APEA Orthopedic Questions and Answers
with Complete Solution 100% Correct |
Updated 2025
Osteoarthritis - ANSWER Pain: exacerbated by activity;
relieved by rest;
sometimes occurring at night
• AM stiffness resolving in ≤60 minutes
• Tenderness to palpation of involved joints
• Crepitus (audible)
•Joint effusion may be present
• Osteophytes palpable bony enlargements
• Joint space narrowing
Joint pain
• Age >50 years
• Presence of joint space narrowing and/or osteophyte on X-ray - ANSWER
Osteoarthritis Diagnosis
Exercise: ROM and strengthening
• Weight loss if appropriate
• Patient education • Heat, ultrasound? - ANSWER Non-pharmacologic
Osteoarthritis TX:
, • Use ONLY when symptoms are present!
• NSAIDs (oral if no relief from topical) Watch for GI, cardiac, renal complications!
• Injectable steroids: not recommended Short duration of effect • Acetaminophen
not first line because no clinically significant effect on pain
• Opioids: NO! MANY side effects - ANSWER Pharm Management for
osteoarthritis
rheumatoid arthritis - ANSWER Autoimmune disease
• Symmetrical, peripheral polyarthritis (leads to joint deformity and destruction)
• Rheumatoid factor (RF)
• Anti-CCP antibodies: citrullinated peptides/proteins (higher specificity than RF,
similar sensitivity as RF)
• Acute phase reactants: ESR, CRP
• ANA: negative may exclude SLE
• CBC, LFTs, BUN, Cr, uric acid level, UA - ANSWER Rheumatoid Workup
Fibromyalgia - ANSWER Chronic widespread musculoskeletal pain >3 months;
accompanied by fatigue, sleep disturbances, and multiple somatic complaints (HA,
bowel irritability, cognitive disturbances)
• Etiology and pathophysiology are unknown
• NO evidence of tissue inflammation
• Lab, radiology WNL
• PE normal (except for tenderness in 9 pairs of specific FM points on exam)
• ACR has preliminary diagnostic criteria
with Complete Solution 100% Correct |
Updated 2025
Osteoarthritis - ANSWER Pain: exacerbated by activity;
relieved by rest;
sometimes occurring at night
• AM stiffness resolving in ≤60 minutes
• Tenderness to palpation of involved joints
• Crepitus (audible)
•Joint effusion may be present
• Osteophytes palpable bony enlargements
• Joint space narrowing
Joint pain
• Age >50 years
• Presence of joint space narrowing and/or osteophyte on X-ray - ANSWER
Osteoarthritis Diagnosis
Exercise: ROM and strengthening
• Weight loss if appropriate
• Patient education • Heat, ultrasound? - ANSWER Non-pharmacologic
Osteoarthritis TX:
, • Use ONLY when symptoms are present!
• NSAIDs (oral if no relief from topical) Watch for GI, cardiac, renal complications!
• Injectable steroids: not recommended Short duration of effect • Acetaminophen
not first line because no clinically significant effect on pain
• Opioids: NO! MANY side effects - ANSWER Pharm Management for
osteoarthritis
rheumatoid arthritis - ANSWER Autoimmune disease
• Symmetrical, peripheral polyarthritis (leads to joint deformity and destruction)
• Rheumatoid factor (RF)
• Anti-CCP antibodies: citrullinated peptides/proteins (higher specificity than RF,
similar sensitivity as RF)
• Acute phase reactants: ESR, CRP
• ANA: negative may exclude SLE
• CBC, LFTs, BUN, Cr, uric acid level, UA - ANSWER Rheumatoid Workup
Fibromyalgia - ANSWER Chronic widespread musculoskeletal pain >3 months;
accompanied by fatigue, sleep disturbances, and multiple somatic complaints (HA,
bowel irritability, cognitive disturbances)
• Etiology and pathophysiology are unknown
• NO evidence of tissue inflammation
• Lab, radiology WNL
• PE normal (except for tenderness in 9 pairs of specific FM points on exam)
• ACR has preliminary diagnostic criteria
