Unit 8-musculoskeletol Flashcards
How are primary and secondary osteoarthritis different?
Primary/idiopathic is from physiologic changes–normal with aging. Secondary is from traumatic injuries
What trait sets OA apart from other disorders?
formation of new bone. There is a decrease in proteoglycans, decrease in cartilage, and bones remodel and can cause spurs.
What body areas are affected by OA?
knees, hips, spine, DP.
What are typical presenting symptoms of OA?
Painless crepitus, deformed joints, painful ROM
What is the most common finding in OA?
decreased ROM
What are herberdens nodules?
osteophyte in Distal interphalangeal joint (DIP)
What are bouchards nodules?
osteophyte in proximal interphalangeal joiont (PIP)
What is non pharmacologic treatment of OA?
moist heat, wt loss, exercise
What is first line treatment for OA?
APAP, 650-1000mg q 4-6hours
What is second line treatment of OA?
Nsaids
What is third line treatment of OA?
intraarticular corticosteroids
What is max dose of APAP? What about in ETOH?
4000mg/d. 1.8-2gm/d
What is the best PPI for NSAID induced issues?
omeprazole
What is normal dosing of capsaicin?
3-4x daily for 7 days.
What characterizes RA?
symmetric polyarthritic and joint changes
What is specific to RA?
formulation of pannus
What is first line treatment for RA?
methotrexate if first line DMARD
How long does methotrexate take to show improvement?
3-8 weeks
What is second line treatment for RA?
a second DMARD after initiation of methotrexate–sulfasalazine, immoral, embroil, hummer.
When should a DMARD be started for RA?
within 3 months of symptoms onset
What is first line treatment for fibromyalgia?
TCAs such as nortriptyline, amitriyptiline
What is second line treatment for fibromyalgia?
SSRI such as prozac
What is third line treatment for fibromyalgia?
analgesic
In whom are TCAs contraindicated? why?
elderly patients-can worsen glaucoma and BPH
