MSK

Question 1

OA you are thinking

Answer 1

Wear and tear problem

Question 2

Progressive joint disorder characterized by slow destruction of the normal collagen architecture

Answer 2

OA

Question 3

After what age do we think wear and tear and is it an older or younger issue

Answer 3

After the age of 35 we think of OA it’s an older problem

Question 4

One or more joint involved and asymmetric

Answer 4

This is classic of OA you have wear and tear of the joint at multiple injuries at different points and due to overuse of one versus the other

Question 5

Pain with OA how does that look

Answer 5

Typical gets WORSE at the end of the day. If you are on your feet or knee all day

Question 6

In the morning patients with OA how does they present

Answer 6

Stiffness

The stiffness last less than 30 minutes a highlight of this disorder

Question 7

Common areas we find OA

Answer 7

Wrist the knees and the hips

Question 8

Classic findings on xray of OA

Answer 8

Narrowing of the joint and osteophytes like bone spurs

Question 9

RA patient population

Answer 9

Older and younger females

Question 10

Findings of RA are symmetrical or asymmetrical

Answer 10

Symmetrical

Question 11

Pain___________ with activity for RA

Answer 11

Improves

Question 12

How is the stiffness in the morning for a patient with RA

Answer 12

Lasts LONGER than 30 minutes me as they get moving the stiffness gets better

Question 14

Xray findings of RA

Answer 14

Osteopenia

Question 16

If you’re pushing on a wound and you feel crepitus on like a area that has tissue not bone what are you thinking?

Answer 16

Necrotizing fasciitis 

Question 17

Etiology of osteoarthritis

Answer 17

Wear and tear, over the age of 60 equals a 60% chance of developing osteoarthritis, after 55 women are affected more, are genetics, hematological, and endocrine conditions again, mechanism stressors, such as repetitive microtrauma, prior trauma, recent exposure to certain chemicals if a patient in a motor vehicle crash and there’s trauma to the knee any neurological disorders that again have repetitive


Question 18

Clinical manifestations of OA 

Answer 18

Pain in one or more joints, stiffness of affected joint after prolonged sitting, grading or crepitus sensation during range of motion, feeling of instability, locking or bucking of the knees 

Question 19

Physical findings of the OA but patient comes in with edema and red hot knee or elbow other differentials

Answer 19

Septic joint or foot flare. Admit but in case it is not OA

Question 20

Bony induration or enlargement of affect joints. These nodes** effusion with warm and or redness involved

Answer 20

Heberden and bouchards
Heberden is the DIP and Bouchard is the PIP

Angular deformed and limited ROM with palpable or audible creptius can lap have pain on palpation

Question 21

RA deformity classic presentation

Answer 21

Swan neck and boutiner

Question 22

RA patients typically develop

Answer 22

Ulnar deviation
The ulnar is going to deviate laterally

Question 24

The bouttanaire deformity tell me about the flexion and extension of the joints

Answer 24

Flexion PIP and extension DIP

Question 25

Tell me about the flexion and extension of swan neck

Answer 25

PIP hyperextended and DIP flexion

Question 26

Lab and diagnostics for osteoarthritis

Answer 26

Plain x-rays, anterior posterior and lateral knee films as well as bilateral to compare, synovial fluid analysis, CBC, BMP, bone scans, MRIs and CT’s 

Question 27

Management of OA

Answer 27

The goals are to relieve symptoms, maintain or improve function, limit disability, as much as possible, avoid drug toxicity, a multidisciplinary approach is best, rest and joint protection may be warranted

Question 28

Top way to reduce the wear and tear on a patients joints that are obese

Answer 28

Losing the weight

Question 29

Management for RA

Answer 29

DDMARDS

Question 30

Drugs and management for OA

Answer 30

Acute exacerbation ice therapy Moist heat for the day to day relief or to help with the morning stiffness Salisatye acid or aspirin good starting drug 650mg if they can’t take they can take acetaminophen. NSAIDs are going to give you the biggest relief but the biggest draw back block cox1casade reduce mucus production and affect kidney function GI bleeding worsening hypertension and AKI

Question 31

Medication providing the biggest bang for your buck for OA

Answer 31

NSAIDS

Question 32

Two fold problem with NSAIDS in the adult gero population