Osteoarthritis Flashcards
What are the three Radiographic Changes seen in Osteoarthritis?
Joint Space Narrowing
Subchondral Sclerosis
Osteophite Formation
What is the Pathology Associated with Osteoarthritis?
Articular cartilage Loss Osteophyte and Bony Sclerosis Devt Inflam Infiltrates in synovium Lax Ligaments Weak muscles
What distripution of joint involvement in OA?
Symetric Polyarthritis
What is the Non-Pharma Tx of OA?
Pt Education, ADLs, PT and OT, Thermal Modalities, Weight loss, Exercise, Assistive Devices, Joint Protection, Splints
What are the Pharma-Tx for OA?
Tramadol, NSAIDS, APAP, Hyaluronates, Topical Capcasin
What are the risks of NSAIDS?
Stomach ulcers/GI effects
What are the risks of COX-2 Spec NSAIDS?
Potential Risk of CV events
What is the overall Managment goal of OA?
Control Pain
Improve Quality of life
Pharm and non-pharm Tx
Avoid Theraputic Tox
What are the Dx Criteria of RA?
Morning Stiffness Arthritis in >3 joint areas Arth of Hand joints Symmetric Arthritis Rheum Nodules Serum Rheum Factor Radiographic Changes
What is seen on labs in RA?
Rheumatoid Factor
Anti CCP
Acute Phase Response
ANA
What is the Tx of RA?
Corticosteroids: Systemic or Intra-articular, "Bridge Thx" Multiple SE NSAIDS: Pain/Stiff but not disease mod DMARDS Methotrexate
What are the Ocular Effects of RA?
Eye Dryness => Scleritis
What are the Traits of Methotrexate Therapy in RA?
Safe, Tolerable and Effective
SE: Hepatic Fibrosis, BM tox, Pulm Tox. OK as monothx
What are the Traits of DMARD thx in RA?
Not everyone Responds, Slows progress, but doesn’t prevent, SE, Part of Combo Thx
What are the traits of Anti TNF Therapies for RA?
Most potent Available. Combo w/ Methotrexate, Inc Granulomatous infections (TB Histoplasma), Malignancy, $$$
