Term
|
Definition
| Not like glucocorticoids, not like cortisol, not mediated through lymphocytes, works through prostaglandins |
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Term
| What is the funciton of prostaglandins? |
|
Definition
| mediators of the inflammatory response |
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|
Term
| What is another term for NSAID's? |
|
Definition
| COX Inhibitors: results in lower tissue levels of prostaglandin |
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Term
| What are the 3 actions of NSAID's? (3 A's) |
|
Definition
| Antipyretic, anagesic, anti-inflammatory |
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Term
| What are 2 NSAID toxicity conditions? |
|
Definition
Gastrointestinal: acid production up, mucus production down, chronic blood loss
Renal: reduced renal function acutely, renal damage long term at high dose |
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Term
|
Definition
| A group of different conditions characterized by inflammatory damage to various joints of the body (very common!) |
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Term
| What are the 4 types of arthritis? |
|
Definition
Auto immune (RA, Lupus), osteo (DJD), Crystal deposition (Gout), and infectious
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|
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Term
| Who is effected by RA more, male or females? |
|
Definition
|
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Term
|
Definition
| Chronic and systemic inflammation of the synovial membranes of multiple joint. Trigger is unknown, has auto-immune underlier. |
|
|
Term
| What are some evidences of autoimmunity? |
|
Definition
| Increased Rheumatoid Factor, elevated ESR, elevated gamma globulins |
|
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Term
| What joints are most likely effected by RA? What is the hallmark symptom? |
|
Definition
| Hands (MP and PIP) and Kness. Early morning stiffness lasting > 1 hours is the hallmark RA trait |
|
|
Term
| What is unique about the DMARD menu for treating RA? |
|
Definition
| There is a ton of options!!! Very odd options as well such as gold salts... |
|
|
Term
| For RA, what's the best way to treat it? |
|
Definition
| The new strategy is early intervention with aggressive treatment! |
|
|
Term
| Who is most suseptable to getting lupus? |
|
Definition
| African Americans and women of child bearing age |
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|
Term
| What are two diffinitive features/symptoms of Lupus that differ it from other arthritic conditions? |
|
Definition
| Hemolytic anemia and renald disease |
|
|
Term
| What is the signature symptom for lupus? |
|
Definition
|
|
Term
| Is there a cure for lupus? How do we treat it? Prognosis? |
|
Definition
| No cure has been found. Use immunosuppressive drugs, and prognosis is usually really good if you get to it early. |
|
|
Term
| Which is more common, osteoarthritis or RA? |
|
Definition
| OA...the most common cause of disability in the U.S. |
|
|
Term
| Whats the key feature of OA? |
|
Definition
| Protein changes in the cartilagge linked to cytokines (esp. interleukins) |
|
|
Term
| What are the the most commonly effected regions for OA? |
|
Definition
|
|
Term
| What are the most commonly replaced joints via arthroplasty? |
|
Definition
| Hips, knees, shoulders, ankles |
|
|
Term
| Who is normally effected by gout? |
|
Definition
|
|
Term
|
Definition
| Disorder of uric acid metabolism. Creates conditions of hyperuricemia in all with gout, BUT, not all with hyperuricemia will have gout! |
|
|
Term
|
Definition
| nodular deposit of urate monohydrate crystals which creates joint inflammation or renal failure! |
|
|
Term
| Where do infectious arthritis usually occur? |
|
Definition
|
|
Term
| Who are the big offenders in IA? |
|
Definition
| Strep, Staph, TB, Gonnorrhea |
|
|
Term
| Who normally gets hematogenous septic arthritis? |
|
Definition
| Intravenous drug abusers. |
|
|
Term
| Define muscular distrophy. |
|
Definition
| A group of inherited disorders, all progressive, produce muscle weakness, and painful. |
|
|
Term
| What's the major type of MD we are concerned with? |
|
Definition
| Duchenne's. Most common form of MD, x-linked recessive mode of transmission. |
|
|
Term
| What causes Duchenne's (mutation of what gene)? |
|
Definition
|
|
Term
| Where is Duchenne's normally first noted? |
|
Definition
|
|
Term
| What is the prognosis for Duchenne's? |
|
Definition
| Not great, very rare to make it past age 30, death usually due to respiratory failure or pneumonia |
|
|
Term
| What is the most ocmmon form of primary bone cancer? |
|
Definition
| Multiple myeloma, derived from a single plasma cell. Higher in males, higher in African Americans, mean age is around 68 |
|
|
Term
| What are some key features of multiple myeloma? |
|
Definition
| Bone pain, gradual bone marrow failure, and x-ray's show "punched out" bone lesions |
|
|
Term
| What's the prognosis for multiple myeloma? |
|
Definition
| Not good, but getting better. Used to only survive 3 years, now is 4-6. Death usually comes from kidney faiulre, infection, or chemotherapy complications |
|
|
Term
| What's the second most common type of primary bone cancer? (still rare though) |
|
Definition
| Osteosarcoma (called the cancer of the young) |
|
|
Term
| What are the 3 subtypes of osteosarcoma? |
|
Definition
| Osteoblastic, fibroblastic, and chondroblastic |
|
|
Term
| Where does osteosarcoma usually begin? |
|
Definition
| Starts in a long bone such as the femur or humerus or tibia |
|
|
Term
| What diagnostic imaging results can key us toward a diagnosis of osteosarcoma? |
|
Definition
| X-ray will show "sunbrust lesion," or Codman's Triangle |
|
|
Term
| What are some options for treating osteosarcoma? |
|
Definition
| Amputation of effected limb, multi agent approach of radiation/chemotherapy |
|
|
Term
| What's the prognosis for osteosarcoma? |
|
Definition
| Long term, (>10 years) survival in 60-80% |
|
|
Term
| How common is Paget's disease? |
|
Definition
| Not common, 1-2% of population, rare under age 40 |
|
|
Term
| What are some common sites to see Paget's? |
|
Definition
| SKull, femur, tibia, pelvis, humerus |
|
|
Term
| What are some Paget's symptoms? |
|
Definition
| Bone pain, deafenss, pathological features...also may see nothing! |
|
|
Term
| What is osteogenesis imperfecta? Out of the 8 types, which are the most common and which is the most lethal? |
|
Definition
| Genetic disorder of collagen production. Type one is the most common and mildest, while type 2 is the most dangeous and lethal (first year death) |
|
|
Term
| What is the difference between Types I-IV and V-VII of osteogenesis imperfecta? |
|
Definition
I-IV --> autosomal dominant transmission!
V-VIII --> autosomal recessive! |
|
|
Term
| What is the big difference between Type I and Type II osteogenesis imperfecta? |
|
Definition
| Type III has more severe bone deformities |
|
|
Term
| Is there a cure for osteogenesis imperfecta? |
|
Definition
| No, gene therapy is our only hope for the future in treatment. |
|
|
Term
|
Definition
| Demineralization of bone, characterized by loss of calcium, osteoclastic activity takeover, and the main resulting problem is loss of bone strength and susceptability to fracture. |
|
|
Term
| What can cause osteoporosis? Which is the most common? |
|
Definition
| Endocrine, Renal Disease, Medication induced, involutional (most common!) |
|
|
Term
| What are the two drugs that can cause osteoporosis? |
|
Definition
| Glucocorticoids and Heparin (anti-coagulant) |
|
|
Term
| Who is most susceptible to osteoporosis? |
|
Definition
| WOMEN (white women over black women). Most common bone disorder in the U.S. |
|
|
Term
| Which areas are most common to fracture in osteoporotic condition? |
|
Definition
|
|
Term
| Osteoporosis treatment options? |
|
Definition
Calcium supplement (although can't cure it on its own!!!)
Estrogen, selective estrogen receptor modulators, biphosphates |
|
|
Term
| What are the risks behind estrogen therapy for osteoporosis? |
|
Definition
| Increased risk of breast canacer, CV disease, thromboembolisms, and uterine cancer (unless progestrerone is added) |
|
|
Term
What's the most safe treatment for osteoporosis? What are its side effects?
|
|
Definition
| SERM is the safest. Hot Flashes are the main side effect. |
|
|
Term
| What does biphosphate treatment do? |
|
Definition
| Blocks bone resorption (which increased bone mass) |
|
|
Term
|
Definition
| Painful muscle or muscle groups (fibro, poly etc.) |
|
|
Term
| What are the symptoms for fibromyaglia? |
|
Definition
| Very common, poorly understood, chronic widespread pain, fatigue, sleep disorders, headaches, heightened pain in response to tactile pressure |
|
|
Term
| What are the 2 key features of Fibromyalgia? |
|
Definition
| Widespread pain for > than 3 months, and the pt. has trigger/tender points. |
|
|
Term
| What do we think is the main cause of fibromyalgia? |
|
Definition
| Central sensatization! (proposes genetic defect in the CNS pain signaling and processing mechanisms involving cytokines and NT's) |
|
|
Term
| Describe Polymyalgia Rheumatica. |
|
Definition
| Pain and stiffness of shoulder and pelvic muscles, ADL's effect DUE TO PAIN, NOT WEAKNESS. Always after age 50. |
|
|
Term
| What does PR respond to very quickly? |
|
Definition
| Prednisone! within 72 hours! |
|
|
Term
| What is one special hazard of PR? |
|
Definition
| Connection with giant cell arteritis can cuase sudden blindness due to occlusive opthalmic arteritis! (1/3 of patients experience this) |
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