CMN 574 MODULE 3 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) HIGHEST
SCORE A+ GRADE.
/.What is rheumatoid arthritis?
A chronic systemic inflammatory disease
Synovitis of multiple joints
Mostly women
Begins at any age
Chronic synovitis > with formation of pannus > erodes cartilage, bone, ligaments,
tendons + effusion + inflammation
/.What are the clinical features of rheumatoid arthritis?
Insidious onset + morning stiffness + joint pain
/.Symmetric polyarthritis
Pain that last >30 min after waking, recurring stiffness after daytime inactivity/more
strenuous activity
/.Joints involved
: PIP, MCP, MTP
Sq nodules
Interstitial lung disease
Pleural effusions
Pericarditis
Splenomegaly with leukopenia
Vasculitis
/.Cardiovascular disease is the most common cause of mortality
What lab finding are associated with rheumatoid arthritis?
Anti-CCP Antibodies + Rheumatoid Factor
^ ESR/CRP
^PLT count
Joint fluid: inflammatory
,/.ANTI-CCP antibodies is the most specific blood test for RA
What is the treatment of choice for rheumatoid arthritis? And what are some
considerations for giving this medication?
Methotrexate
7.5 mg PO/Wk
Must have baseline CBC & CMP
Get follow-up labs Q4-6wks (for 12 wks), then Q8-12 wks for remainder of treatment
Assess for GI irritation and pancytopenia
/.When treating rheumatoid arthritis with methotrexate what are some supportive
treatments you can offer?
NSAIDS can be used for symptomatic relief
Corticosteroids can be used as a bridge when starting methotrexate
What medications should you not take when you are on methotrexate?
Bactrim
Amoxicillin
Probenecid
What supplement should every person taking methotrexate have?
1 mg of FOLIC ACID daily
What disease processes would make you reconsider giving your
patient methotrexate?
Liver failure
Renal failure
What is osteoarthritis?
Degenerative joint disorder
No systemic symptoms
Narrowed joint space
Weight bearing joints by age 40
Women
, Obesity
degeneration of cartilage + hypertrophy of bone at articular margins
Minimal inflammation
What are its clinical features of osteoarthritis?
AM stiffness <30 min
Pain relieved with rest
Insidious
Onset
DIP and PIP joints of the fingers
Carpometacarpal joint of thumb
Hip
Knee
Metatarsophalangeal (MTP) joint of big toe
Cervical/lumbar spine
What is the appropriate daily limit for Tylenol?
3g/24hr
What are the treatments for osteoarthritis?
Weight loss
Splinting of the hands
Regular exercise
Vitamin D
Tylenol (1st line for mild OA)
Can use NSAIDS but there are many SE
Topical NSAIDS
Triamcinolone inj in the knee or hip
NO STEROID INJ IN THE HANDS
What are the lab findings in osteoarthritis?
No elevation of the ESR
No elevation of CRP
Synovial fluid: Non-Inflammatory
What is spondylolysis? And what are its clinical features?
Injury to the parsinterarticularis
Presents as pain with low back extension
Gymnasts, wrestlers, dancers, divers, trampolines
What is the treatment for spondylolysis?
DETAILED ANSWERS (VERIFIED ANSWERS) HIGHEST
SCORE A+ GRADE.
/.What is rheumatoid arthritis?
A chronic systemic inflammatory disease
Synovitis of multiple joints
Mostly women
Begins at any age
Chronic synovitis > with formation of pannus > erodes cartilage, bone, ligaments,
tendons + effusion + inflammation
/.What are the clinical features of rheumatoid arthritis?
Insidious onset + morning stiffness + joint pain
/.Symmetric polyarthritis
Pain that last >30 min after waking, recurring stiffness after daytime inactivity/more
strenuous activity
/.Joints involved
: PIP, MCP, MTP
Sq nodules
Interstitial lung disease
Pleural effusions
Pericarditis
Splenomegaly with leukopenia
Vasculitis
/.Cardiovascular disease is the most common cause of mortality
What lab finding are associated with rheumatoid arthritis?
Anti-CCP Antibodies + Rheumatoid Factor
^ ESR/CRP
^PLT count
Joint fluid: inflammatory
,/.ANTI-CCP antibodies is the most specific blood test for RA
What is the treatment of choice for rheumatoid arthritis? And what are some
considerations for giving this medication?
Methotrexate
7.5 mg PO/Wk
Must have baseline CBC & CMP
Get follow-up labs Q4-6wks (for 12 wks), then Q8-12 wks for remainder of treatment
Assess for GI irritation and pancytopenia
/.When treating rheumatoid arthritis with methotrexate what are some supportive
treatments you can offer?
NSAIDS can be used for symptomatic relief
Corticosteroids can be used as a bridge when starting methotrexate
What medications should you not take when you are on methotrexate?
Bactrim
Amoxicillin
Probenecid
What supplement should every person taking methotrexate have?
1 mg of FOLIC ACID daily
What disease processes would make you reconsider giving your
patient methotrexate?
Liver failure
Renal failure
What is osteoarthritis?
Degenerative joint disorder
No systemic symptoms
Narrowed joint space
Weight bearing joints by age 40
Women
, Obesity
degeneration of cartilage + hypertrophy of bone at articular margins
Minimal inflammation
What are its clinical features of osteoarthritis?
AM stiffness <30 min
Pain relieved with rest
Insidious
Onset
DIP and PIP joints of the fingers
Carpometacarpal joint of thumb
Hip
Knee
Metatarsophalangeal (MTP) joint of big toe
Cervical/lumbar spine
What is the appropriate daily limit for Tylenol?
3g/24hr
What are the treatments for osteoarthritis?
Weight loss
Splinting of the hands
Regular exercise
Vitamin D
Tylenol (1st line for mild OA)
Can use NSAIDS but there are many SE
Topical NSAIDS
Triamcinolone inj in the knee or hip
NO STEROID INJ IN THE HANDS
What are the lab findings in osteoarthritis?
No elevation of the ESR
No elevation of CRP
Synovial fluid: Non-Inflammatory
What is spondylolysis? And what are its clinical features?
Injury to the parsinterarticularis
Presents as pain with low back extension
Gymnasts, wrestlers, dancers, divers, trampolines
What is the treatment for spondylolysis?
