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AAA-MEDICINE (GI) > OSTEOARTHRITIS & GOUT > Flashcards

OSTEOARTHRITIS & GOUT Flashcards

1
Q

What is the most common type of arthritis?

A

Osteoarthritis (OA)

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2
Q

Which age group is most commonly affected by osteoarthritis?

A

Elderly (60 years and above)

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3
Q

Which joints are most commonly affected in osteoarthritis?

A

Cervical and lumbosacral spine. hip. knee. 1st metatarsophalangeal joint (MTP)

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4
Q

Which joints are typically spared in osteoarthritis?

A

Wrist. elbow. ankle

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5
Q

What is the characteristic cartilage loss in osteoarthritis?

A

Focal and non-uniform hyaline articular cartilage loss

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6
Q

What bony changes are seen in osteoarthritis?

A

Sclerosis of the subchondral bony plate and outgrowth of osteophytes at the joint margin

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7
Q

What type of synovitis is seen in osteoarthritis?

A

Mild synovitis

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8
Q

What muscle changes contribute to joint failure in osteoarthritis?

A

Weakness of muscles bridging the joint

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9
Q

What is the primary initial event leading to osteoarthritis?

A

Joint injury with failure of protective mechanisms

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10
Q

Which nodes are associated with osteoarthritis in the hands?

A

Heberden’s nodes (DIP) and Bouchard’s nodes (PIP)

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11
Q

Which gender is more commonly affected by osteoarthritis?

A

Women

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12
Q

What is the most potent risk factor for osteoarthritis?

A

Age

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13
Q

Why are women more prone to osteoarthritis after 60 years?

A

Loss of hormone protection

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14
Q

Which genetic polymorphism influences joint shape in osteoarthritis?

A

GDF5 polymorphism

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15
Q

Which joints have the highest heritability for osteoarthritis?

A

Hand and hip joints (50%). Knee joints (30%)

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16
Q

What joint environmental factors increase the risk for osteoarthritis?

A

Congenital dysplasia. Legg-Perthes disease. slipped capital femoral epiphysis. acetabular dysplasia

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17
Q

What major joint injuries predispose to osteoarthritis?

A

Ligament tear. joint malalignment (varus/valgus deformity)

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18
Q

What loading factor increases the risk for osteoarthritis?

A

Obesity

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19
Q

Which occupation increases the risk of hip osteoarthritis?

A

Farmers

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20
Q

Which occupation increases the risk of knee and spine osteoarthritis?

A

Miners

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21
Q

Which occupations involve high risk of knee osteoarthritis?

A

Jobs requiring knee bending and heavy lifting

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22
Q

Which sports are exceptions and do not increase osteoarthritis risk despite high impact?

A

Jogging. walking

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23
Q

What is the hallmark pathology of osteoarthritis on X-ray?

A

Osteophytes

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24
Q

What is the role of chondrocytes in osteoarthritis?

A

They produce matrix molecules (collagen type 2

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25
What growth factor stimulates bone invasion in osteoarthritis?
Vascular Endothelial Growth Factor (VEGF)
26
Which inflammatory mediators are involved in osteoarthritis pathogenesis?
Interleukins (IL). Tumor Necrosis Factor (TNF). Transforming Growth Factor (TGF)
27
What is the primary complaint of patients with osteoarthritis?
Pain
28
When does pain occur in early-stage osteoarthritis?
During or after joint use and gradually resolves
29
When does pain become continuous in osteoarthritis?
Later stages with loss of cartilage integrity and neurovascular invasion
30
How long does morning stiffness last in osteoarthritis?
Less than 30 minutes
31
How does morning stiffness in osteoarthritis differ from rheumatoid arthritis?
Osteoarthritis: <30 minutes; Rheumatoid arthritis: >1 hour
32
What mechanical symptoms are seen in osteoarthritis?
Knee buckling. catching. locking
33
What is the expected white blood cell (WBC) count in synovial fluid of osteoarthritis patients?
<1000 WBC/uL
34
Which imaging modality is not routinely used but reveals the extent of osteoarthritis pathology?
MRI
35
What are the goals of osteoarthritis treatment?
Alleviate pain and minimize loss of physical function
36
What is the mainstay non-pharmacologic management of osteoarthritis?
Alter load across the painful joint and improve joint protector function
37
What exercise is recommended for obese women with knee osteoarthritis?
Swimming (to offload the joint)
38
What assistive device helps redistribute joint load in osteoarthritis?
Brace. splint. cane or crutch
39
What medication is first-line for osteoarthritis pain management?
Acetaminophen
40
Which class of drugs is used when acetaminophen is insufficient for osteoarthritis pain?
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
41
What medication is used for severe osteoarthritis pain?
Opioids
42
Which SNRI can be used for osteoarthritis pain and depression?
Duloxetine
43
What intra-articular injection provides lubrication in osteoarthritis?
Hyaluronic acid
44
What intra-articular injection is used to reduce inflammation in osteoarthritis?
Glucocorticoids
45
What dietary supplements may help improve osteoarthritis symptoms?
Glucosamine
46
What surgical procedures are considered for severe osteoarthritis?
Arthroscopic debridement. arthroplasty. chondrocyte transplantation
47
What bony abnormality on X-ray is a hallmark of osteoarthritis?
Osteophytes
48
What is the function of joint protectors like muscles and tendons?
Absorb and distribute joint impact forces
49
What type of joint injury leads to focal stress and osteoarthritis?
Joint malalignment (varus/valgus)
50
What is the primary pathology in osteoarthritis cartilage?
Proteoglycan depletion and collagen matrix damage
51
What stimulates osteoblast and osteoclast activation in osteoarthritis?
Growth factors and cytokines
52
Which imaging modality correlates poorly with osteoarthritis symptoms?
X-ray
53
What drug class should be avoided in severe osteoarthritis unless necessary?
Opioids
54
Which joint condition in osteoarthritis is associated with cartilage ulceration?
Advanced osteoarthritis
55
What are the two most affected hand joints in osteoarthritis?
Distal interphalangeal joint (DIP). Proximal interphalangeal joint (PIP)
56
What non-pharmacologic intervention corrects malalignment in osteoarthritis?
Bracing. splinting or corrective surgery
57
What is the main difference in pathogenesis between rheumatoid arthritis and osteoarthritis?
Osteoarthritis: cartilage degradation; Rheumatoid arthritis: autoimmune inflammation
58
Which joint movement stimulates mechanoreceptor sensory afferents in osteoarthritis?
Joint movement with load-bearing
59
Why is proprioception impaired in osteoarthritis?
Joint malalignment and muscle weakness
60
What physical therapy goal improves osteoarthritis prognosis?
Strengthening muscles that bridge the joint
61
What is the role of acetaminophen in osteoarthritis management?
First-line pain relief
62
Which medication class can slow down the progression of osteoarthritis?
None; current treatments focus on symptom management
63
What is the most common crystal arthropathy?
Gout
64
What is the main crystal deposit in gout?
Monosodium urate
65
What is the classic presentation of acute gout?
Sudden onset of severe pain. redness and swelling in a joint. typically the first metatarsophalangeal joint (big toe)
66
Which joint is most commonly affected in gout?
First metatarsophalangeal joint (big toe)
67
What is the primary cause of hyperuricemia in gout?
Underexcretion of uric acid
68
What enzyme deficiency can lead to increased uric acid production?
Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) deficiency
69
What condition is associated with HGPRT deficiency?
Lesch-Nyhan syndrome
70
What are common triggers for acute gout attacks?
Alcohol
71
What are examples of high-purine foods that can trigger gout?
Red meat. seafood. alcohol (especially beer)
72
What is the characteristic finding on joint aspiration in gout?
Negatively birefringent needle-shaped crystals
73
What is the serum uric acid level usually like during an acute gout attack?
Can be normal or elevated
74
What is the first-line treatment for acute gout?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
75
What are alternative treatments for acute gout if NSAIDs are contraindicated?
Colchicine or corticosteroids
76
What is the mechanism of action of colchicine?
Inhibits microtubule polymerization. reducing neutrophil migration and inflammation
77
What lifestyle modifications are recommended for gout prevention?
Weight loss. low-purine diet. increased hydration. reduced alcohol intake
78
What medication is used for long-term urate-lowering therapy in gout?
Allopurinol or febuxostat
79
What is the mechanism of action of allopurinol?
Inhibits xanthine oxidase. reducing uric acid production
80
What is the mechanism of action of febuxostat?
Selective xanthine oxidase inhibitor. reducing uric acid production
81
What is the mechanism of action of probenecid?
Increases renal excretion of uric acid
82
What is the most common adverse effect of allopurinol?
Hypersensitivity reaction (rash. Stevens-Johnson syndrome)
83
What condition presents similarly to gout but with calcium pyrophosphate crystals?
Pseudogout (calcium pyrophosphate deposition disease)
84
What is the characteristic finding on joint aspiration in pseudogout?
Positively birefringent. rhomboid-shaped crystals
85
Which joints are commonly affected in pseudogout?
Knee
86
What is the first-line treatment for pseudogout?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
87
What radiographic finding is associated with pseudogout?
Chondrocalcinosis (calcification of cartilage)
88
What is the main risk factor for pseudogout?
Aging. hyperparathyroidism. hemochromatosis
89
Which crystal deposition disease is associated with hemochromatosis?
Pseudogout (calcium pyrophosphate deposition disease)

AAA-MEDICINE (GI) (8 decks)

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