| Term 
 
        | Steroids (glucocorticoids/corticosteroids) Immunosuppressive Drugs
 Nonsteroidal Anti-inflammatory drugs
 |  | Definition 
 
        | Drugs that can reduce auto-immune related inflammation |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | What are the mediators of the inflammatory response? |  | 
        |  | 
        
        | Term 
 
        | Inhibit action of cyclooxygenase (COX) which… 
 Results in lower tissue levels of prostaglandins
 
 Hence, another term for NSAIDs is…
 COX inhibitors***
 |  | Definition 
 
        | Main NSAID Mode of Action |  | 
        |  | 
        
        | Term 
 
        | All antipyretic (fever reducer) 
 All analgesic (pain killer)
 
 All anti-inflammatory
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | A group of different conditions characterized by inflammatory damage to various joints of the body |  | 
        |  | 
        
        | Term 
 
        | Auto-immune arthritis Osteoarthritis
 Crystal deposition arthritis
 Infectious arthritis
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Female to male ratio of Rheumatoid arthritis |  | 
        |  | 
        
        | Term 
 
        | Rheumatoid Arthritis (RA) |  | Definition 
 
        | chronic and systemic inflammation of the synovial membranes of multiple joints |  | 
        |  | 
        
        | Term 
 
        | Hands (MP and PIP, but not DIP) and knees*** |  | Definition 
 
        | What are the two areas most often involved with Rheumatoid arthritis |  | 
        |  | 
        
        | Term 
 
        | Early morning stiffness lasting an hour or more |  | Definition 
 
        | What is a hallmark of ongoing RA inflammation? |  | 
        |  | 
        
        | Term 
 
        | New drugs (DMARDs) New strategy:
 Early intervention
 Aggressive treatment
 |  | Definition 
 
        | Why is their newfound optimism for RA treatment? |  | 
        |  | 
        
        | Term 
 
        | Systemic Lupus Erythematosus |  | Definition 
 
        | auto-immune mediated disorder that can cause arthritis Antibodies are initially directed against DNA/protein complexes
 |  | 
        |  | 
        
        | Term 
 
        | Initial onset similar to RA with Fatigue, malaise, weight loss, intermittent fever 
 Later, polyarthritis (60%)
 Hemolytic anemia (70%)
 Renal disease (30-50%)
 |  | Definition 
 
        | Systemic Lupus Erythematosus Symptoms |  | 
        |  | 
        
        | Term 
 
        | Malar rash “Butterfly rash”
 
 Present in 50 – 65%
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | THE most common cause of disability in the U.S. |  | 
        |  | 
        
        | Term 
 
        | “Wear and tear” is involved but… Key feature may be protein changes in cartilage linked to cytokines (esp. interleukins)
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Hips and spine are involved |  | Definition 
 
        | Main difference of Osteoarthritis compared to rheumatoid arthritis |  | 
        |  | 
        
        | Term 
 
        | Steroids (glucocorticoids) "Cortisone shot)
 |  | Definition 
 
        | What do you inject into a joint? |  | 
        |  | 
        
        | Term 
 
        | Gout (Crystal deposition arthritis) |  | Definition 
 
        | Arthritis Disorder of uric acid metabolism |  | 
        |  | 
        
        | Term 
 
        | Hyperuricemia in all with gout Not all with hyperuricemia will have gout
 |  | Definition 
 
        | Describe hyperuricemia and gout |  | 
        |  | 
        
        | Term 
 
        | Intravenous drug abusers*** |  | Definition 
 
        | What group of people are more likely to develop Hematogenous Septic Arthritis? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | A group of inherited disorders All are progressive
 All produce muscle weakness
 Some also cause pain
 |  | 
        |  | 
        
        | Term 
 
        | Duchenne Muscular Dystrophy |  | Definition 
 
        | Most common form of muscular dystrophy 
 Incidence:  30 per 100,000 live births
 
 X-linked recessive mode of transmission
 |  | 
        |  | 
        
        | Term 
 
        | Loss of muscle strength is slow but relentlessly progressive 
 Death from pulmonary infections is possible beginning in the late teens
 
 Survival past age 30 is rare
 Death is most often due to respiratory failure or pneumonia
 |  | Definition 
 
        | Prognosis of Duchenne Muscular Dystrophy |  | 
        |  | 
        
        | Term 
 
        | Primary Secondary (metastatic)
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Malignancy arising in the bone marrow Most common form of primary bone cancer
 Derived from a single plasma cell
 Produces larges amounts of antibody
 |  | 
        |  | 
        
        | Term 
 
        | bone pain Typically in the back and ribs
 Worse with movement, better at rest
 |  | Definition 
 
        | Most common symptom in Multiple Myeloma |  | 
        |  | 
        
        | Term 
 
        | Bone Pain Gradual bone marrow failure
 "punched out' bone lesions in imaging
 |  | Definition 
 
        | Clinical features of multiple myeloma |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Second most common primary bone cancer but overall a rare cancer |  | 
        |  | 
        
        | Term 
 
        | Usually begins in a long bone: Femur, tibia, humerus
 
 Presenting complaint:
 Bone pain
 Pathologic fracture
 
 Can metastasize early
 To other bones
 To the lung
 |  | Definition 
 
        | Clinical Features of Osteosarcoma |  | 
        |  | 
        
        | Term 
 
        | “sunburst lesion” or Codman Triangle |  | Definition 
 
        | Xray may show what in osteosarcoma? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Characterized by one or more bony lesions with: High bone turnover and…
 Disorganized osteoid formation
 |  | 
        |  | 
        
        | Term 
 
        | Can be limited to one bone (monostotic) or multiple bones (polyostotic) 
 Common sites:  skull, femur, tibia, pelvis, humerus
 
 Symptoms:
 None or…
 Bone pain and/or…
 Deafness…
 Pathologic fractures
 |  | Definition 
 
        | Clinical Features of Paget’s Disease of Bone |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Genetic disorder of collagen production Insufficient collagen or abnormal collagen
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | How many types of Osteogenesis Imperfecta are there? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | What is the most common and mildest type of Osteogenesis Imperfecta? |  | 
        |  | 
        
        | Term 
 
        | Type I Osteogenesis Imperfecta |  | Definition 
 
        | Gene mutation results in normal but insufficient collagen quantity Bones fracture easily
 Blue color to the sclera
 Loose joints and poor muscle tone
 Some children with early hearing loss
 |  | 
        |  | 
        
        | Term 
 
        | Type III Osteogenesis Imperfecta |  | Definition 
 
        | Gene defect results in poor quality collagen 
 Bones fracture easily, even before birth
 Bone deformities (often severe) common
 Spinal deformities common
 Short stature due to fractures
 
 Blue sclera, loose joints, poor muscle tone
 
 Hearing loss in some children
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Demineralization of bone Loss of calcium
 Osteoclastic activity dominates over osteoblastic efforts
 Bone matrix remains normal
 |  | 
        |  | 
        
        | Term 
 
        | Main resulting problem is loss of bone strength and susceptibility to fracture*** |  | Definition 
 
        | Main problem of Osteoporosis |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | What is the most common cause of osteoporosis? |  | 
        |  | 
        
        | Term 
 
        | Binds to estrogen receptors in bone Reduces osteoclastic activity
 
 Estrogen replacement is known to:
 Increase bone mass
 Reduce fracture rates
 |  | Definition 
 
        | Estrogen Effects on bones |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | “Muscle pain” Painful muscle or muscle groups
 |  | 
        |  | 
        
        | Term 
 
        | Widespread pain for >3 months In all “four quadrants” which means…
 Both sides of the body and both above & below the waist
 
 Trigger/tender points
 |  | Definition 
 
        | Key clinical features of Fibromyalgia |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Fibromyalgia Proposes genetic defect in CNS pain signaling  and processing mechanisms involving… 
 Cytokines and…
 
 Neurotransmitters
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Pain & stiffness of shoulder & pelvic muscles Trouble combing hair
 Difficult to rise up from chair
 Due to pain, not muscle weakness
 |  | 
        |  | 
        
        | Term 
 
        | Should respond very quickly to prednisone!*** |  | Definition 
 
        | Etiology & Treatment of PR |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  |