Q4 MSK Flashcards
What is Reye syndrome and what causes it?
Febrile illness
Use of salicylates in those <19yo
Chronic overuse injuries where inflammation causes pain and loss of motion - what is best to treat?
NSAIDS>
Naproxen approved for those > ____yo
12
How does capsaicin work?
Stimulates release of substance P from nerve fibers and depletes the store over time. Burning lasts for about 1-2 weeks and then pain relief occurs.
Best for chronic MSK and neuropathic disorders. Used as adjuvant
What is not used to treat acute gout?
Opioids. The issue is inflammation.
Which gout patients are candidates for prevention therapy?
More than 2 attacks/year, CKD >=2, past urolithiasis, and radio graphic damage from gout.
When to treat OP?
Hip or vertebral fx
Osteoporosis (T-score 2.5 or less at femoral neck, hip or spine)
Osteopenia (T-score btwn 1-2.5, AND either 10yr risk of hip fx >3% or 10yr risk of other major fx >20%)
What are some SEs of Ca and vit D intake?
Kidney stones, hypercalciuria, hypercalcemia, increased risk of CV events.
What is essential for the absorption of vit D?
Absorbed in small intestines, bile is essential. Activated in kidneys and stored in liver.
What are DMARDS and what are they used to treat?
Disease-Modifying Antirheumatic Drugs.
RA
DMARDS should be started ______ and are effective, however may take ________ to work, so ______ must be initiated.
Right away (w/in 3 mo of dx)
Weeks to months
Bridge therapy
Patients who use glucocorticoids as a bridge therapy for DMARDS should be aware of what?
May cause loss in bone density - osteoporosis. Only use for 3mo or less.
Categories of DMARDS and their MOAs
Traditional(nonbiological)
- Methotrexate, hydroxychloroquine, sulfasalazine
Biologic
-TNF inhibitors
-B-lymphocyte depleting agents (rituzimab)
-IL-6 receptor inhibitors
-T-cell activation inhibitor (abatacept)
-IL-1 Receptor antagonist (anakinra)
Small molecule DMARD
-JAK inhibitors (Upadacitinib)
What should be given with Methotrexate to prevent toxicities?
Folic acid.
