Osteoarthritis

Question 1

These joints are usually spared in osteoarthritis.

Answer 1

Ankle, Wrist, Elbow

Question 2

It is a disease in which all structures of the joint have undergone pathologic change, often in concert.

a. Rheumatoid arthritis
b. Osteoarthritis
c. Septic arthritis
d. Gouty arthritis

Answer 2

B

Question 3

The following are articular structures except:

a. Synovium
b. Synovial fluid
c. Supportive extraarticular ligaments
d. Intraarticular ligaments

Answer 3

C

Question 4

The following musculoskeletal complaints are characterized as Articular, Chronic, Noninflammatory except:

a. Osteonecrosis
b. Charcot arthritis
c. Hemochromatosis
d. Chronic arthritis

Answer 4

D

MNEMONICS FOR Articular, Chronic, Noninflammatory: CHO (Carbohydrate)

Question 5

The following musculoskeletal complaints are characterized as Articular, Chronic, Inflammatory, >3 joints, symmetric, NOT INVOLVED: PIP, MCP, MTP joints, Autoimmune, EXCEPT:

a. Polymyositis
b. Psoriatic arthritis
c. Systemic Lupus Erythematosus
d. Scleroderma

Answer 5

B

MNEMONICS: PLS

Question 6

It is a pentameric protein synthesized by the liver, whose level rises in response to inflammation. It is an acute-phase reactant protein that is primarily induced by the IL-6 action on the gene responsible for transcription.

Answer 6

C-reactive protein

Question 7

It measures the rate at which the red blood cells (RBCs), or erythrocytes, in a sample of whole blood, fall to the bottom of the Westergren tube. This process of “falling” is called sedimentation.

Answer 7

Erythrocyte Sedimentation Rate (ESR)

Question 8

It is found intrinsically within the knee joint and provides viscoelastic properties to synovial fluid.

Answer 8

Hyaluronic Acid

Question 9

This is used to test the medial collateral ligament.

a. Abduction or Valgus test
b. Abduction or Varus test
c. Adduction or Valgus test
d. Adduction or Varus test

Answer 9

A

MNEMONICS:
aBduction - vaLgus - Mcl
Big-Large-Massive (synonyms)

Question 10

It is the normal posterior curvature of lower spine.

Answer 10

Kyphosis

Lordosis - normal anterior curvature of lower spine
How to remember: kyPhosis = Posterior

Question 11

The triad of symptoms of osteoarthritis are the following except:

a. joint pain
b. stiffness
c. locomotor restriction
d. muscle weakness

Answer 11

D

Question 12

Typical exam findings in osteoarthritis include:

a. bony enlargement
b. crepitus
c. effusions
d. limited range of motion
e. two of the options are correct
f. all of the above

Answer 12

F

Question 13

Drug group that is well absorbed (food does not change their bioavailability), highly metabolized, highly protein bound (98%), and found in synovial fluid after repeated dosing.

Answer 13

NSAID (Non-Steroidal Anti-Inflammatory Drugs)

Question 14

It is a pain amplification disorder unified by sleep disturbance, exaggerated by pain and sensitivity and a multiplicity of symptoms with paucity of abnormalities on clinical examination or laboratory testing.

Answer 14

Fibromyalgia

Question 15

The two major macromolecules in cartilage are _________ and _________.

Answer 15

type 2 collagen, aggrecan

Question 16

It is the initial analgesic of choice for patients with osteoarthritis.

Answer 16

Acetaminophen (paracetamol)

Question 17

It reduces friction between articulating cartilage surfaces, which serves as a protector against friction-induced cartilage wear.

Answer 17

Synovial fluid

Question 18

The lubrication function of synovial fluid depends on two factors.

Answer 18

hyaluronic acid, lubricin

Question 19

It develops when a minor joint injury occurs in the presence of posterior column peripheral neuropathy.

Answer 19

Charcot arthropathy

Question 20

Inflammatory cytokines that induce chondrocytes to synthesize prostaglandin E2 and nitric oxide which have complex effects on matrix synthesis and degradation.

Answer 20

interleukin 1-beta, tumor necrosis factor alpha

Question 21

To minimize the risk of nonsteroidal-related GI side effects, patients should ____________.

Answer 21

take NSAIDs after food, gastroprotective agent

Question 22

The only conventional NSAID that appears safe from cardiovascular perspective but have GI toxicity.

Answer 22

Naproxen

Question 23

These are secreted by the synovium which activate the chondrocytes to produce enzymes which accelerate destruction of matrix in osteoarthritis.

a. inflammatory cytokines
b. alarmins
c. fibroblasts
d. two of the options are correct
e. all of the options

Answer 23

D. inflammatory cytokines and alarmins

Question 24

(TRUE or FALSE) Stiffness in OA of the affected joint may be prominent, but morning stiffness usually lasts for >30min.

Answer 24

FALSE. <30min (brief)

Question 25

It is also called a degenerative joint disease which is characterized by cartilage degeneration that results in structural and functional failure of synovial joints.

Answer 25

Osteoarthritis

Question 26

It is the principal pathogenic mechanism of osteoarthritis. a. genetic factors b. age c. biomechanical stress d. obesity

Answer 26

C

Question 27

These are mushroom-shaped bony outgrowths which develop at the margins of the articular surface and are capped by fibrocartilage and hyaline cartilage that gradually ossify.

Answer 27

Osteophytes

Question 28

(TRUE or FALSE) Joint deformities develop over time in OA leading to fusion.

Answer 28

FALSE

Question 29

It is characterized by erythema, warmth, and tenderness on palpation of the bursa, and possibly decreased range-of-motion in certain planes secondary to discomfort.

Answer 29

Bursitis

Question 30

These are considered red flags of musculoskeletal disorders and are Acute, Focal, and Monoarticular, except: a. Gout b. Septic arthritis c. Fibromyalgia d. Vascular ischemia e. Carpal tunnel syndrome

Answer 30

C. it should be fracture MNEMONICS: GradSchoolFVCk

Question 31

What makes aspirin unique from other NSAIDs? a. Reduces the risk of GI toxicity b. Reduces fever c. Irreversibly inhibits its target enzyme d. Selectively inhibits the COX-2 enzyme

Answer 31

C

Question 32

Acetaminophen is an analgesic and antipyretic drug which lacks __________ action.

Answer 32

anti-inflammatory

Question 33

It is a nonselective COX inhibitor NSAID which have shown to interfere with the antiplatelet effects of aspirin.

Answer 33

Ibuprofen

Question 34

It is a non--purine xanthine oxidase inhibitor which prevents hyperuricemia and should not be given to patients on azathioprine or mercaptopurine as plasma levels of these drugs will rise.

Answer 34

Febuxostat

Question 35

I has been widely used for treatment of knee OA, with the rationale to reduce joint inflammation and pain by the local delivery of a potent anti-inflammatory agent.

Answer 35

intra-articular corticosteroids