Brainscape's Knowledge GenomeTM

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


See full index

Clin Med Exam 3 (Lauren) > RA, OA, PMR And Fibromyalgia > Flashcards

RA, OA, PMR And Fibromyalgia Flashcards

1
Q

Should we give opioids for fibromyalgia

A

No

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

Name it:

Subchondral bone thickening with degeneration of cartilage

A

OA

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

What is the most specific autoantibody for RA

A

Anti CCP

Specificity is 90-98%

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

What will the labs look like in PMR

A

Elevated ESR

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

Will people with RA have trouble opening jars?

A

Yes, they have reduced grip strength and ROM

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

How long does morning stiffness last with RA and what makes it better?

A

Lasts over an hour and gets better with movement

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

Is the onset of polymyalgia rheumatica progressive or sudden?

A

Sudden***

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

What kinds of external triggers might wake up a genetic predisposition for RA?

A

SMOKING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name it:

Enthesitis with chronic inflammation

A

Ankylosing Spondylitis

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

What is the most common inflammatory arthritis?

A

RA

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

What are the primary joints affected in RA?

A

MCP and PIP

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

What is the main nonbiologic DMARD used in RA

A

Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name it:
More common in women

Chronic, generalized pain

Fatigue

Sleep and mood disturbances

Headaches

IBS

Multiple tender areas

No inflammatory muscle or joint disease

Labs unremarkable

A

Fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the main types of biologic DMARDs used in RA?

A

TNF inhibitors

Non-TNF inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment of RA?

A

DMARDS in all patients

Quit smoking

PT/OT

Rest if needed

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the primary joints affected in OA?

A

DIP

1st CMC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is RA symmetrical

A

Yes**

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

Does the joint space narrow in OA

A

Yes and it can be seen on x ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the treatment for PMR?

A

Low dose steroids!!

PROFOUND RESPONSE

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

How do DMARDs help RA

A

Slow/halt disease progression and preserves joint function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What will you see on an X-ray of OA

A

Joint space narrowing

Osteophytes ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat OA

A

Weight loss **

Oral and topical NSAIDs

Topical capsaicin

Cymbalta

Steroid injections

Tramadol

Tylenol

Opioids sparingly if at all
**know all of these

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes the compression on the cervical spinal cord in RA

A

Inflammation (?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

“I hurt all over”. “It feels like i always have the flu”

A

Fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common joint disorder

A

OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Is the DIP joint affected in OA

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Are there any specific labs for OA

A

No

Negative RF and anti-CCP

Normal ESR and CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How long will morning stiffness last in OA

A

Less than 30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the difference between OA and greater trochanteric pain syndrome

A

GTPS will usually be more lateral with point tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a pathognomic sign of OA

A

Osteophytes (bone spurs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is seronegative RA?

A

RA that lacks both RF and anti-CCP antibodies but otherwise is characteristic of RA in every other way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Is RA a gradual onset

A

Yes, RA pts will have gradual difficulty with ADL’s like walking, dressing, toileting, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Is carpal tunnel syndrome a complication of RA?

A

Yes because the inflammation makes the tunnel smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Is osteoarthritis an autoimmune disease?

A

No it is a degenerative disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Is CAD associated with RA?

A

Yes, the inflammation may increase atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which has extra-articular manifestations: OA or RA?

A

RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the preferred initial imaging study for RA

A

X ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which type of arthritis causes an inflamed synovium?

A

RA

39
Q

Who should be tested for RA?

A

Have at least 1 joint with definite synovitis

Synovitis not better explained by another disease

40
Q

Is OA usually symmetrical or asymmetrical

A

Asymmetrical

41
Q

What is it:
Autoimmune disease that is chronic, systemic, inflammatory that primarily involves the synovial joints with extraarticular manifestations

A

RA

42
Q

“No matter how much i sleep, it’s like i got hit by a truck”

A

Fibromyalgia

-they always feel unrefreshed even after sleeping for 8-10hrs

43
Q

How will the joints appear in OA

A

Hard and bony

44
Q

Name it:

Synovial hypertrophy with chronic joint inflammation

A

RA

45
Q

Is OA just wear and tear of the cartilage

A

No, it involves all of the joint tissues (cartilage, bone, ligaments and synovium)

46
Q

“I suddenly can’t brush my hair or put on my bra or pull shirt over my head”

A

Polymyalgia rheumatica

47
Q

Does RA involve constitutional symptoms like fatigue, myalgia, fever, weight loss

A

Yes

48
Q

Which way do the fingers deviate in RA

A

Ulnar

49
Q

When would we use MRI in the assessment of RA

A

When looking at cervical spine

50
Q

What are all the things you need to know about PMR

A
  • women
  • over 50
  • steroids are 1st line- profound response
  • sudden, recent change
  • giant cell arteritis
  • elevated ESR
51
Q

What are the classic symptoms in classic locations for RA

A

Pain, stiffness and swelling

In the small joints of the hands, wrists and forefoot

52
Q

What are the 2 types of DMARDS

A

Nonbiologic “traditional”

Biologic

53
Q

Does OA affect the synovial membrane or the soft tissue components of the joint?

A

Yes

54
Q

What condition is polymyalgia rheumatica associated with

A 
Giant cell (temporal) arteritis 
********
55
Q

Which has more morning stiffness: RA or OA?

A

RA

56
Q

Why do you need to order both RF and anti-CCP labs for RA?

A

One or the other may be negative, but if they are both positive, it really suggests RA

57
Q

Does RA affect the DIP joints?

A

NO!!!*******

58
Q

What is Felty syndrome and what causes it?

A

It’s a triad of RA, splenomegaly and neutropenia

*******

59
Q

How does RA cause cervical myelopathy?

A

The C1 - C2 joint is unstable and may subluxate causing impingement on the cord

60
Q

Which type of arthritis has Heberdens nodes?

A

OA

61
Q

What is it:

Progressive loss and destruction of cartilage****

A

OA

CARTILAGE EROSION

BONE SPURS

62
Q

RA usually spares the axial skeleton, except for which part?

A

The cervical spine! C1 and C2

63
Q

How will the joints appear in RA?

A

Soft

Warm

Tender

64
Q

What is the most common site for rheumatoid nodules to appear

A

Elbow

65
Q

What kinds of bony changes will be seen in the joint in OA

A

Bone sclerosis (bone thickening)

Osteophytes (bone spurs)

66
Q

What 2 labs do you need to order when diagnosing RA

A

Rheumatoid factor

Anti-CCP antibodies

67
Q

Who is more likely to get polymyalgia rheumatica

A

Women of Northern European descent over 50

68
Q

When should DMARDs be started in RA

A

As early as possible

69
Q

What are some controversial treatments for OA

A

Intrarticular hyaluronic acid

Glucosamine/chondroitin

70
Q

How does RA affect the popliteal fossa

A

Bakers cysts common

71
Q

What is the nonpharmacologic treatment for fibromyalgia

A

Exercise (especially water aerobics)

PT

Behavioral therapy

72
Q

Is secondary Sjögren’s syndrome a manifestation of RA

A

Yes

73
Q

Which type of arthritis involves cartilage loss

A

OA

74
Q

Do you see swan neck and boutonnière deformities in RA?

A

Yes

75
Q

What will you see on X-ray of RA

A

PIP joint erosions

Periarticular osteopenia

Joint space narrowing

Soft tissue swelling around joint

76
Q

What is it:
Proximal** aching and stiffness in the shoulder, pelvic girdle and neck

Over 50 years old

Women of Northern European descent

A

Polymyalgia rheumatica (PMR)

77
Q

How does RA affect the feet

A

Common to see bunions and hammer toes

78
Q

What is thought to cause the symptoms of polymyalgia rheumatica?

A

Nonerosive synovitis and tenosynovitis

79
Q

Is fibromyalgia true inflammation

A

No

80
Q

What makes OA worse and what makes it better?

A

Activity makes it worse

Rest makes it better

81
Q

What will analysis of the synovial fluid in RA reveal?

A

Inflammatory effusion

82
Q

What is the leading cause of chronic disability in old people

A

OA

83
Q

How does the pain present in polymyalgia rheumatica (PMR)

A

Sudden

Bilateral

Shoulders and hips

Morning stiffness/gel phenomenon

84
Q

What do you need to do before starting DMARDs?

A

Check a bunch of labs, give them vaccines, check their eyes and test for TB since the medication can cause malignancy/infection

85
Q

What are the classic findings on the hands in OA

A

Bilateral

Heberdens nodes

Bouchards nodes

First carpometacarpal joint

Often “squared off” due to CMC having osteophytes

86
Q

What is the treatment for fibromyalgia

A

Antidepressants- amitriptyline

Anticonvulsants - gaba

SNRIs- cymbalta or savella

87
Q

What are the locations of the joints usually affected by RA?

A

Many joints on both sides, starting with the peripheral joints to more proximal.

Axial skeleton spared except for cervical spine

88
Q

When does the stiffness of OA get worse?

A

After effort

“Evening stiffness”

89
Q

Who usually gets RA?

A

Women between 35 and 50

90
Q

What are two words you can use to describe the swollen joints of RA?

A

Boggy

Fluctuance

91
Q

What is a marker of disease severity in RA?

A

How many extraarticular manifestations you have

92
Q

What parts of the spine are affected in OA

A

Cervical and Lumbar

RA was just cervical

93
Q

What makes RA worse and what makes it better?

A

Rest makes it worse

Activity makes it better

Clin Med Exam 3 (Lauren) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions