OA,RA,fibromyalgia

Question 1

OA sx

Answer 1

asymmetric joint pain following activity/insidiously
quick morning stiffness, comes back end of day/activity
joints cool w crepitus, limited ROM
Heberdons/bouchards nodes

Question 2

Heberdons and bouchards nodes

located where

Answer 2

bouchards-middle finger
heberdons-tip of finger
(OA bony growth)

Question 3

Rheumatoid and osteoarthritis tx

Answer 3

nsaids, corticosteroids
RA-dmards
OA-opioids, glucosamine/chondroitin

Question 4

OA RA differentiation labs

xray

Answer 4

RA=^ESR, RF, ANA
OA= negative;xray-osteophytes
RA=small and symmetrical joints affected

Question 5

When do you refer

Answer 5

refer to pt or ortho if conservative tx fails or bone on bone

Question 6

if taking NSAIDS, monitor what labs

how long to be off if doing stool blood test

Answer 6

cbc, BUN/cr, liver function,

2-3 days

Question 7

what is RA

Answer 7

chronic inflammatory disease- joint swelling/tenderness, synovial joint destruction=severe disability
autoimmune disease- RF, ACPA! antibodies

Question 8

RA tx and se

Answer 8

nsaids (bleeding/ulcers), dmards, glucocorticoids

Question 9

RA tx non-biologic dmards

Answer 9

methotrexate (rapid)-hepatic fibrosis, BM suppression, GI ulceration,pneumonitis
sulfasalazine-slows joint damage, GI effects intolerable to some

Question 10

RA tx biologic

Answer 10

etanercept-TNFi=vImmunity, HF, hematologic disorders, liver injury, CNS demyelating disorder
Rituximab-vB lymphocytes, vRA sx/disease progression; infusion rxcn, hep B reactivation, PML
((infections/ BM suppression, keep up w vaccines)

Question 11

RA needs referral

Answer 11

early