CMN 574 EXAM 3 Rheumatology Questions with ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
verified detailed solutions ||\\//|| ||\\//||
Osteoarthritis S/S - correct answer✔✔- AM stiffness <30min ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Non-inflammatory
||\\//||
- Pain relived at rest
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- No systemic S/S
||\\//|| ||\\//|| ||\\//||
- Slow onset
||\\//|| ||\\//|| ||\\//||
- Weight bearing joints
||\\//|| ||\\//|| ||\\//||
- Normal ESR, Non-inflammatory synovial fluid
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Osteoarthritis prevelence - correct answer✔✔- Women ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Age 40 or older
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Most common joint disease
||\\//|| ||\\//|| ||\\//|| ||\\//||
Osteoarthritis TX - correct answer✔✔- Weight loss ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Vit D management
||\\//|| ||\\//|| ||\\//||
- Splinting [hands]
||\\//|| ||\\//||
- Tylenol 3g/24hr
||\\//|| ||\\//||
- Triamcinolone [knee/hip] injection if no response to OTC meds (No injections in hands!)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Ortho referral for hip / knee replacement
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout S/S - correct answer✔✔- Mono-articular
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Inflammatory
||\\//||
- 1st MTP Joint [great toe]-podagra
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,- Intense, tender joints + warm, dusky red skin
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Acute onset
||\\//|| ||\\//||
- Tophus in cartilage, subQ / periarticular tissue, bone, kidney
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Primary gout - correct answer✔✔- Hereditary ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Men >30yr
||\\//|| ||\\//||
- Postmenopausal women
||\\//|| ||\\//||
Secondary Gout - correct answer✔✔- Acquired causes of hyperuricemia ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Excessive ETOH [beer]
||\\//|| ||\\//|| ||\\//||
- Diuretics
||\\//||
- Aspirin
||\\//||
- Cyclosporine
||\\//||
- Niacin
||\\//||
- Changes in diet or fluid intake
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout Labs - correct answer✔✔- Serum uric acid >6.8
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- ↑ Peripheral WBC [acute attack]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout DX - correct answer✔✔- Na+ urate crystals [aspirated joint fluid]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- US confirms
||\\//|| ||\\//||
Acute TX of gout - correct answer✔✔- NSAIDs
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Colchicine [<36hr attack; 1.2mg - 0.6mg 1hr later - 0.6mg BID for prophylaxis]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Allopurinol
||\\//||
- Corticosteroids are most useful for pt with contraindications to NSAIDs (given IV or PO)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, 2+ episodes of gout/year - correct answer✔✔- Initiate urate lowering meds [colchicine]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Maintain serum uric acid at or below 6mg/dL
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Colchicine for gout suppression - correct answer✔✔- Usual dose = 0.6mg once-BID daily
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Cleared by kidneys
||\\//|| ||\\//|| ||\\//||
- Co-existing CKD only take once daily
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout prevention (things to avoid) - correct answer✔✔- ETOH
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- High-purine foods [organ meat, yeast [beer]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Seafood
||\\//||
- Beans, peas, lentils
||\\//|| ||\\//|| ||\\//||
- Oatmeal, spinach, asparagus, cauliflower, mushrooms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Corn syrup drinks
||\\//|| ||\\//|| ||\\//||
- Thiazide / loop diuretics & niacin
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout prevention fluid intake - correct answer✔✔2L/day output
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
What does gout increase the risk of? - correct answer✔✔- HTN
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- kidney dx
||\\//|| ||\\//||
- DM
||\\//||
- High triglycerides
||\\//|| ||\\//||
- Atherosclerosis
||\\//||
Gout prognosis - correct answer✔✔- Acute attacks without tx last few wks - several wks.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Intervals between attacks, vary.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
verified detailed solutions ||\\//|| ||\\//||
Osteoarthritis S/S - correct answer✔✔- AM stiffness <30min ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Non-inflammatory
||\\//||
- Pain relived at rest
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- No systemic S/S
||\\//|| ||\\//|| ||\\//||
- Slow onset
||\\//|| ||\\//|| ||\\//||
- Weight bearing joints
||\\//|| ||\\//|| ||\\//||
- Normal ESR, Non-inflammatory synovial fluid
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Osteoarthritis prevelence - correct answer✔✔- Women ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Age 40 or older
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Most common joint disease
||\\//|| ||\\//|| ||\\//|| ||\\//||
Osteoarthritis TX - correct answer✔✔- Weight loss ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Vit D management
||\\//|| ||\\//|| ||\\//||
- Splinting [hands]
||\\//|| ||\\//||
- Tylenol 3g/24hr
||\\//|| ||\\//||
- Triamcinolone [knee/hip] injection if no response to OTC meds (No injections in hands!)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Ortho referral for hip / knee replacement
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout S/S - correct answer✔✔- Mono-articular
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Inflammatory
||\\//||
- 1st MTP Joint [great toe]-podagra
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,- Intense, tender joints + warm, dusky red skin
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Acute onset
||\\//|| ||\\//||
- Tophus in cartilage, subQ / periarticular tissue, bone, kidney
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Primary gout - correct answer✔✔- Hereditary ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Men >30yr
||\\//|| ||\\//||
- Postmenopausal women
||\\//|| ||\\//||
Secondary Gout - correct answer✔✔- Acquired causes of hyperuricemia ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Excessive ETOH [beer]
||\\//|| ||\\//|| ||\\//||
- Diuretics
||\\//||
- Aspirin
||\\//||
- Cyclosporine
||\\//||
- Niacin
||\\//||
- Changes in diet or fluid intake
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout Labs - correct answer✔✔- Serum uric acid >6.8
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- ↑ Peripheral WBC [acute attack]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout DX - correct answer✔✔- Na+ urate crystals [aspirated joint fluid]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- US confirms
||\\//|| ||\\//||
Acute TX of gout - correct answer✔✔- NSAIDs
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Colchicine [<36hr attack; 1.2mg - 0.6mg 1hr later - 0.6mg BID for prophylaxis]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Allopurinol
||\\//||
- Corticosteroids are most useful for pt with contraindications to NSAIDs (given IV or PO)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, 2+ episodes of gout/year - correct answer✔✔- Initiate urate lowering meds [colchicine]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Maintain serum uric acid at or below 6mg/dL
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Colchicine for gout suppression - correct answer✔✔- Usual dose = 0.6mg once-BID daily
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Cleared by kidneys
||\\//|| ||\\//|| ||\\//||
- Co-existing CKD only take once daily
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout prevention (things to avoid) - correct answer✔✔- ETOH
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- High-purine foods [organ meat, yeast [beer]
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Seafood
||\\//||
- Beans, peas, lentils
||\\//|| ||\\//|| ||\\//||
- Oatmeal, spinach, asparagus, cauliflower, mushrooms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Corn syrup drinks
||\\//|| ||\\//|| ||\\//||
- Thiazide / loop diuretics & niacin
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Gout prevention fluid intake - correct answer✔✔2L/day output
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
What does gout increase the risk of? - correct answer✔✔- HTN
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- kidney dx
||\\//|| ||\\//||
- DM
||\\//||
- High triglycerides
||\\//|| ||\\//||
- Atherosclerosis
||\\//||
Gout prognosis - correct answer✔✔- Acute attacks without tx last few wks - several wks.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Intervals between attacks, vary.
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