MS 2 Flashcards
imaging - OA
x ray
imaging - joint space narrowing
x ray
imaging - bleeding
CT
imaging - aneurysms
CT
imaging - pelvic and bone trauma
CT
imaging - gold standard for injuries of cartilage, menisci, tendons, ligaments, or joints
MRI
imaging - soft tissue
MRI
imaging - joints
MRI
imaging - occult fractures
MRI
ankylosing spondylitis
chronic inflammatory disorder (seronegative arthritis) that affects mainly the spine and sacroiliac joints
chronic inflammatory disorder (seronegative arthritis) that affects mainly the spine and sacroiliac joints
ankylosing spondylitis
ankylosing spondylitis - early s/sx
neck pain
ankylosing spondylitis - classic case
male patient, c/o neck pain that gradual goes down spine, impaired spinal mobility, wakes him up at night, pain diminished with exercise but not rest
ankylosing spondylitis obj findings
3
- marked loss of ROM of the spine when bending forward, rotation, lateral bending
- decreased respiratory excursion
- uveitis - eye irritation, photosensitivity, eye pain
loss of ROM in spine mobility with eye irritation - think
ankylosing spondylitis
ankylosing spondylitis - refer to
rheumatologist
ankylosing spondylitis - initial pharm tx
NSAIDs; if risk of bleeding, then add PPI
ankylosing spondylitis - tx for severe causes
4
TNF
biologics
DMARDS
spinal fusion
bamboo spine is pathognomic for
ankylosing spondylitis
ankylosing spondylitis - uveitis tx with
topical steroids; oral if resistant to initial therapy
lateral epicondylitis aka
tennis elbow
medial epicondylitis aka
golfer’s elbow
gradual onset of pain on the outside of elbow that can radiate to forearms; pain worse with twisting or grasping movements
lateral epicondylitis/tennis elbow
gradual onset of aching pain on the medial area of the elbow, can last a few weeks to months; mild to severe pain
medial epicondylitis/Golfer’s Elbow
gout
deposits of uric acid crystals inside joints and tendons d/t genetic excess production or low excretion of purine crystals
gold standard tx to dx gout
joint aspiration of the synovial fluid of the joint
gout elevated serum uric acid value
> 6.8
uric acid target goal value
<6
gout - uric acid level during acute phase
normal; uric acid level doesn’t begin to rise until after the acute phase
most accurate time to assess for serum urate is when
2 weeks or more after a gout flare subsides
conditions that increase serum uric acid levels
2
chemo
radiation
medications that increase uric acid
2
hydrochlorothiazide
furosemide
during gout flare, if the patient is taking a daily urate lowering therapy should they continue
yes, continue
gout flare meds
3
NSAIDs
steroids
cholchicine
gout flare - steroids
glucocorticoids such as prednisone or prednisolone 7-10 days, or short 5 days course; taper off
colchicine - avoid what food/drink
grapefruit
colchicine side effects
5
diarrhea
abd pain
cramps
NV
