Osteoarthritis Flashcards
(82 cards)
It is a common, progressive disorder affecting primarily weightbearing diarthrodial joints
Osteoarthritis
Osteoarthritis is characterized by:
- progressive deterioration and loss of articular cartilage
- osteophyte formation
- pain
- limitation of motion
- deformity
- disability
Idiopathic Osteorarthritis is also known as:
Primary OA
T/F:
Trauma, metabolic or endocrine disorders, and congenital disorders are the known cause of Secondary OA?
- True
Risk factors for OA:
- increasing age
- obesity
- repetitive use through work or leisure
activities - joint trauma
- genetic predisposition
ESR for the diagnosis of Hip OA?
- less than 20 mm/h
Age more than 50 years, morning stiffness
lasting 30 minutes or less, crepitus on motion, bony enlargement, bony
tenderness, and/or, palpable joint warmth are the symptoms needed for the diagnosis of what kind of OA?
- Knee OA
T/F:
ESR may be slightly elevated if inflammation is present. Rheumatoid factor is negative.
Analysis of synovial fluid reveals high viscosity and mild leukocytosis (<2000 white
blood cells/mm3 [<2 × 109
/L]) with predominantly mononuclear cells are the signs associated with OA?
- True
T/F:
The goals of treatment for OA are: (1) educate patient, family members, and caregivers; (2) relieve
pain and stiffness; (3) maintain or improve joint mobility; (4) limit functional impairment; and (5) maintain or improve quality of life.
- True
T/F:
Drug therapy for OA is targeted at relief of pain?
- True
Preferred first-line treatment for Knee and Hip OA?
- Acetaminophen
Acetaminophen is much effective than NSAIDs. Also, has less risk of serious gastrointestinal (GI) and cardiovascular events.
- Acetaminophen is less effective than NSAIDs
Advantage of COX-2 inhibitors than non-selective NSAIDs in the treatment of OA?
- less
risk for adverse GI events than nonselective NSAIDs
Drug that reduces adverse GI events in patients
taking NSAIDs?
CLUE: PGE1
- Misoprostol
Drug that reduces adverse GI events in patients
taking NSAIDs?
- Proton pump inhibitors
COX-2 inhibitors may not be sustained beyong?
- 6 months
For knee OA, it is the recommended medication if acetaminophen fails?
- Topical NSAIDs
Topical NSAIDs are preferred than Oral NSAIDs in what patient age?
- older than 75 years old
Advantage of Topical NSAIDs compared to Oral NSAIDs in Knee OA?
- fewer adverse GI events
A drug that is recommended for both hip and
knee OA when analgesia with acetaminophen or NSAIDs is suboptimal?
CLUE: corticosteroid injection, but what route?
- Intra-articular corticosteroid injection
T/F:
IA corticosteroid injections should not be administered more frequently than once every 3 months to minimize adverse effects?
- True
Criteria for using Tramadol as a treatment for Hip and knee OA?
- patients who have failed scheduled full-dose acetaminophen and topical NSAIDs
- who are not appropriate candidates for oral NSAIDs
- who are not able to receive IA corticosteroids.
Criteria for using Opioids as a treatment OA?
- patients not responding adequately to nonpharmacologic and first-line pharmacologic therapies
- Patients who are at high surgical risk
and cannot undergo joint arthroplasty are also candidates for opioid therapy.
T/F:
Adverse
events limit routine use of opioids for treatment of OA pain.
- True
