COMPLETE ACCURATE EXAM
QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT ANSWERS)
AND RATIONALES / ALREADY GRADED
A+
Arthritis - ANSWER ✓ Along leading cause of disability in Canada, affecting 4.5
million people of every age, physical condition, and ethnic background
Osteoarthritis - ANSWER ✓ Most common type of arthritis, affects 1 in 10
Canadian adults. women 10x more likely.
Osteoarthritis symptoms - ANSWER ✓ Swelling, joint pain, stiffness (worse in
morning or on arising after prolonged sitting, improves within 30 mins), loss of
motion, lumps around knuckles
Osteoarthritis definition - ANSWER ✓ Manifests first as a molecular derangement
(abnormal joint tissue metabolism) followed by anatomic, and/or physiologic
derangement (characterized by cartilage degradation, bone remodeling, osteophyte
formation, joint inflammation and loss of normal joint function) that can culminate
in illness
Pathophysiology of OA - ANSWER ✓ Proinflammatory factors are responsible
for the progressive destruction and remodeling of the joint through the stimulation
of matrix-degrading enzymes, including the matrix metalloproteinases.
Growth factor role in OA pathophysiology - ANSWER ✓ Certain growth factors
promote osteophyte formation and contribute to subcondral sclerosis.
Location of production of proinflammatory mediators and anabolic factors -
ANSWER ✓ Produced locally by the cells within the affected tissues, including
the articular chondrocytes, synovial fibroblasts, and immune cells in the synovium;
,inflammatory cells in periarticular fat; cells in the bone, including osteoblasts,
osteocytes, osteoclasts, and bone marrow mesenchymal stem cells
Characterization of OA pathophysiology - ANSWER ✓ OA is characterized by
progressive cartilage loss, accompanied by subcondral bone cysts, narrowing of
joint space, osteophytes, and increased thickness of the subchondral plate.
Radiological findings in OA - ANSWER ✓ Joint space narrowing due to loss of
articular cartilage and meniscus and bone changes including sclerosis of
subchondral bone and osteophytes
Clinical signs of OA - ANSWER ✓ Heberden's nodes on the dorsolateral aspects
of the distal interphalangeal joints from bony overgrowth of osteoarthritis.
Bouchard's nodes.
Heberden's nodes - ANSWER ✓ Usually hard and painless, they affect the middle
aged or elderly. Often associated with arthritic changes in other joints. Flexion and
deviation deformities may develop.
Bouchard's nodes - ANSWER ✓ On the proximal interphalangeal joints are less
common. Metacarpophalangeal joints are spared.
Risk factors of osteoarthritis - ANSWER ✓ Age (aging of the cartilage), gender
(female), obesity (wear and tear), previous repetitive injuries (biomechanics
damage), lack of physical activity (occupation, lifestyle), malalignment of joints,
muscle weakness, diet
Nonpharmacological treatments for OA - ANSWER ✓ Weight loss, self-
management/ education programs, physical exercise, balance training, yoga, tai
chi, cognitive behaviour therapy, acupuncture, transcutaneous electrical nerve
stimulation
Pharmacological treatment of OA - ANSWER ✓ Anti-inflammatory agents, intra-
articular injections, additional medications, surgery
Anti-inflammatory agents used in treatment of OA - ANSWER ✓ Topical
NSAIDs, oral NSAIDs, COX-2 inhibitors
,Intra-articular injections used in treatment of OA - ANSWER ✓ Corticosteroids,
hyaluronic acid compounds
Additional medications used in management of OA - ANSWER ✓ Duloxentine,
opioids
Surgery used in management of OA - ANSWER ✓ Arthroscopy, total joint
replacement
Joint replacement - ANSWER ✓ About 90% of recipients of total tip replacement,
80% of recipients of total knee replacement report substantial improvement in
pain. Durable impacts- 90% of knee and 80% of hip implants lasting 20 years
Rheumatoid arthritis - ANSWER ✓ Is a chronic, inflammatory type of arthritis,
also classified as an autoimmune disease
Stages of rheumatoid arthritis - ANSWER ✓ Stage 1, 2, 3, 4
Stage 1 of rheumatoid arthritis - ANSWER ✓ The body mistakenly attacks its own
joint tissue
Stage 2 of rheumatoid arthritis - ANSWER ✓ The body makes the antibodies and
the joints begin to swell.
Stage 3 of rheumatoid arthritis - ANSWER ✓ Joints start becoming bent and
deformed, the fingers become crooked. These misshapen joints can press on the
nerves and can cause nerve pain.
Stage 4 of rheumatoid arthritis - ANSWER ✓ If not treated, the disease will
progress to the last stage, in where there's no joint remaining at all and the joint is
essentially fused
RA vs OA: symmetry - ANSWER ✓ RA: pattern of joint involvement is
symmetrical
OA: usually asymmetrical affecting one or two joints
RA vs OA: morning stiffness - ANSWER ✓ RA: 30+ minutes
OA: 15-30 minutes
, RA vs OA: joints affected - ANSWER ✓ RA: predominantly affects the smaller
joints of hands, feet, and wrists
OA: often affect the large weight-bearing joints such as knees and hips
RA vs OA: swelling - ANSWER ✓ RA: joint swelling appears red and hot to
touch
OA: swelling is not as evident and the joints are cool to touch
RA vs OA: nodes - ANSWER ✓ RA: distal interphalangeal joints (DIPs) are not
typically involved in RA
OA: may be able to see swellings of the distal (Herberden's nodes) or proximal
interphalangeal joints (Bouchard's nodes)
RA vs OA: course - ANSWER ✓ RA: course is unpredictable with episodes of
flares and remission
OA: progressive
RA vs OA: systemic manifestations - ANSWER ✓ RA: anaemia of chronic
disease is a feature of RA but not OA
OA: OA is not a systemic disease, therefore it is not necessarily associated with
fever or weight loss. OA pain is more symptomatic after repetitive use of joints or
activity
Markers present in RA - ANSWER ✓ Osteophytes absent. Rheumatoid factor
present.
Chronic rheumatoid arthritis - ANSWER ✓ In chronic disease, range of motion of
the bones becomes limited and fingers may deviate toward the ulnar side.
Interosseous muscle atrophy.
Extra-articular features of RA - ANSWER ✓ Neurological, pulmonary,
dermatological, ocular, cardiac, haematological
Neurological extra articular features of RA - ANSWER ✓ peripheral neuropathy,
cervical myelopathy