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Flashcards in MSK= rheum and ortho Deck (166)
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1

absence of inflammation and normal lab tests

osteoarthritis

2

best initial analgesic in OA

acetaminophen

3

efficacy of glucosamine and chrondroitin sulfate

NO more effective than placebo

4

chronic gout

tophi--ANYWHERE in body
uric acid kidney stones
LONG ASYMPTOMATIC periods between attacks

5

most accurate test in gout

aspiration joint: needle shaped negative birefringence

6

what is essential to do in dx of gout

TAP JOINT-- exclusion of infection

7

protein and glucose levels in synovial fluid

NOT HELPFUL in diagnosis of gout

8

acute attack lab findings in podagra

ELEVATED ESR and LEUKOCYTOSIS

9

x-rays in gout

NORMAL early on
EROSIONS of cortical bone occur latter

10

intial tx of gout

1. NSAID's
2.STEROIDS
3. colchicine-- used when cannot use NSAIDs or steroids

11

when to use steroid injections in gout

RENAL INSUFFICIENCY or unrepsonsive to NSAIDs

12

diet change in gout

- decrease beer
- weight loss
- decrease high purine foods: meat and seafood

13

side effects of colchicine

neutropenia
and diarrhea

14

benefit of colchicine in gout

effective in PREVENTING SECOND ATTACK of hout

15

gout drugs contraindicated if have renal insufficiency

probenecid
NSAIDs
sulfinpyrazone

16

gout drugs safe if have renal insufficiency

allopurinol

17

which gout drugs not okay to use in podagra

uricosuric agents-- probenecid and sulfinpyrazone
or allopurinol

18

what drug to use if patient has high bp AND gout

losartan-- since lowers uric acid aswell

19

2 big risk factors for pseudogout

HFE
hyperparathyroidism

20

confirmation dx of pseudogout= calcium pyrophosphate deposition disease= CPPD

MUST HAVE ASPIRATION OF JOINT-- positively birefringent rhomboid crystals

21

initial tx of CPPD

1. NSAIDS
2. IA steroids
3. colchicine-- prevent subsequent attacks

22

lower back pain without neuro deficits etc.

NSAIDs. nothing more.

23

lower back pain with sensory loss, point tenderness over spine, hx of cancer, hyperreflexia

CORD COMPRESSION-- malignancy

24

lower back pain with sensory loss, point tenderness over spine, hx of cancer, hyperreflexia AND FEVER AND INCREASE ESR

epidural abscess

25

MRSA epidural abscess

vancomycin or linezolid

26

acute neuro deficits, epidural abscess

systemic steroids

27

methicillin sensitive s.aureus epidural abscess

oxacillin, naficillin, cefazolin

28

leg pain in sciatica

buttocks and BELOW level of the knee

29

DIAGNOSTIC OF SCIATICA

positive SLR

30

L4

m: dorsiflex foot
s: inner calf
r: knee jerk