Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

clinical medicine exam 3 > RA and OA > Flashcards

RA and OA Flashcards

1
Q

what is rheumatoid arthritis

A
  • autoimmune
  • systemic, inflammtory disorder
  • primarily involves joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

these three characteristics indicate what disease:

  • inflammation
  • destruction of cartilage and bone
  • joint deformity and loss of function
A

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

clinical presentation

  • symmetric polyarthritis
  • morning stiffness for at least 1 hr
  • pain and swelling
  • MCP and PIP
  • IP joints of thumbs
  • wrists
  • MTP joints of toes
  • cervical spine
  • soft, warm, tender joints
A

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

physical exam findings:

  • tenderness
  • swelling
  • ulnar deviation of MCP joints
  • Boutonniere deformity of PIP joints (PIP flexion)
  • swan-neck deformity (DIP flexion)
  • interosseus muscle atrophy
A

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the presence of rheumatoid nodules is what type of prognostic sign

A

unfavorable: usualy means a more severe, progressive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

felty syndrome

A

triad of

  • RA
  • splenomegaly
  • neutropenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the most common cause of death in patients with rheumatoid arthritis

A

cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

name some extraarticular manifestations of rheumatoid arthritis

A
  • episcleritis
  • pleuritis
  • pericarditis
  • vasculitis
  • felty syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the prefered initial imaging study in patients with suspected rheumatoid arthritis

A

radiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

radiologic findings

  • STS around joint
  • periarticular osteopenia
  • narrowing of joint space
  • subluxation/dislocation
  • eventuallu -> joint erosion and obliteration
A

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

diagnostic lab testing for rheumatoid arthritis

A

rheumatoid factor

  • first autoantibody associated with RA
  • RF (+) 80%
  • elevated titers 3x upper limit of normal -> greater specificity

Anti-CCP antibodies

  • present in 60-70%
  • 90-98% specific for RA

elevated ESR and CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

in rheumatoid arthritis, what would be typical of CBC

A
  • anemia (normocytic, normochromic)
  • leukocytosis
  • thrombocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

american college of rheumatology recommend who should be tested

A
  • have at least 1 joint with definite clinical synovitis
  • synovitis not better explained by another disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

nonpharmacologic treatment for rheumatoid arthritis

A
  • exercise
  • PT/OT
  • rest
  • smoking cessation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pharmacologic treatment for rheumatoid arthritis

A
  • NSAIDS and glucocorticoids together
  • DMARDs (disease modifying antirheumatic drugs)
    • Start ASAP
    • slows/halts disease progression, preserving joint function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

list the synthetic (nonbiologic) DMARDs (disease modifying antirheumatic drugs)

A
  • methotrexate
  • sulfasalazine
  • hydrochloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the side effects of methotrexate

A
  1. hepatotoxic
  2. cytotoxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the side effects of sulfasalazine

A
  • hepatotoxic
  • nephrotoxic
  • myelosuppression
  • “sulfa” allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the side effects of hydroxychloroquine

A

vision changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

list the biologic DMARDs (disease modifying antirheumatic drugs)

A
  • etanercept (enbrel)
  • Infliximab (remicaid)
  • Adalmumab (humira)
21
Q

what is the risk of using biologic DMARDs (disease modifying antirheumatic drugs) to treat RA

A
  • inhibit inflammatory cytokines (TNF-a)
  • Risks: infection, malignancy, myelosuppression
22
Q

Risk factors for osteoarthritis

A
  • age
  • female
  • obesity
  • genetic
  • joint wear and tear
23
Q

pathogenesis of osteoarthritis

A
  1. damage to chondrocytes
  2. thinning of articular cartilage
  3. bone remodeling
    1. osteophytes
    2. joint space narrowing
24
Q

patients with osteoarthritis usually have what type of stiffness?

A
  • stiffness is usually worse after effort, may be described as evening stiffness
  • if they have morning stiffness, it is usually resolved < 30 minutes
25
pain associated with osteoarthritis is exacerbated and relieved by what
exacerbated by activity and relieved by rest
26
physical exam findings * crepitus * bony enlargement * **hard and bony joints** * decreased ROM * malalignment * tenderness to palpation * predilection for * hands * knee * hip * spine
osteoarthritis
27
what clinical manifestations do patients with osteoarthritis usually have on thier hands
* Heberden's nodes (DIP) * Bouchard's nodes (PIP) * first carpometacarpal joint
28
what exam characteristics on commonly found on the knees in patients with osteoarthritis
* osteophytes * effusions * crepitus * limitation of ROM
29
what exam characteristics on commonly found on the hips in patients with osteoarthritis
* restricted internal ROM * pain around hip/groin * may result in pain that is referred to knee
30
what is the name for spine degenerative disk disease
cervical, lumbar spondylosis \*specialized terms for OA that affect the spine
31
radiographic changes * joint space narrowing * osteophyte formation * subchondral sclerosis * subchondral cysts
osteoarthritis \*no joint obliteration as seen in RA
32
laboratory findings of osteoarthritis
* no specific test * negative RF and anti-CCP * normal ESR and CRP
33
nonpharmacologic treatment of osteoarthritis
* exercise program * weight loss * rest peroids * PT
34
pharmacologic treatment of osteoarthritis
1. Tylenol (if patient hasn't already tried) 2. NSAIDs 3. Topical NSAID (diclofenac) or capsaicin 4. intraarticular steroids
35
polymyalgia rheumatica is associated with aching and morning stiffness if what joints
**shoulders, hip girdle,** and neck
36
what disease is associated with giant cell (temporal) arteritis
polymyalgia rheumatica
37
polymyalgia rheumatica affects what patient population primarily
\>50 years of age
38
clinical presentation * stiffness at least 30 minutes * 'gel' phenomenon * **symmetric** * shoulder pain \> hip and neck * synovitis and bursitis * edema * decreased ROM * subjective weakenss
polymyalgia rheumatica
39
diagnostic studies * elevated **ESR** * CRP * negative ANA, RF, CCP antibodies
polymyalgia rheumatica
40
what clinical findings are enough to diagnose a person with polymyalgia rheumatica
* proximally and bilat aching and morning stiffness * \> 30 min * persisting \> 2 weeks * 2/3 (neck or torso, shoulder/proximal region of arm, hips/proximal thight) * elevated ESR \> **40** * **rapid resolution with low dose glucocorticoids**
41
initial treatment for polymyalgia rheumatica
**glucocorticoids** 15-20mg/day
42
second line of treatment for polymyalgia rheumatica
methotrexate or TNF inhibitors
43
what is fibromyalgia
* soft tissue pain disorder * muscles, tendons, ligaments * widespread chronic musculoskeletal pain * \*\*no tissue inflammation
44
fibromyalgia commonly affects men or women
women
45
clinical presentation * aching, stiffness, paresthesia * headache * fatigue * cognitive/mood disturbance * disturbed sleep * pelvic pain * IBS * painful bladder syndrome
fibromyalgia
46
what laboratory studies indicate fibromyalgia
negative lab studies
47
what clinical findings must be present to diagnose a patient with fibromyalgia
* symptoms of widespread pain, occuring above and below waist, affecting R and L sides of body * 11-18 common tender points
48
pharmacologic treatment for fibromyalgia
* analgesics * cyclobenzaprine: Treats pain and stiffness caused by muscle spasms * anti-depressant * lyrica \*avoid narcotics

clinical medicine exam 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions