Chapter 52

Question 1

OSTEOARTHRITIS
-What is this?

Answer 1

Progressive, noninflammatory disease of diarthrodial joints

Question 2

OSTEOARTHRITIS
-What does this affect?

Answer 2

Joints that are weight bearing (hips & knees, but also hands and feet)

Question 3

OSTEOARTHRITIS
-This is the most common form of ____ & leading cause of what?

Answer 3

-arthritis
-chronic disability

Question 4

OSTEOARTHRITIS: Etiology
-What does this result from? (2)

Answer 4

-Stress to the joints OR previous joint injury or trauma

Question 5

OSTEOARTHRITIS: Clinical Manifestations
-Prevalence increases with what?

Answer 5

Age

Question 6

OSTEOARTHRITIS: Clinical Manifestations
-This may occur where in relation to the joints?

Answer 6

In an isolated joint or multiple joints

Question 7

OSTEOARTHRITIS: Clinical Manifestations
-What will the patient experience?

Answer 7

-Pain
-Stiffness
-Crepitus (crackling/popping in the joints)
-Enlargement of the joint

Question 8

OSTEOARTHRITIS: Clinical Manifestations
-In terms of joint enlargement, what will appear on the hands?

Answer 8

-Heberden & Bouchard nodes

Question 9

OSTEOARTHRITIS: Clinical Manifestations
-What are Heberden nodes

Answer 9

Enlargement at the distal joints of fingers

Question 10

OSTEOARTHRITIS: Clinical Manifestations
-What are Bouchard nodes?

Answer 10

Enlargement in the proximal joints of fingers

Question 11

OSTEOARTHRITIS: Treatment
-What are the types of treatment?

Answer 11

1. Conservative
2. Surgical

Question 12

OSTEOARTHRITIS: Treatment
-What is the main goal of treatment?

Answer 12

To decrease stress on joint & protect it from additinal trauma

Question 13

OSTEOARTHRITIS: Treatment
-What is conservative treatment?

Answer 13

-Exercise & weight loss
-Pharmacologic therapies

Question 14

OSTEOARTHRITIS: Treatment
-What medications can be given?

Answer 14

-Analgesics
-Anti-inflammatories

Question 15

OSTEOARTHRITIS: Treatment
-Why is surgical treatment used?
-What is it used to correct?

Answer 15

-To improve joint movement
-Deformity or malalignment

Question 16

OSTEOARTHRITIS: Treatment
-With surgical treatment, you can create a new joint with what?

Answer 16

artificial implants

Question 17

RHEUMATOID ARTHRITIS
-What is this?

Answer 17

Systemic autoimmune inflammatory disease

Question 18

RHEUMATOID ARTHRITIS
-This usually affects ____ but it can invovle what?

Answer 18

-joints
-multiple organ systems

Question 19

RHEUMATOID ARTHRITIS: Etiology
-Describe etiology

Answer 19

Specific cause is unknown, but there is a genetic predisposition

Question 20

RHEUMATOID ARTHRITIS: Etiology
-This can occur when in terms of age?

Answer 20

At any age

Question 21

RHEUMATOID ARTHRITIS: Clinical Manifestations
-What are they?

Answer 21

-Bilateral symmetric polyarthritis (affecting multiple joints)
-Malaise
-Diffuse musculoskeletal pain durin acute exacerbations
-Systemic symptoms

Question 22

RHEUMATOID ARTHRITIS: Clinical Manifestations
-What are the systemic symptoms?

Answer 22

Fatigue, low-grade fever, depression, & weight loss

Question 23

RHEUMATOID ARTHRITIS: Clinical Manifestations
-How is the deformity described as?

Answer 23

Swan-neck deformity

Question 24

RHEUMATOID ARTHRITIS: Diagnosis
-How can this be diagnosed?

Answer 24

-Number & size of the swollen joints
-Presence of absence of the RF antibody or CCP antibody
-Level of patient’s markers of inflammation

Question 25

**RHEUMATOID ARTHRITIS**: *Treatment* -Give the patient ____

Answer 25

-education

Question 26

**RHEUMATOID ARTHRITIS**: *Treatment* -What do you want to decrease? -What should be prevented? -What should be preserved?

Answer 26

-pain & swelling -structural damage -function

Question 27

**RHEUMATOID ARTHRITIS**: *Treatment* -What medications should they be given?

Answer 27

Anti-inflammatory medications (NSAIDs)

Question 28

**SYSTEMIC LUPUS ERYTHEMATOSUS** -What kind of disease is this? -What is is characterized by?

Answer 28

-chronic, multisystem, inflammatory, autoimmune disease -Periods of exacerbations and remission

Question 29

**SYSTEMIC LUPUS ERYTHEMATOSUS**: *Etiology* -What does it result from?

Answer 29

B-lymphocytic overactivity

Question 30

**SYSTEMIC LUPUS ERYTHEMATOSUS**: *Clinical Manifestations* -It can affect what?

Answer 30

Multiple organ systems

Question 31

**SYSTEMIC LUPUS ERYTHEMATOSUS**: *Clinical Manifestations* -What are the clinical manifestations, and state the classic one

Answer 31

-Arthralgias & synovitis -Skin lesions -Butterfly rash (classic)

Question 32

**SYSTEMIC LUPUS ERYTHEMATOSUS**: *Diagnosis* -How is this diagnosed?

Answer 32

Through a positive ANA test

Question 33

**SYSTEMIC LUPUS ERYTHEMATOSUS**: *Treatment* -What are the treatments?

Answer 33

-Patient education -Topical corticosteroids -Avoidance of sun -NSAIDs and/or antimalarial drugs -Elimumab & immunosuppressive agents

Question 34

**GOUT** -This is a ___ disorder that is caused by what?

Answer 34

-metabolic -abnormal uric acid metabolism

Question 35

**GOUT** -There is elevated ____ levels in the blood -What is this called?

Answer 35

-uric acid -hyperuricemia

Question 36

**GOUT** -What forms & deposits in the joints & tissues?

Answer 36

uric acid crystals

Question 37

**GOUT** -What will the patient have?

Answer 37

Sudden, severe episodes of joint inflammation (gouty arthritis)

Question 38

**GOUT**: *Clinical Manifestations* -They will experience recurrent episodes of what?

Answer 38

Articular & periarticular inflammation (acute gouty arthritis)

Question 39

**GOUT**: *Clinical Manifestations* -Describe what will accumulate and where?

Answer 39

-Tophi (crystalline deposits -in bony & connective tissue

Question 40

**GOUT**: *Clinical Manifestations* -What is impaired? -There is presence of what?

Answer 40

-the renal system -uric acid calculi

Question 41

**GOUT**: -What are the 4 phases of gout?

Answer 41

1. Asymptomatic hyperuricemia 2. Acute gouty arthritis 3. Intercritical gout 4. Chronic tophaceous gout

Question 42

**ACUTE GOUTY ARTHRITIS** -What is most commonly affected?

Answer 42

Weight-bearing joints

Question 43

**ACUTE GOUTY ARTHRITIS** -How will the joints feel? -Whatis most often involved? -What will they experience?

Answer 43

-warm, red, and tender to palpation -Great toe -Sudden, severe pain at night that awakens them

Question 44

**ACUTE GOUTY ARTHRITIS** -What is the treatment for this? (3)

Answer 44

1. NSAIDs 2. Corticosteroids 3. Colchicine