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Wolff Crosswords > Osteoporosis, RA & Gout > Flashcards

Osteoporosis, RA & Gout Flashcards

1
Q

Uricemia due to excess synthesis, diet intake, or excess cell turnover

A

overproducer

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2
Q

What activates NFkB?

A

RANKL

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3
Q

What governs the formation & activation of osteoclasts?

A

RANKL

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4
Q

Indication for DULOXETINE

A

SNRI used to tx OA

increased risk for constipation

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5
Q

What are tophi?

A

large aggregations of monosodium urate crystals surrounded by intense inflammatory reaction

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6
Q

What is a pathognomonic hallmark of gout?

A

tophi

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7
Q

What is an absolute CI for tx of RA w/ MTX?

A

PREGNANCY

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8
Q

MOA of uricosuric drugs

A

lower serum urate levels by increasing urate fractional excretion by kidneys

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9
Q

MOA & use of prednisone

A

glucocorticoid

short term use in tx for RA until DMARD effects are seen

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10
Q

Sxs of OA

A

localized pain, stiffness, tenderness, crepitus, bone spurs (joint mice)

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11
Q

MOA & use of ANAKINRA

A

late choice biologic DMARD (limited efficacy)

recombo version of endogenous human IL-1 receptor antagonist

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12
Q

AEs of SERMs (raloxifene)

A

DVT
PE
Stroke

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13
Q

MOA & use of infliximab

A

biologic DMARD, monoclonal AB v TNFa

IV every 6 weeks

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14
Q

MOA & use of tofacitinib

A

biologic DMARD, JAK3 antagonist

orally active

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15
Q

MOA & use of tocilizumab

A

biologic DMARD, humanized anti IL-6 receptor AB

decrease acute phase response of liver in RA

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16
Q

MOA of febuxostat

A

non purine, non competitive xanthine oxidase inhibitor

reduce urate levels in pts w/ allopurinol intolerance

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17
Q

MOA & use of pegloticase

A

PEGylated version of recombo mammal uricase

tx chronic gout in those refractory to conventional tx

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18
Q

What is NOT altered by use of NSAIDs or glucocorticoids in RA?

A

disease progression

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19
Q

What should pts take if on MTX or sulfasalazine in tx of RA?

A

B9 (folate) supplement

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20
Q

What hormone acts to increase free Ca2+ levels in plasma?

A

PTH

increases bone breakdown, promotes reabsorption of Ca2+ in kidney & promotes generation of calcitriol

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21
Q

Indication & AEs of Ca2+ salts

A

diet supplement in teen & post meno Fs to facilitate bone growth or limit bone loss

AEs w/ constipation, lethargy, polyuria, kidney stones

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22
Q

MOA & use of colchicine

A

blocks tubulin polymerization (& MT formation) in leukocytes which needed for migration & phagocytosis

tx acute gout in pts who cannot take NSAIDs & relieves inflammation w/ in 12-24hrs of sxs

23
Q

MOA & use of rasburicase

A

non peg recombo uricase

prevention of acute uric acid nephropathy due to tumor lysis syndrome

24
Q

MOA & use sulfinpyrazone

A

uricosuric agent

requires GFR>60, only works for under excreters of uric acid

25
Q

MOA & use of hydroxychloroquine

A

traditional DMARD that alters antigen presentation by disrupting lysosomal pH

tx of RA

26
Q

Indication for cinacalcet

A

secondary hyperPTH caused by CKD

27
Q

MOA & use of denosumab

A

monoclonal AB v RANKL to lower its bone microenviro levels relative to OPG (decreases formation & function of osteoclasts)

tx of osteoporosis

28
Q

MOA & use of allopurinol

A

competitive xanthine oxidase inhibitor that lowers serum urate levels

standard tx of recurrent gout if low GFR or past urate stone or urate overproduction

29
Q

MOA & use of leflunomide

A

disrupts pyrimidine synthesis

2nd choice traditional DMARD for RA

30
Q

MOA & use of raloxifene

A

SERM w/ agonist effects on bone

tx of osteoporosis

31
Q

What type of tx for prostate cancer increases pt risk for developing osteoporosis?

A

androgen deprivation

32
Q

What type of bone is broken in atypical femoral fractures due to bisphosphonate tx?

A

cortical bone

33
Q

What autoABs in RA pts that target protein arginine residues?

A

cirtulline (anti CCP)

34
Q

MOA & use of indomethacin

A

NSAID w/ COX1 selectivity

tx acute gouty arthritis

35
Q

MOA & use of abatacept

A

biologic DMARD that blocks T cell CD80/86 co stimulatory signal needed for activation

tx of RA

36
Q

What is uric acid?

A

poorly soluble end product of purine metabolism

cuase of kidney stones

37
Q

MOA & use of teriparatide

A

1-34 PTH

only agent that FORMS bone via PULSED daily therapy

tx of osteoporosis

38
Q

Major AE of hydroxychloroquine

A

retinal damage

39
Q

MOA & use methotrexate

A

traditional DMARD

must monitor for myelosuppression, tx of RA

40
Q

AE of colchicine

A

GI distress

41
Q

How to tx hyperCa2+ of malignancy?

A

w/ bisphosphonates or furosemide

42
Q

MOA of cinacalcet

A

Ca2+ receptor sensitizer

acts to lower PTH secretion

43
Q

What is triple tx for RA?

A

MTX
Hydroxychloroquine
Sulfasalazine

44
Q

MOA & use of alendronate

A

bisphosphonate, incorporates into bone to inhibit # & activity of osteoclasts

1st choice to tx osteoporosis in M & F

45
Q

MOA & use of sulfasalazine

A

traditional DMARD used for RA

AEs of GI side effects

46
Q

MOA & use of adalimumab

A

antiTNF biologic DMARD

tx psoriatic arthritis, ankylosing spondylitis

47
Q

MOA, use & major AE of zoledronic acid

A

bisphosphonate, IV injection 1x/year for tx of osteoporosis

highest risk of ONJ

48
Q

MOA & use rituximab

A

targets CD20 on B cells

tx RA

49
Q

MOA & use of probenecid

A

blocks urate reabsorption @ URAT1 transporter in kidney prox tubule

increase excretion of urate in urine to tx gout

50
Q

Major AE of allopurinol

A

Stevens Johnson syndrome (fatal epidermal necrolysis)

mc HLAB5801

51
Q

Major AE of oral bisphosphonates

A

esophagitis

52
Q

MOA of etanercept

A

biologic DMARD, sc injection 1-2x/week

tx for psoriasis

53
Q

What is a common target to tx RA & other autoimmune dzs?

A

TNFa block

Wolff Crosswords (2 decks)

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