CMN 574 EXAM 3 – Rheumatology UPDATED ACTUAL Exam Questions and CORRECT Answers

CMN 574 EXAM 3 – Rheumatology
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Osteoarthritis S/S - CORRECT ANSWER - - AM stiffness <30min
- Non-inflammatory
- Pain relived at rest
- No systemic S/S
- Slow onset
- Weight bearing joints
- Normal ESR, Non-inflammatory synovial fluid


Osteoarthritis prevelence - CORRECT ANSWER - - Women
- Age 40 or older
- Most common joint disease


Osteoarthritis TX - CORRECT ANSWER - - Weight loss
- Vit D management
- Splinting [hands]
- Tylenol 3g/24hr
- Triamcinolone [knee/hip] injection if no response to OTC meds (No injections in hands!)
- Ortho referral for hip / knee replacement


Gout S/S - CORRECT ANSWER - - Mono-articular
- Inflammatory
- 1st MTP Joint [great toe]-podagra
- Intense, tender joints + warm, dusky red skin
- Acute onset

, - Tophus in cartilage, subQ / periarticular tissue, bone, kidney


Primary gout - CORRECT ANSWER - - Hereditary
- Men >30yr
- Postmenopausal women


Secondary Gout - CORRECT ANSWER - - Acquired causes of hyperuricemia
- Excessive ETOH [beer]
- Diuretics
- Aspirin
- Cyclosporine
- Niacin
- Changes in diet or fluid intake


Gout Labs - CORRECT ANSWER - - Serum uric acid >6.8
- ↑ Peripheral WBC [acute attack]


Gout DX - CORRECT ANSWER - - Na+ urate crystals [aspirated joint fluid]
- US confirms


Acute TX of gout - CORRECT ANSWER - - NSAIDs
- Colchicine [<36hr attack; 1.2mg - 0.6mg 1hr later - 0.6mg BID for prophylaxis]
- Allopurinol
- Corticosteroids are most useful for pt with contraindications to NSAIDs (given IV or PO)


2+ episodes of gout/year - CORRECT ANSWER - - Initiate urate lowering meds
[colchicine]
- Maintain serum uric acid at or below 6mg/dL