bone and joint disorders

Question 1

These are rigid organs that make up the skeleton. They provide structure, support, and protection to the body.

Answer 1

Bones

Question 2

An adult human body has _ bones.

Answer 2

206

Question 3

It is the place where two or more bones meet, it connects the bones, allowing for flexibility and movement while maintaining overall stability.

Answer 3

joint

Question 4

This helps to reduce friction between the bones and cushions the joint.

Answer 4

synovial fluid in synovial joints

Question 5

A sudden and severe inflammatory arthritis caused by the buildup of uric acid crystals in the joints, leading to intense pain, swelling, redness, and warmth

Answer 5

Gout

Question 6

Causes of Gout

Answer 6

Excess Uric Acid Production
Uric Acid Excretion Problems

Question 7

a waste product formed during the breakdown of purines (substances found naturally in the body and some foods).

Answer 7

Uric acid

Question 8

Normal Uric Acid for Males:

Answer 8

4.0 to 8.5 mg/dL (0.24 to 0.51 mmol/L)

Question 9

Normal Uric Acid for Females:

Answer 9

2.7 to 7.3 mg/dL (0.16 to 0.43 mmol/L)

Question 10

Medications that can Increase Uric Acid Levels:

Answer 10

Diuretics
Low-dose Aspirin
Nicotinic Acid (Vitamin B3)
Levodopa
Immunosuppressants

Question 11

Often used for high blood pressure and heart failure, can elevate uric acid levels by reducing its excretion through the kidneys.

Answer 11

Diuretics

Question 12

While it is often used for its blood-thinning effects, low doses (less than 300 mg daily) can decrease the kidneys’ ability to eliminate uric acid.

Answer 12

Low-dose Aspirin

Question 13

High doses, sometimes used to lower cholesterol, can raise uric acid levels.

Answer 13

Nicotinic Acid (Vitamin B3)

Question 14

A medication used for Parkinson’s disease, can increase uric acid production.

Answer 14

Levodopa

Question 15

Medications that suppress the immune system, such as __, can elevate uric acid levels as a side effect

Answer 15

Immunosuppressants

cyclosporine and tacrolimus

Question 16

It is the mainstay of treatment, reducing uric acid production.

Answer 16

Xanthine oxidase inhibitors (Allopurinol)

Question 17

It helps the kidneys eliminate uric acid. (Not always combined with allopurinol due to potential interactions).

Answer 17

Uricosurics (Probenecid)

Question 18

Unlike low-dose aspirin, this (greater than 300 mg daily) can increase uric acid excretion.

Answer 18

Salicylates (High-Dose Aspirin)

Question 19

Important to note: High-dose aspirin can have serious side effects and should not be taken without consulting a doctor.

Question 20

Certain medications used for cancer treatment can lower uric acid levels as a side effect.

Answer 20

Chemotherapy Drugs

Question 21

Mechanism of action: These drugs block the enzyme xanthine oxidase, which is involved in the production of uric acid. By inhibiting this enzyme, less uric acid is formed.

Answer 21

Xanthine Oxidase Inhibitors:

Question 23

Enzyme involved in the production of uric acid

Answer 23

Xanthine oxidase

Question 24

(Drug of choice for chronic gout):

This is the most commonly used and well-established medication for lowering uric acid levels.

It’s generally well-tolerated but can cause side effects like skin rash in some people.

Answer 24

Allopurinol

Question 25

Mechanism of action: These drugs help the kidneys eliminate more uric acid through the urine.

Answer 25

Uricosurics

Question 26

This is the main uricosuric medication. It's important to note that it can increase the excretion of some other medications, potentially affecting their effectiveness.

Answer 26

Probenecid

Question 27

Can be a good option for people who cannot tolerate allopurinol.

Answer 27

Probenecid

Question 28

To reduce inflammation and pain during gout attacks (e.g., ibuprofen, naproxen).

Answer 28

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 29

(Drug of choice for acute gout) Can shorten the duration and severity of gout flares.

Answer 29

Colchicine

Question 30

Definition: A chronic autoimmune disease that causes inflammation and progressive damage to the joints.

Answer 30

Rheumatoid Arthritis (RA)

Question 31

Low likelihood of RA, but further evaluation might be needed depending on symptoms.

Answer 31

RF Negative

Question 32

Indeterminate, requires consideration of other factors and symptoms.

Answer 32

RF Positive (Weak)

Question 33

Increases suspicion for RA, needs evaluation with other clinical features.

Answer 33

RF Positive (Strong)

Question 34

Low risk for RA.

Answer 34

Anti-CCP Negative

Question 35

Strong indicator of RA, especially with suggestive symptoms.

Answer 35

Anti-CCP Positive

Question 36

To slow disease progression and joint damage

Answer 36

Disease-modifying antirheumatic drugs (DMARDs)

Question 37

Disease-modifying antirheumatic drugs (DMARDs)

Answer 37

Methotrexate Leflunomide Sulfasalazine

Question 38

These are a class of medications used to treat various inflammatory rheumatic diseases, primarily rheumatoid arthritis (RA).

Answer 38

Disease-modifying antirheumatic drugs (DMARDs)

Question 39

They work by slowing down the progression of the disease and preventing joint damage. Unlike pain relievers, they don't directly address pain during a flare-up, but their long-term effects can significantly improve a patient's quality of life.

Answer 39

DMARDs

Question 40

This is the most widely used DMARD for RA, offering a good balance of effectiveness and tolerability.

Answer 40

Methotrexate

Question 41

Another commonly used DMARD, often used for patients who cannot tolerate methotrexate.

Answer 41

Leflunomide

Question 42

May be used alone or in combination with other DMARDs.

Answer 42

Sulfasalazine

Question 43

Primarily used for mild RA and may also have benefits for managing symptoms like fatigue.

Answer 43

Hydroxychloroquine

Question 44

These are newer and more targeted therapies that block specific molecules involved in the inflammatory process.

Answer 44

Biologic DMARDs (bDMARDs)

Question 45

Target a molecule called tumor necrosis factor-alpha (TNF-alpha) which plays a key role in inflammation. (e.g., _)

Answer 45

TNF-alpha inhibitors adalimumab, etanercept

Question 46

Block a signaling pathway involved in inflammation. (e.g., _)

Answer 46

JAK inhibitors tofacitinib

Question 47

Target interleukin-6, another inflammatory molecule. (e.g., _

Answer 47

IL-6 inhibitors tocilizumab)

Question 48

It can be used for short-term relief of inflammation, but long-term use has side effects.

Answer 48

Corticosteroids: Prednisone

Question 49

● Definition: A degenerative joint disease characterized by the breakdown of cartilage, the protective tissue cushioning the ends of bones in joints. This breakdown leads to pain, stiffness, swelling, and reduced mobility in the affected joint.

Answer 49

Osteoarthritis (OA)

Question 50

Reduce pain and inflammation. (OA)

Answer 50

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 51

Over-the-counter options like acetaminophen (Tylenol) or ibuprofen (Advil) may help manage pain. For stronger pain relief, prescription medications may be considered. (OA)

Answer 51

Pain Relievers

Question 52

Can provide temporary pain relief, but not commonly used long-term due to potential side effects(OA)

Answer 52

Corticosteroid injections

Question 53

Non-pharmacological Intervention for Osteoarthritis

Answer 53

○ Weight management ○ Exercise ○ Physical therapy ○ Heat or cold therapy ○ Joint support devices

Question 54

Definition: A metabolic bone disease characterized by decreased bone density and increased risk of fractures. While bones become weaker, they may appear normal on X-rays in the early stages.

Answer 54

Osteoporosis

Question 55

It often has no symptoms in the early stages until a fracture occurs.

Answer 55

Osteoporosis

Question 56

The gold standard test for measuring bone mineral density

Answer 56

Dual-energy X-ray absorptiometry (DXA) scan

Question 57

These are the mainstay medication for treating and preventing osteoporosis. They work by slowing down the activity of osteoclasts, cells responsible for breaking down bone tissue.

Answer 57

Bisphosphonates

Question 58

By reducing bone resorption (breakdown), they help increase bone mineral density and decrease the risk of fractures.

Answer 58

Biphosphonates

Question 59

Another medication that inhibits bone breakdown and helps increase bone density. An injection medication that works similarly to bisphosphonates. It targets a protein called RANK ligand, which is essential for the function of osteoclasts (bone-resorbing cells).

Answer 59

Denosumab

Question 60

By inhibiting RANK ligand, it reduces osteoclast activity and helps increase bone mineral density.

Answer 60

denosumab

Question 61

A protein which is essential for the function of osteoclasts (bone-resorbing cells)

Answer 61

RANK Ligand

Question 62

cells responsible for breaking down bone tissue

Answer 62

osteoclasts

Question 63

Primarily used for managing menopausal symptoms, it can also have benefits for bone health in women.

Answer 63

Hormone replacement therapy (HRT)

Question 64

__ deficiency after menopause is a significant risk factor for osteoporosis. HRT can help slow down bone loss and may even increase bone density in some women.

Answer 64

Estrogen

Question 65

(suitable for women who have had a hysterectomy).

Answer 65

Estrogen-only therapy

Question 66

for women who have not had a hysterectomy.

Answer 66

Combination therapy (estrogen and progesterone)

Question 67

Both vitamins are essential nutrients for building and maintaining strong bones.

Answer 67

Calcium and vitamin D

Question 68

The main mineral component of bone. Our bodies need adequate calcium intake to ensure proper bone mineralization.

Answer 68

Calcium

Question 69

Helps the body absorb calcium from food. This deficiency can hinder calcium absorption and contribute to bone loss.

Answer 69

Vitamin D

Question 70

Non-pharmacological Interventions for Osteoporosis

Answer 70

○ Weight-bearing exercises ○ Healthy diet ○ Fall prevention ○ Smoking cessation ○ Limiting alcohol consumption

Question 71

May scavenge free radicals

Answer 71

Antioxidants

Question 72

May protect brain cells from damage

Answer 72

Neuroprotection