Term
Nonarticular
Chronic
Noninflammatory
genetically predisposed |
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Definition
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Term
Cant sleep
stressors cause pain
uknown etiology |
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Definition
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Term
| may be involved with serotonin and or catecholamine pathways |
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Definition
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Term
Pain - diffuse, chronic muscular, crawling sensation
fatigue
sleep disturbances
depression or anxiety |
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Definition
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Term
| 9 fibromyalgia pressure points |
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Definition
Insertion of neck muscles into the occiput
Pectoralis at 2nd costochondral junction
Just posterior to greater trochanter (hip)
Upper-gluteal area
Mid-scapular area
Superior mid-trapezius
Just below lateral epicondyle
Medial knee
Lower cervical-anterior C5-C7 |
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Term
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Definition
| DDx rule out Fibromyalgia |
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Term
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Definition
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Term
| Promotes sleep and de pain, generic and affordable |
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Definition
| Tricyclic Antidepressants (TCA) |
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Term
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Definition
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Term
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Definition
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Term
| Dual NE and serotonin reuptake inhibitor |
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Definition
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Term
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Definition
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Term
| Combination of TCA’s & SSRI’s also studies & found effective |
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Definition
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Term
Exact mechanism of action is unknown
Mimics neurotransmitter gamma-aminobutyric acid (GABA)
Binds calcium subunits in brain and spinal cord |
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Definition
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Term
| fibromyalgia tx (not first line) |
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Definition
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Term
Articular
chronic
inflammatory / noninflammatory
Systemic |
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Definition
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Term
| Pain in weight bearing joints particularly ppl with physical labor jobs |
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Definition
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Term
| DJD, irregularity, erosion, and ulceration of the articular cart |
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Definition
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Term
| osteophyte formation causes a sig amt of pain |
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Definition
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Term
Use related pain
Joint stiffness
morning pain that resolves after 10min
Dec ROM (inability to kneel and cut toe nails) |
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Definition
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Term
| Morning pain that resolves in 10min |
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Definition
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Term
| Morning pain that resolves in 30-60min |
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Definition
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Term
sudden pain
night pain
morning stiffness
rubor, calor, dolor, tumor
joint effusion
post traumatic chondromalacia |
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Definition
| OA suggestion of inflammation |
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Term
| Pt was on vacation with grand kids walking around disney world and began to feel pain in knees |
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Definition
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Term
joint space narrowing
subchondral cysts
osteophytes |
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Definition
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Term
| _____ change in pain is clinically relevant after tx |
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Definition
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Term
| Marker of generalized (polyarticular) OA |
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Definition
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Term
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Definition
| contralateral hand to painful joint |
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Term
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Definition
| equal to the length from the floor to the pts greater trochanter |
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Term
| size of a wallet, sticky pads around affected joint and turn up electrical conduction – keeps the area stimulated, inc blood flow, contraindicated for defribulator, pacemaker, seizure person |
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Definition
| Transcutaneous electrical nerve stimulation (TENS) |
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Term
OMT
TENS
Magnets
Acupuncture
Yoga |
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Definition
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Term
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Definition
| pain relief - cant stop joint damage |
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Term
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Definition
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Term
| adverse effects of narcotics in geriatrics |
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Definition
Sedation
Confusion
Constipation |
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Term
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Definition
| Triamcinolone - intraarticular glucocorticoids |
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Term
| – smells good, feels good, cooling, anti inflammatory too, problem is that you must put it on 4 times a day and let it sit for 10min |
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Definition
| Diclofenac Gel (Voltaren Gel® |
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Term
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Definition
| Hyaluronans - lubricate and absorb shock in joints |
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Term
| must give multiple injs to work |
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Definition
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Term
| Tend to have them redone a second time if they are young and very active |
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Definition
| Joint replacements: life span 10-15 yrs |
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Term
arthroscopic debridement or lavage in OA
Osteotomies
Joint replacements |
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Definition
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Term
Articular
Chronic
most common chronic inflammatory arthritis
systemic |
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Definition
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Term
| Pregnancy associated w remission |
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Definition
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Term
tobaco
infection
stress
trauma
2x greater onset in winter (north) |
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Definition
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Term
| sheet of inflammatory granulation tissue that spreads from the synovial membrane and invades the joint leadng to fibrous ankylosis |
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Definition
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Term
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Definition
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Term
| Why supplement RA pt with Ca? |
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Definition
| osteopenia occurs due to inc osteoclast activity (bone resorption) |
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Term
At least 4 of the following:
Morning stiffness 1+hour for 6+ weeks
Swelling of 3+ joints for 6+ weeks
Swelling of wrist, hand or finger joints for 6+ weeks
Symmetrical joint swelling
Characteristic x-ray changes in hands
Rheumatoid Factor + |
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Definition
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Term
Autoantibody against the Fc portion of IgG
RF and IgG join to form immune complexes
Contribute to the disease process. |
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Definition
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Term
| can precede the onset of sx by years |
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Definition
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Term
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Definition
| become sero positive after yr of sx usu |
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Term
| Diff test that is more specific for RA than RF+??? |
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Definition
| Anti-CCP (Anti-cyclic citrullinated peptide antibody) |
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Term
During inflammation, citrulline is incorporated enzymatically into proteins
Citrullination |
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Definition
| Anti-CCP in RA - more specific |
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Term
If seroneg but your convinced that they have RA – you should get _________
It is more expensive so that is why you don’t get this first |
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Definition
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Term
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Definition
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Term
| Unlike OA, pain in RA is ________ |
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Definition
| symmetrical on both sides |
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Term
Pain in one joint
sx for hrs or days with swelling and erythema
then seq reverses and sx resolve |
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Definition
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Term
| Less likely to have subcutaneous nodules like OA |
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Definition
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Term
TMJ pain
hoarseness (cricoarytenoid joints)
hearing loss (ossicles of ear)
pain lying on side (sternoclavicular) |
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Definition
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Term
ulnar deviation of MCP joints and fingers
swan neck deformity
Boutonniere deformity
DeQuervain's tenosynovitis (finkelstein's test) |
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Definition
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Term
AA joint prone to subluxation
progression of peripheral joint erosions parallels that of cervical spine
get c spine xrays flexed and ext
no HVLA in cspine |
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Definition
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Term
rocker bottom deformity
hallux valgus
nodules on achilles causing spontaneous rupture |
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Definition
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Term
| softer nodules that role around a little bit and can occur anywhere, not like Heberdens and Bouchards nodes which are firm boney structures |
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Definition
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Term
Eosinophilia
Thrombocytosis
inc sed rate
anemia
inc inflammation |
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Definition
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Term
Pleural effusion
Interstitial fibrosis (hard to breath)
Pulmonary nodules - can be mistaken for a tumor |
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Definition
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Term
| Reactivation of TB by anti-TNF alpha biologic agents |
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Definition
| risk of anti TNF alpha drugs for RA |
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Term
Pericardial effusion (diminished heart sounds and flat EKG)
myocarditis
pericarditis
endocardial inflammation |
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Definition
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Term
Conduction defects secondary to nodules
In 30% complete heart block occurs with established erosive nodular disease |
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Definition
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Term
| dry eyes (keratoconjunctivitis sicca) |
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Definition
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Term
| cardiovasular mortality is inc with high CRP |
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Definition
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Term
Triad:
chronic seropositive RA arthritis
Splenomegally (4x)
Granulocytopenia |
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Definition
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Term
Brown pigmentation over extremities
hepatomegally
and the triad |
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Definition
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Term
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Definition
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Term
| Dry eyes and dry mouth secondary to autoimmune dysfunction of exocrine glands |
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Definition
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Term
Xeroopthalmia
Xerostomia
Large parotid
Xerotrachea
Esophageal dysmotility |
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Definition
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Term
Shirmer test (make lacrimal fluid)
cracker sign, caries, burning
chipmunk like face
cough, dyspnea, chest pain
trouble swallowing |
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Definition
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Term
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Definition
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Term
Antibody to SS-A (75%)
Antibody to SS-B (40%)
2/3 ANA+
RF+ |
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Definition
Antibody to SS-A (75%)
Antibody to SS-B (40%)
2/3 ANA+
RF+ |
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Term
Articular
Acute
Inflammatory
Nonsystemic
1st MTP
Knee |
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Definition
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Term
Elevated serum urate concentration
Overproduction
Underexcretion |
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Definition
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Term
| Solid collections of sodium urate crystals are deposited chiefly in & around joints (small masses) |
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Definition
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Term
| Serum urate concentrations vary with age and gender |
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Definition
>7 mg/dl in males
>6 mg/dl in females |
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Term
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Definition
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Term
| Why do high BMI ppl get gout? |
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Definition
| High body mass index is a predictor of hyperuricemia in people of differing races and cultures |
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Term
EtOH
prev injured joint
High Purine diet (meat, seafood) |
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Definition
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Term
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Definition
1. Asymptomatic hyperuricemia
2. Acute gouty arthritis
3. Intercritical (or interval) gout
4. Chronic tophaceous |
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Term
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Definition
| Gout - 10-40% have 1+ attacks of renal colic before first articular event - kidney stone from uric acid crystals |
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Term
| gouty attack of the 1st MTP joint |
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Definition
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Term
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Definition
Joint aspiration
Intracellular needle-shaped: negative birefringence with compensated polarized light microscopy |
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Term
Occurs suddenly
joint becomes hot, dusky red, swollen, tender |
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Definition
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Term
| Duration of gout & degree of hyperuricemia correlate with |
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Definition
| rate and formation of tophi |
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Term
| Tense, shiny skin overlying tophi may ulcerate & extrude white, pasty material composed of urate crystals |
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Definition
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Term
| Erosions with sclerotic margins and thin overhanging calcified edges |
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Definition
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Term
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Definition
Gout - worse with inc uric actid excretion, low urine volume, low urin pH
-low pH = insoluble urate
-high pH = soluble uric acid |
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Term
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Definition
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Term
| inc urinary uric acid excretion with |
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Definition
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Term
| dec uric acid production with |
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Definition
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Term
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Definition
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Term
NSAIDs
Colchicine
Glucocorticoids |
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Definition
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Term
| inhibits leukocyte entry into joints |
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Definition
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Term
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Definition
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Term
| Allopurinol is not first like bc |
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Definition
| it can exacerbate some gouty sx |
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Term
| first line NSAID tx for gout |
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Definition
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Term
| contraindicated until infection is ruled out tx for gout |
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Definition
| interarticular glucocorticoids |
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Term
| systemic glucocorticoid for gout |
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Definition
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Term
| cranberry juice is good for gout pts bc |
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Definition
| it makes urine more basic so more uric acid is excreted |
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Term
| dec urate reabsorption in the tubules and can have an adverse rxn rash |
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Definition
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Term
S/E: Rash, hepatitis, neutropenia, diarrhea, fever
Can affect prothrombin time
Monitor INR in anticoagulated patients
Decreases metabolism of warfarin |
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Definition
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Term
Decrease red meat
Decrease seafood
Decrease hard alcohol |
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Definition
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Term
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Definition
Calcium Pyrophosphate Dihydrate
Basic Calcium Phosphate |
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Term
Can be asymptomatic
Increases progressively with age
Idiopathic or sporadic
Age >50
Becomes Pseudogout |
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Definition
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Term
| Resembles gouty arthritis but with CPPD crystals |
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Definition
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Term
Acute monoarthritic pain
Edema, effusion, warmth, tenderness
Radiographically
Heavy punctuate & linear calcification in chondral regions |
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Definition
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Term
Deposition:
Periarticular structures
Rotator cuff
Subacromial bursa of the shoulder
Calcific tendonitis |
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Definition
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Term
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Definition
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Term
B/L shoulder pain due to capsular calcification
Joint effusions
Elderly females |
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Definition
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Term
| Arthrocentesis: Weakly birefringent, rhomboid, rod-shaped, intracellular |
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Definition
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Term
| Arthrocentesis: negatively birefringent |
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Definition
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Term
Most common cause of urinary stones
May cause arthritic changes
Multifactorial etiology
Most commonly increased serum calcium
Dietary
Higher risk for arthritis
Postmenopausal women with kidney stones – don’t supplement with Ca2+ |
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Definition
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Term
OA
Milwaukee shoulder
Tendonitis |
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Definition
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Term
Pseudogout
Chondrocalcinosis |
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Definition
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Term
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Definition
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Term
Urinary tract stones
Calcium oxalate associated arthritis |
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Definition
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