Rheumatology

Question 1

Joint Diseases

Answer 1

• Osteoarthritis (OA)
• Rheumatoid arthritis (RA)
• Gout
• Septic arthritis
• ankylosing spondylitis
• systemic lupus erythematosus (SLE)
• Juvenile idiopathic arthritis (JIA)-Peds

Question 2

RA

Answer 2

• affects hands and metacarpophalangeal joints
• Herberden’s nodes (DIP), Bouchard’s nodes (PIP), Bunions (first MTP)-Absent
• joints are soft, warm and tender
• RF, ANA, CRP and ESR are positive for all

Question 3

OA

Answer 3

• Weight baring joints and carpometacarpal, DIP joints are affected
• Herberden’s nodes (DIP), Bouchard’s nodes (PIP), Bunions (first MTP)-usually present, overgrowth of osteocytes
• joints are bony and hard
• RF, ANA, CRP, ESR are negative for all

Question 4

Acetaminophen (NSAID of choice)

Answer 4

• 1st line therapy for OA
• Up to 4g/day
• potential for hepatic toxicity w/ prolonged high dose

Question 5

NSAIDS

Answer 5

• All NSAIDs have GI toxicity
• initially therapy for all forms of inflammatory joint diseases
• Traditional NSAIDS
• –Salicylates
• –Aspirin (ASA)
• –Non-acetylated salicylates
• –Cyclooxygenase II (COX2) specific inhibitors