Osteoarthritis Flashcards
These joints are usually spared in osteoarthritis.
Ankle, Wrist, Elbow
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
B
The following are articular structures except:
a. Synovium
b. Synovial fluid
c. Supportive extraarticular ligaments
d. Intraarticular ligaments
C
The following musculoskeletal complaints are characterized as Articular, Chronic, Noninflammatory except:
a. Osteonecrosis
b. Charcot arthritis
c. Hemochromatosis
d. Chronic arthritis
D
MNEMONICS FOR Articular, Chronic, Noninflammatory: CHO (Carbohydrate)
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
B
MNEMONICS: PLS
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.
C-reactive protein
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.
Erythrocyte Sedimentation Rate (ESR)
It is found intrinsically within the knee joint and provides viscoelastic properties to synovial fluid.
Hyaluronic Acid
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
A
MNEMONICS:
aBduction - vaLgus - Mcl
Big-Large-Massive (synonyms)
It is the normal posterior curvature of lower spine.
Kyphosis
Lordosis - normal anterior curvature of lower spine
How to remember: kyPhosis = Posterior
The triad of symptoms of osteoarthritis are the following except:
a. joint pain
b. stiffness
c. locomotor restriction
d. muscle weakness
D
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
F
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.
NSAID (Non-Steroidal Anti-Inflammatory Drugs)
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.
Fibromyalgia
The two major macromolecules in cartilage are _________ and _________.
type 2 collagen, aggrecan
It is the initial analgesic of choice for patients with osteoarthritis.
Acetaminophen (paracetamol)
It reduces friction between articulating cartilage surfaces, which serves as a protector against friction-induced cartilage wear.
Synovial fluid
The lubrication function of synovial fluid depends on two factors.
hyaluronic acid, lubricin
It develops when a minor joint injury occurs in the presence of posterior column peripheral neuropathy.
Charcot arthropathy
Inflammatory cytokines that induce chondrocytes to synthesize prostaglandin E2 and nitric oxide which have complex effects on matrix synthesis and degradation.
interleukin 1-beta, tumor necrosis factor alpha
To minimize the risk of nonsteroidal-related GI side effects, patients should ____________.
take NSAIDs after food, gastroprotective agent
The only conventional NSAID that appears safe from cardiovascular perspective but have GI toxicity.
Naproxen
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
D. inflammatory cytokines and alarmins
(TRUE or FALSE) Stiffness in OA of the affected joint may be prominent, but morning stiffness usually lasts for >30min.
FALSE. <30min (brief)
It is also called a degenerative joint disease which is characterized by cartilage degeneration that results in structural and functional failure of synovial joints.
Osteoarthritis
It is the principal pathogenic mechanism of osteoarthritis.
a. genetic factors
b. age
c. biomechanical stress
d. obesity
C
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.
Osteophytes
(TRUE or FALSE) Joint deformities develop over time in OA leading to fusion.
FALSE
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.
Bursitis
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
C. it should be fracture
MNEMONICS: GradSchoolFVCk
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
C
Acetaminophen is an analgesic and antipyretic drug which lacks __________ action.
anti-inflammatory
It is a nonselective COX inhibitor NSAID which have shown to interfere with the antiplatelet effects of aspirin.
Ibuprofen
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.
Febuxostat
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.
intra-articular corticosteroids
