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32 Cards in this Set
- Front
- Back
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What is the most common type of arthropathy
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Osteoathritis
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Is OA typically inflammatory or non-inflammatory
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Non- Inflammatory
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Does the pahtophysiology of OA vary depending on the joint type involved
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no it is the same regardless of joint involved
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What is OA
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progressive deterioration and loss of articular cartilage leading to loss of normal joint strucutre and function
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What is the primary etiology of OA
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aging or idiopathic there cand be gentic such as Nodal OA
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What is secondary OA
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OA caused by disorders that damage joint surface
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What are the pathological characterisitcs of OA
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Altered chondrocyte function, loss of cartilage (thinning), subchondral bone thickening (sclerosis), Remodeling of bone, marginal spurs (osteophytes), cystic changes in subchondral bone and mild reactive synovitis
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What are some systemic risk factors for OA
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age, obesity, gentics, gender, menopause(?)
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What are some local factors that can influence risk of OA
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Muscle strenght, joint proprioception, repetitive use, configuration of joint, trauma
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What are the common locations for OA
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cervical spine, lumbar spine, 1st cmc (carpometacarpophalangeal), PIP, DIP, Hip, Knee, 1st MTP (metatarsophalangeal)
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What are some uncommon locations for OA
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SHoulder, Thoracic Spine, Elbow, Wrist, MCP (metacarpophalangeal), Ankle, Subtalar
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What are the 7 subsets of OA
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Generalized OA, Nodal OA, Spondylosis, Erosive OA, Inflammatory OA, Diffuse idiopathic skeletal hyperostosis (DISH), Chondromalacia patellae
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Where are heberden's nodes found
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DIP
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Where are bouchards nodes found
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PIP
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Where is the most common location to find nodes in OA
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Knees 3 compartments med/lat/pat-fem
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What are the common symptoms of OA
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insidious onset of joint pain w/ movement, limitation of motion, referred pain, minimal stiffness after rest, (systemic symptoms are rare)- acute flares of these symptoms suggest another dx
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Why do you get pain in OA if the cartilage is avascualr and aneuritic
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could cause synovitis, joint capsule/ligament stretchin, periosteal irritation from osteophytes, travecular microfractures, muscle spasm, intraosseous hypertension
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What physical exam findings would you expect to find in an OA patient
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Bondy changes in joint shape, crepitus, malalignement/instability, limited ROM, join line tenderness, cool effusions, spasm or atrophy of adjacent muscle
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What lab tests are indicative of OA
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non really but ESR and RF appropriate for age and synovial fluid shiould be class 1 (non-inflammatory)
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What x-ray findings are indicative of OA
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cartilage loss/joint space narrowing, subchondral sclerosis, osteophytes at joint margins, subchondral cysts
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What is Genu Varus
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bowleg
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This type of OA is marked by exuberant osteophytosis of the spine spanning 3-4 vertebral segments with preservation of disc spaces. Ligament calcification is noted.
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Diffuse Idiopathic Skeletal Hyperostosis (DISH)
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Who is more affected with DISH diffuse idiopathic skeletal hyperostosis
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M>F
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What other pathology is diffuse idiopathic skeletal hyperostosis (DISH) associated with
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Diabetes Mellitus
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A person with dish may develop anterior cervical osteophytes what may that cause them to have
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dysphagia
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What are some of the ways to manage a pt with OA
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education, weight reduction, nutriceuticals, topical agents, analgesics, NSAIDs, phyical therpay, occupational therapy, surgery, conditioning, Intra-articular steroids, Viscosupplementation, SMOADS (systemic modulating osteoarthritic drugs)
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What are SMOADS (systemic modulating osteoarthritic drugs) in management of OA
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MMPI, Residronate, Doxycycline, Glucosamine, Chondroitin
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How is capsaicin work in tx of OA
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it is a topical agent that can be rubbed on the joint it causes a rxn that with time will cause a person to exhaust their supply of substance P which without they don't have pain.
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What is the primary analgesic in management of OA
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acetaminophen (3g maximum per day) easily overdosed on
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What is the definitive tx for OA
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Surgery
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What are the tx goals for OA
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pain control, improve function, enhance health related quality of life, avoid Rx related side effects. Sadly there is not cure
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What are the essential to dx of OA
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degenerative disorder w/o systemic manifestations, pain relived by rest, morning stiffness, articular inflammation is minimal, x-ray finding of joint space narrowing, osteophytes, increased subchondral bone, bone cysts
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