Term
What joints are affected by osteoarthritis?
What is the MATest?
What are the results of this test? |
|
Definition
Weight bearing joints (knee, hip, ankle)
Xray
Joint space narrowing
Osteophytes
Dense subchondral bone
Bone Cysts |
|
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Term
What is the treatment for DJD?
What is the benefits of Glucosamine? |
|
Definition
Weight loss, and moderate exercise
Acetaminophen/NSAIDS
Capsaicin cream
Intra Articular= if worse
Hyaluronan injection in joint
Joint replacement if disease is severe
Glucosamine and chondroitin no more effective than placibo |
|
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Term
What is the BIT and results for a monoarticular joint:
if Crystals?
if Septic? |
|
Definition
first do a Arthrocentesis
Septic >75 wbc then do a gram stain
Crystal shows 5-50 wbcs then do a polar light |
|
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Term
| What is the Polar light results for Gout and pseudo gout? |
|
Definition
Gout: (-) birifringent that is needle like
pseudo gout: (+) birifingment with rhomboid like |
|
|
Term
| What is best initial treatment for an acute attack of gout? x3 |
|
Definition
NSAIDs
Corticosteroids by injection
answer when there is no response to NSAIDs, CI to NSAIDs such as renal insuff
Colchicine is used if pt cant used other tx |
|
|
Term
what is the Mech of action of Colchicine?
what is the Adverse Effects? |
|
Definition
affects microtubule formation decreasing macrophage migration and phagocytosis
Gives diarrhea and Bone marrow supppression (neutropenia) |
|
|
Term
| what is the Chronic managment of gout? x6 |
|
Definition
Diet: decrease: alcohol,beer, weight, highpurine foods like meat and seafood
2. stop thiazides,asprin, niacin,
3. Colchicine
4. Allopurinol (Febuxostat if CI)
5. Pegloticase
6. Probenecid (rarley used) |
|
|
Term
What is Stevens-Johnson syndrome?
What anti gout med causes it? |
|
Definition
SJS is a hypersensitivity distored characterized by slophing of the mucous membranes and respiratory epithelium
caused by Allopurenol and other meds |
|
|
Term
what drug is good for Blood pressure and Gout?
What are the AE of uricosuric agents? |
|
Definition
Losartan lowers uric acid
Hypersensitivity
TEN or SJS |
|
|
Term
What is another name for pseudo Gout?
What are the most common risk factors?
What joints are effected compaired to Gout? |
|
Definition
Calcium Pyrophasphate deposition disease
Hemochromatosis or Hyperparathroidism
Large joints like knee and wrist not the MCP in foot like in gout |
|
|
Term
| What is the Best initial treatment of Pseudogout? |
|
Definition
NSAIDs
Colchicine is prophilactic
and if that does not respond
1)intra articular steroids (triamcinolone) |
|
|
Term
describe the Onset,
Alleviating aggravating factors,
Radiation,
Provocation
of Ankylosing spondylitis |
|
Definition
Onset is under 40
wosened by rest relieved by activity
Pain starts at back stiffness and pain then radiates to buttocks |
|
|
Term
What is the BITest&R of Ankylosing Spondylitis?
MAT? |
|
Definition
xray shows narrowing (blurring) of the sacroilliac joint
MRI
Bamboo spine is a very late finding
and ESR is (+) in 85% |
|
|
Term
What is the treatment of Anklosing spondylitis?
What HLA is Positive in Seronegative spondyloarthropathies? |
|
Definition
exersise program and NSAID
if insufficent use anti TNF drugs (etanercept, adalimumab, infliximab)
-------
HLA-B27 |
|
|
Term
What are the physical characteristics of Psoriatic Arthritis?
What is the BITest?
other tests? |
|
Definition
Sausage digits, Nail Pitting
------
xray shows 'pencil in a cup' deformity
ESR almost always +
also bony errosions and irregular bone distruction |
|
|
Term
| what is the treatment for Psoriatic arthritis? |
|
Definition
Nsaids
if dont work
Methotrexate
if dont work
Anti TNF agents |
|
|
Term
What is another name for Reactive Arthritis?
What is in reaction to:? x3 |
|
Definition
Reiter Syndrome
Inflammatory bowl (Crohns and UC)
STD
GI infections |
|
|
Term
What is the Triad for Reactive arthritis?
What is the skin lesion ass with reactive arthritis? |
|
Definition
Joint Pain
Ocular findings( uveitis, conjunctivits)
Genital abnorm(urethritis, balantis) |
|
|
Term
What is the diagnostic test for Reactive arthritis
What is the tx? x3 |
|
Definition
no specific test; based on triad Joint, ocular, genital
tap joint to rule out septic joint
Treat with NSAIDS
Treat underlying cause
Sulfasalazine is used when NSAIDS dont control |
|
|
Term
What is the MAT for Osteoporosis?
What indicates Osteoporosis v Osteopenia |
|
Definition
DEXA scan
Bone dencity T scores
Normal: <1
Osteopenia 1-2.5
Osteoporosis: >2.5 |
|
|
Term
What are the AE of Bisphosphonates?
What are the blood tests for osteoporosis? |
|
Definition
Pill Esophagitis (if prologed exposure to esophygus)
osteonecrosis of the jaw (rare)
All blood tests are normal in osteoporosis |
|
|
Term
| What is the treatment for Osteoporosis? |
|
Definition
First and foremost:
Ca++, Vit D, Bisphosphonates
Estrogen replacment, Raloxifen,
Teriparatide, nasal calcitonin |
|
|
Term
what does Raloxifene do?
what does Teriparatide do? |
|
Definition
R: substrate for estrogen in post menopausal women. also, lowers risk of breast cancer and LDL levels
T: analog of PTH and stimulates new bone formataiton |
|
|
Term
What is the best imperical treatment for non gonococcal septic arthritis?
What is the most common organism of recently placed articicial joints? |
|
Definition
Ceftriaxone, and Vanco
S. epidermidis |
|
|
Term
| how does Conococcal arthritis differ than Septic arthritis? |
|
Definition
Rash,
Tenosynovitis-finger movments painful
Polyarticular involvment |
|
|
Term
| What is the best emperical treatment for gonococcal arthritis |
|
Definition
|
|
Term
What is the most common orgonism to cause osteomyelitis in
The general Population?
Sickle cell
Who is most likely to be affected? |
|
Definition
G: Staph Aureus
HbS: Salmonella
----
Diabetics (with ulcer)
vascular insufficiency |
|
|
Term
What is the BITest for Osteomyilits
If normal?
MAT?
When is bone scan used? |
|
Definition
BIT: xray
if normal
use MRI
if MRI is CI then; bone scan
MAT: biopsy |
|
|
Term
What is the tx for Osteomyilits
When is ESR used? |
|
Definition
Treat the infection when identified
used to follow response of therapy |
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