HA, PSGAGs, and PG

Question 1

What are the 2 layers of the synovial membrane?

Answer 1

Subintimal and intimal

Question 2

Which synovial membrane layer contains blood supply and innervation?

Answer 2

Subintimal

Question 3

What cells are in the intimal layer of the synovial membrane?

Answer 3

Synoviocytes

Question 4

What function do macrophage Type A cells perform in the synovial membrane?

Answer 4

Phagocytosis

Question 5

What type of cells are HA, aggrecan, collagen, cytokines, eicosanoids, and proteases?

Answer 5

Type B fibroblasts

Question 6

What is the shock absorber of the joint b/c it is more deformable than cortical bone?

Answer 6

Subchondral bone

Question 7

This disease may contribute to OA progression

Answer 7

Sclerosis

Question 8

Creates the joint surface and is used to define the health of the joint

Answer 8

Articular cartilage

Question 9

What does the specialized extacellular matrix do?

Answer 9

Distributes compressive loads

Question 10

What is the articular cartilage composed of?

Answer 10

80% water, PG, HA, collagens

Question 11

Backbone of he cartilaginous matrix

Answer 11

HA

Question 12

What binds to HA via protein ink?

Answer 12

Proteoglycans/glycosaminoglycans

Question 13

Creates a polarized charge to provide shock absorbing effect

Answer 13

HA

Question 14

What is the charge of HA?

Answer 14

Negatie

Question 15

Asking for athleticism over time aka microtrauma

Answer 15

Use trauma

Question 16

How does OA present?

Answer 16

Effusion, decreased viscosity, increased TP

Question 17

How will cartilage change grossly w/cartilage changes?

Answer 17

Dull, yellow, fibrillated, ulcerated

Question 18

What does chronic inflammation cause in a joint capsule?

Answer 18

Thickening

Question 19

What does pain cause to the synovial lining?

Answer 19

Hypertrophy

Question 20

What does pain do to the subintima?

Answer 20

Fibrosis

Question 21

What are clinical signs of OA?

Answer 21

Lameness, joint pain, decreased ROM, joint effusion

Question 22

Can arthritis be present even w/o radiographic changes?

Answer 22

Yes

Question 23

Can you stop OA progression with treatment?

Answer 23

No

Question 24

Designed for post-arthroscopic lavage

Answer 24

Polyglycan (PG)

Question 25

Why are results of studies of chondroprotectives so inconsistent/confusing?

Answer 25

Absence of a control group

Question 26

Where does HA come from?

Answer 26

Type B synoviocytes, chondrocytes

Question 27

Long unbranched non-sulfated GAG

Answer 27

HA

Question 28

Provides viscoelasticity, boundary lubricaiton

Answer 28

HA

Question 29

Modulates chemotactic response and scavenges free radicals

Answer 29

HA

Question 30

Increases production of endogenous HA and decreases degradation of aggrecan

Answer 30

HA

Question 31

When is HA chondroprotective?

Answer 31

Intra-articular administration

Question 32

How must HA be administered to reduce cartilage fibrillation?

Answer 32

Intra-articular

Question 33

What amount of HA is required for lameness improvement?

Answer 33

20mg/joint once weekly for 3wk

Question 34

Imparts viscosity to synovial fluid, lubriates unloaded joints, and exerts a direct anti-inflammatory effect and restores rheologic properties of synovial fluid

Answer 34

HA

Question 35

Both ___ and ___ doses of HA result in significant improvement in horses

Answer 35

20mg and 40mg

Question 36

Is IV or IA HA more efficacious?

Answer 36

IA

Question 37

Which HA administration treats multiple joints less effectively?

Answer 37

IV

Question 38

HA + _____ are chondroprotective w/potent anti-inflammatory effect

Answer 38

Triamcinolone

Question 39

Inhibits degradative enzymes

Answer 39

PSGAGs

Question 40

Counteracts deleterious effects of IL-1

Answer 40

PSGAGs

Question 41

What mechanism of PSGAGs do you not see with IA HA?

Answer 41

Reduces of synovial effusion

Question 42

Decreases inflammatory mediators (PGE2) and improves synovial membrane

Answer 42

Adequan

Question 43

What is the drawback of Adequan?

Answer 43

It immunosuppresses the joints

Question 44

How do you counteract joint immunosuppression caused by Adequan?

Answer 44

125mg Amikacin

Question 45

PSGAG levels that are required to reduce PGE2 are only achieved with what administration?

Answer 45

IA (not IM)

Question 46

What is polyglycan?

Answer 46

HA + chondroitin sulfate + N-acetyl-D-glucosamine

Question 47

Both of these drugs have disease-modifying OA actions w/good efficacy in cases of synovitis

Answer 47

PSGAGs and HA

Question 48

Does PSGAGs or HA have a greater effect on articular cartilage fibrillation?

Answer 48

HA

Question 49

Does PSGAGs or HA have a greater positive effect on synovial membrane health?

Answer 49

PSGAGs

Question 50

Is PSGAG or HA more effective for mild synovitis/capsulitis?

Answer 50

HA

Question 51

What corticosteroid has chondroprotective effects?

Answer 51

Triamcinolone acetonide

Question 52

Which corticosteroids have been shown to have deleterious effects on chondrocytes @ therapeutic levels (use minimum dose possible for tx)?

Answer 52

Methylprednisolone acetate

Question 53

Which corticosteroid is "middle of the road" with no deleterious effects on articular cartilage?

Answer 53

Betamethasone

Question 54

High level of IL-1 antagonists to combat inflammatory process in the joint

Answer 54

IRAP

Question 55

Aseptic blood draw, draw off supinate, inject into joint once per week for 3 weeks

Answer 55

IRAP