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random > wolff crosswards- OA, gout > Flashcards

wolff crosswards- OA, gout Flashcards

1
Q

Hormone that acts to increase free Ca2+ levels in the plasma, does this increasing bone breakdown promoting reabsorption of Ca 2+ in kidney, and promoting generation of calcitriol

A

PTH

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2
Q

Often the dose-limiting adverse effect when colchicine is administered for gout prophylaxis

A

GI Distress

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3
Q

Late choice biologic DMARD due to limited efficacy, it is a recombinant version of endogenous human Il-1 receptor antagonist

A

Anakinra

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4
Q

Supplementation of this is recommendation for people prescribed methotrexate and/or sulfasalazine for the treatment of RA

A

Folate

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5
Q

Abruptly doing this with exogenous glucocorticoids can be deadly

A

Stopping

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6
Q

Needed to hasten the nevertheless sow-onset responses for DMARDs such as hydroxychloroquine and leflunomide because of their long half-life

A

Loading Dose

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7
Q

Calcitonin from this species has a longer half-life and greater potency than human calcitonin

A

Salmon

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8
Q

Agent used as a traditional DMARD alone or in combination and also to treat IBD, GI side effects are a common reason for discontinuing

A

Sulfasalazine

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9
Q

Absolute contraindication for treatment of RA with methotrexate, reason to choose hydroxychloroquine instead

A

Pregnancy

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10
Q

Drugs that lower serum urate levels by increasing its fractional excretion by the kidneys

A

Uricosuric

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11
Q

Very effective pain relievers, unfortunately have a high risk of abuse and misuse so not used for pain of osteoarthritis etc

A

Opioid

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12
Q

Biologic DMARD, generally not initial choice, a fusion protein blocks T- cell CD80/86 co stimulatory signal needed for activation

A

Abatacept

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13
Q

Microscopic canals between the lacunae of ossified bone; large enough for bacterial but too small for white blood cells so healing with osteomyelitis requires wither that efficacious abx can reach bacteria or that infected bone is removed

A

Canaliculi

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14
Q

COX-2 inhibitor that can be administered to treat pain and inflammation of RA if benefits>risks; only member of its class is still marketed in the US

A

Celecoxib

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15
Q

Intense and historically feared during acute gout attack

A

Pain

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16
Q

Part of dietary intake ( DNA, RNA) that is abundant in, for example organ meats, also synthesized and salvaged as necessary

A

Purines

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17
Q

Nonpegylated recombinant uricase administered for prevention of acute uric acid nephropathy due to tumor lysis syndrome

A

Rasburicase

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18
Q

Refers to person with hyperuricemia due to excess synthesis, excess dietary intake and/or excess cell turnover

A

Overproducer

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19
Q

PEGylated version of recombinant mammalian uricase uses to treat chronic gout in those refractory to conventional therapy

A

Pegloticase

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20
Q

Biologic DMARD, generally a later choice, that is humanized antihuman 1L-6 receptor antibody among its effects is to decrease the acute- phase response to liver

A

Tocilizumab

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21
Q

Should not be administered to RA patients due to the risk of infection

A

Live Vaccines

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22
Q

Blocking the effects of this inflammatory mediator is a common target when treating RA and various other autoimmune disease

A

TNF- Alpha

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23
Q

SNRI that is being used to treat osteoarthritis with some success but increased risk for constipation is problematic

A

Duloxetine

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24
Q

Important non-pharmacological component of RA management

A

Exercise

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25
Q

This of the malignancy can be treated with bisphosphonates or furosemide

A

Hypercalcemia

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26
Q

Non- Aspirin NSAID with long half-life that can be useful for treating inflammation and/or pain of arthritis a recommendation drug choice when benefits still outweigh concurrent cardiovascular risks

A

Naproxen

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27
Q

Refers to the use of methotrexate, hydroxychloroquine and sulfasalazine together to treat RA

A

Triple Therapy

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28
Q

Autoantibodies present in majority of RA patients target arginine residues in proteins that have been converted to a cyclic form of this

A

Citrulline

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29
Q

Can occur in people using bisphosphonates (or denosumab) jaw is a common site where it can be triggered by dental work = osteonecrosis

A

Osteonecrosis

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30
Q

Associated with high serum urate levels (and gluttony), exquisitely painful with big toe being a frequent site

A

Gout

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31
Q

Anti- malarial that is also a traditional DMARD used alone or in combination, alters antigen presentation by disrupting lysosomal pH

A

Hydroxychloroquine

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32
Q

Happens to methotrexate, appears to be responsible for its low-dose ability to treat RA and reasons its beneficial effects persist for some time after drug discontinuation

A

Polyglutamation

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33
Q

Type of bone that is broken in the atypical femoral fractures seen with bisphosphonate treatment

A

Cortical

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34
Q

Patient population at greater risk for serious adverse effects of NSAIDs…and risk for osteoarthritis

A

Elderly

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35
Q

Expensive non-purine/noncompetitive xanthine oxidase inhibitor useful for reducing urate levels in those with allopurinol intolerance

A

Febuxostat

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36
Q

Bisphosphonate administered by IV injection once per year; also associated with highest incidence of osteonecrosis of jaw

A

Zoledronic Acid

37
Q

Not altered by use of NSAIDs or glucocorticoids in RA

A

Disease progression

38
Q

Methotrexate, hydroxychloroquine and sulfasalazine are examples of this type of DMARD

A

Traditional

39
Q

Class of drugs widely used for the treatment of pain and inflammation, but significant cardiovascular/respiratory/renal/GI contraindications and can cause hypersensitivity reactions skin reactions

A

NSAIDs

40
Q

Refers to the response that can occur in people when foreign peptides or proteins are injected

A

Hypersensitivity

41
Q

Calcium- receptor sensitizer, acts to lower PTH secretion in chronic kidney disease

A

Cinacalcet

42
Q

Ensuring adequate intake of this is a means of decreasing risk for osteoporosis

A

Vitamin D

43
Q

Chimeric ( human and mouse) monoclonal antibody directed against TNF- alpha that can be administered IV every 6 weeks as a biologic DMARD

A

Infliximab

44
Q

Anti-TNF- biologic DMARD, this is humanized monoclonal antibody administered subq every 2 weeks; also used for psoriatic arthritis, ankylosing spondylitis Crohns disease ; top selling drug in the world ( Humera))

A

Adalimumab

45
Q

JAK3 antagonist used as a biologic DMARD, novel in that it is orally active

A

Tofacitinib

46
Q

Poorly soluble end product of purine, metabolism in humans, cause of kidney stones

A

Uric Acid

47
Q

Glucocorticoids, prednisolone prodrug, short-term use is useful in therapy for RA until DMARD effects are seen

A

Prednisone

48
Q

Refers to receptor activator of nuclear factor kappaB ligand, its ratio to OPG in the bone microenvironment governs the formation/activation of osteoclasts

A

RANKL

49
Q

Dexamethasone, betamethasone and triamcinolone are among the______ prednisolones, which have much greater potency and/or half-time than natural hydrocortisone

A

Fluorinated

50
Q

Blocks urate reabsorption by URAT1 transporter in proximal tubule to increase fractional excretion of filtered urate in urine

A

Probenacid

51
Q

Along with chondroitin, widely used in hope of treating osteoarthritis but little evidence of benefit beyond placebo effect

A

Glucosamine

52
Q

Route of administration required whenever administering peptides, antibodies, or fusion proteins

A

Parenteral

53
Q

Parenteral route for administration of calcitonin- salmon

A

Intranasal

54
Q

Accumulates outside of the cells as a consequence of AICAR accumulation inside cells due to the action of polyglutamated methotrexate; binds to purinergic GPCR on cell surface to exert anti-inflammatory response

A

Adenosine

55
Q

Never do this with biologic DMARDs

A

Combine Them

56
Q

Dietary supplements for adolescents, postmenopausal women and elderly to treat mild hypocalcemia ( to facilitate bone growth or limit bone loss)

A

Calcium Salts

57
Q

Targets CD20 antigen of B cells to cause a B cell “do-over”, used to treat non-Hodgkin’s lymphoma and chronic lymphocytic leukemia, and can be effective in some antibody- dependent autoimmune diseases

A

Rituximab

58
Q

Relieves inflammation from gout if administered w/in 12-24 hours of symptom onset by blocking the tubulin polymerization (microtubule formation) needed by leukocytes for migration and phagocytosis

A

Colchicine

59
Q

Allopurinol is among the widely used drugs that can cause this potentially fatal syndrome of epidermal necrolysis

A

Stevens Johnsons Syndrome

60
Q

1-34 PTH, only agent that forms bone but must be administered in a PULSED manner…otherwise leads to bone resorption

A

Teriparatide

61
Q

Drug class associated with atypical bone fractures

A

Bisphosphonates

62
Q

Most effective and fastest acting of the traditional DMARDs, monitor for myelosuppression but generally well tolerated at low doses, often added to biologic DMARDs

A

Methotrexate

63
Q

Person with hyperuricemia due to lower than normal fractional excretion of urate or low GFR necessitating higher urate plasma concentrations to adequately filter/eliminate urate production per minute

A

Underexcreter

64
Q

Noteworthy because it suppresses fever and pain but not inflammation, presumably in part by inhibiting prostaglandin synthesis in the CNS; no longer recommended as first-line therapy for osteoarthritis pain, used as adjunct for pain relief in RA

A

Acetaminophen

65
Q

Word applying to pain in joints that suggests a systemic disease such as RA

A

Bilateral

66
Q

Fusion protein made from Fc portion of IgG and two TNF receptors, a biologic DMARD administered 1-2x wk by sc injection also used for psoriasis

A

Etanercept

67
Q

Refers to 1, 25 dihydroxy vitamin D, a hormone of calcium homeostasis that increases Ca2+ absorption from gut and reabsorption in kidney

A

Calcitriol

68
Q

Gouty form of this is due to precipitation of uric acid in tubules if acute and, if chronic, interstitial accumulation of monosodium urate

A

Nephropathy

69
Q

A classic NSAID with COX-1 selective, remains a drug of choice for treating acute gouty arthritis

A

Indomethacin

70
Q

Prototypical bisphosphonate, drug class of first choice for treating osteoporosis in both women and men, its incorporation into bone inhibits the number and activity of osteoclasts

A

Alendronate

71
Q

Increases the risk for developing gout

A

Hyperuricemia

72
Q

NSAID ingredient of topical gel that is perhaps the most effective topical pain remedy for osteoarthritis

A

Diclofenac

73
Q

Hormone that acts to lower free Ca2+ levels in the plasma, does this in part by suppressing bone breakdown

A

Calcitonin

74
Q

Type of therapy for prostate cancer that increase patient risk for developing osteoporosis

A

Androgen Deprivation

75
Q

Disrupts pyrimidine synthesis, a second-choice traditional DMARD due to greater prevalence of more serious adverse effects

A

Leflunomide

76
Q

Damage to serious side effect of hydroxychloroquine, but little risk from low doses now used to treat RA

A

Retinal Damage

77
Q

General name referring to infections more commonly seen in patients using a biologic DMARD

A

Opportunistic

78
Q

Uricoduric agent acting similar to probenecid, both require GFR>60 ml/min

A

Sulfinpyrazone

79
Q

Competitive xanthine oxidase inhibitor that lowers serum urate levels, preferred/standard of care therapy for treatment of recurrent gout if low GFR or past urate stone of urate overproduction

A

Allopurinol

80
Q

SERM with agonist effects on bone but not breast or uterus that is used to treat osteoporosis

A

Raloxifene

81
Q

Mammalian enzyme that converts uric acid to allantoin, in mutated/nonfunctional in humans

A

Uricase

82
Q

Refers to gout needing a management plan that lowers plasma urate levels

A

Recurrent

83
Q

______ urate forms negatively birefringent needle- shaped crystals that can precipitate in and around joints, ear helices, soft tissue, etc, and can impale neutrophils during phagocytosis

A

Monosodium

84
Q

Abundant evidence shows people can have this type of predisposition for gout

A

Genetic

85
Q

For gout, low-dose colchicine or low-dose NSAIDs can be administered with this as a goal

A

Prophylaxis

86
Q

Large aggregations of monosodium urate crystals surrounded by intense inflammatory reaction including large foreign- body giant cells; pathogonomic hallmark of gout

A

Tophi

87
Q

Osteoporosis monoclonal antibody therapy that binds RANKL to lower its bone microenvironment levels relative to OPG, and thereby decrease formation and function of osteoclasts

A

Denosumab

88
Q

Patients with pain due to RA are often administered NSAIDs or glucocorticoids despite their lack of effect on disease progression while waiting for a drug from this broad class to begin exerting its effects

A

DMARD

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