.
Do gout flares more often occur at night or during the day?
More often at night.
Patient’s may wake up with the new symptoms without “cause”
The two main symptoms of Sjogren’s syndrome are:
Dry Eyes
Dry Mouth
Is Sjogren’s syndrome an autoimmune disorder?
YES, the immune system first targets the glands that make tears and saliva
It is Common for people with Sjogren’s syndrome to also have a rheumatic disease.
It is also more common in people
Age: () 40?
Gender: M or F
Age. Sjogren’s syndrome is usually diagnosed in people older than 40.
Gender. Women are much more likely to have Sjogren’s syndrome.
Complications of Sjogren’s syndrome:
a. Dental cavities
b. oral yeast infections
c. vision problems
d. all of the above
d. all of the above
Dental cavities. saliva helps protect the teeth from the bacteria that cause cavities,
Yeast infections. Sjogren’s syndrome are much more likely to develop oral thrush, a yeast infection in the mouth.
Vision problems. Dry eyes can lead to light sensitivity, blurred vision and corneal damage.
______ measures the rate at which the red blood cells separate from the plasma and fall to the bottom of a test tube. The rate is measured in (mm/hr).
ESR
erythrocyte sedimentation rate
What does an elevated ESR indicate?
If certain proteins cover red cells, these will stick to each other and cause the red cells to fall more quickly. So, a high ESR indicates that you have some inflammation, “somewhere” in the body.
____ increases when you have certain diseases which cause inflammation.
CRP
C-Reactive protein or “acute phase protein”
____ test measures the level of one specific protein, whereas the ______ takes account of many proteins.
CRP test measures the level of one specific protein, whereas the ESR takes account of many proteins.
Fibromyalgia is defined as ____ or more pain sites from a total of nine possible sites
SIX
In addition to pain sites, __________
must have been present for at least 3 months
Moderate to severe sleep problems or fatigue
BOTH pain sites and sleep problems/fatigue must be be present x3+ months
Intra-articular injections can be given _____ times per year.
4
True or False:
Tylenol is used first line for mild to moderate osteoarthritis.
True
per discussion board
For severe osteoarthritis, what med is superior for treatment (if not contraindications)?
NSAIDs for severe
Should you stop Allopurinol when starting colchicine for a gout flare?
YES!
You do NOT keep the chronic (suppressive) medication while treating the acute.
((per discussion board)
Can intra-articular injections be used in the hands?
No. Not recommended. Too much risk for septic joint
