Gout Treatment Options Quiz
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Questions and Answers

What is the primary symptom of gout?

  • Pain (correct)
  • Swelling
  • Redness
  • Stiffness

    • What are the mainstays of acute pain reduction in gout?

  • Colchicine and acetaminophen
  • Massage and acupuncture
  • NSAIDs and steroids (correct)
  • Rest and ice

    • Why have many moved away from using colchicine first in acute gout?

  • Colchicine takes too long to work
  • Colchicine is not effective for gout
  • Colchicine is too expensive
  • Colchicine has adverse effects (correct)

    • What is the recommended dosing for indomethacin in acute gout?

    <p>50 mg three times a day until pain is controlled, then tapered</p> Signup and view all the answers

    Why is the use of a COX-2 inhibitor not a safer alternative to indomethacin for gout patients?

    <p>Many gout patients also have conditions that make COX-2 inhibitors risky</p> Signup and view all the answers

    What is one of the most common complaints in primary care clinics around the world?

    <p>Osteoarthritis</p> Signup and view all the answers

    What is the major adverse effect of topical NSAID pain relief?

    <p>Localized irritation from application</p> Signup and view all the answers

    Which of the following is true about the long-term effects of chronic glucosamine intake?

    <p>The long-term effects are not known</p> Signup and view all the answers

    What is the intent of the Glucosamina formula, which is a crystalline form of glucosamine sulfate sodium chloride available in Portugal?

    <p>To inhibit the inflammatory interleukin-1 linked to an inflammatory response in the joints</p> Signup and view all the answers

    What is the most recent finding regarding the effects of glucosamine for knee or hip arthritis?

    <p>The most recent systematic review has shown no effects for knee or hip arthritis</p> Signup and view all the answers

    What is the key safety factor of topical NSAID pain relief compared to oral therapy?

    <p>Lack of gastrointestinal disturbance</p> Signup and view all the answers

    What is the relationship between glucosamine and acetaminophen according to the text?

    <p>Glucosamine should not be used in combination with acetaminophen</p> Signup and view all the answers

    What is the typical approach for providers before turning to joint injections for OA pain relief?

    <p>Providers typically use a more conservative approach of topical and oral pain medications, physical therapy, or other modalities before turning to injections</p> Signup and view all the answers

    What does the text state about the long-term pain relief provided by triamcinolone injections in knee arthritis?

    <p>Triamcinolone injections provide no long-term pain relief in knee arthritis</p> Signup and view all the answers

    What is the purpose of injecting hyaluronate and viscous solutions into joints for OA?

    <p>To supplement or replace the natural synovial fluid of the joint</p> Signup and view all the answers

    What is the main limitation of steroid injections for OA joint pain according to the text?

    <p>Steroid injections are restricted to four per year</p> Signup and view all the answers

    What is the primary role of the primary care provider in managing rheumatoid arthritis (RA) patients?

    <p>To find early cases, monitor for side effects, and alert the rheumatology team</p> Signup and view all the answers

    Which medication is sometimes used as the first treatment for very mild, early rheumatoid arthritis?

    <p>Minocycline</p> Signup and view all the answers

    What is the primary mechanism of action of methotrexate in the treatment of rheumatoid arthritis?

    <p>Inhibiting cytokine activity and purine production</p> Signup and view all the answers

    Which route of administration of methotrexate is preferred if higher bioavailability is required?

    <p>Both IM and subcutaneous routes</p> Signup and view all the answers

    What is a potential risk associated with using more than 5 mg of prednisolone daily?

    <p>Increased risk of diabetes by 25 to 30 times</p> Signup and view all the answers

    Which statement is true regarding the use of opioids in the treatment of rheumatoid arthritis?

    <p>Some experts believe that 90% or more of RA patients are taking opioids</p> Signup and view all the answers

    What is the purpose of using disease-modifying antirheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis?

    <p>To directly affect the destructive processes that destroy the synovial lining and erode the joints</p> Signup and view all the answers

    Which statement is true regarding the use of methotrexate in pregnant women?

    <p>Methotrexate is contraindicated in pregnant women as it is teratogenic</p> Signup and view all the answers

    What is the recommended starting oral dosage of methotrexate for the treatment of rheumatoid arthritis?

    <p>7.5 mg once a week or 2.5 mg twice a day for 3 days</p> Signup and view all the answers

    Which statement is true regarding the use of aggressive dose increases of methotrexate in rheumatoid arthritis patients?

    <p>Aggressive dose increases are beneficial only for patients diagnosed early</p> Signup and view all the answers

    Which of the following is considered a TNFα inhibitor biologic drug?

    <p>Infliximab</p> Signup and view all the answers

    What is a common concern associated with TNF inhibitor medications?

    <p>Sepsis caused by infections</p> Signup and view all the answers

    Which medication needs to be passively warmed up before delivery due to refrigeration?

    <p>Abatacept</p> Signup and view all the answers

    What potential side effect is associated with rituximab use?

    <p>Renal toxicity</p> Signup and view all the answers

    Which demographic is more likely to experience extra-articular risks from TNF inhibitors?

    <p>Older people with advanced joint issues</p> Signup and view all the answers

    Which biologic drug is administered only intravenously for the first dose?

    <p>Infliximab</p> Signup and view all the answers

    What is a precaution regarding abatacept administration?

    <p>Avoid taking with TNF inhibitors</p> Signup and view all the answers

    "Specialists have the option of different dosing regimens to include an IV loading dose followed by SC weekly injections or only SC dosing based on patient body weight." This statement refers to which drug?

    <p>Abatacept</p> Signup and view all the answers

    What is a notable warning about rituximab that differs from abatacept?

    <p>Progressive multifocal leukoencephalopathy (PML)</p> Signup and view all the answers

    Which medication can be given subcutaneously after the initial intravenous dose?

    <p>Rituximab</p> Signup and view all the answers

    What is the recommended approach for women planning to become pregnant while taking methotrexate?

    <p>Stop taking the drug for a few months before conception</p> Signup and view all the answers

    Which precaution should men taking methotrexate follow during sexual intercourse?

    <p>Wear condoms to prevent pregnancy</p> Signup and view all the answers

    Which of the following side effects of methotrexate requires periodic monitoring and supplementation?

    <p>Folic acid deficiency</p> Signup and view all the answers

    What precaution should caregivers take when handling methotrexate-soiled laundry?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a potential ocular issue associated with hydroxychloroquine?

    <p>Corneal deposits</p> Signup and view all the answers

    How do patients self-monitor for visual acuity changes while taking hydroxychloroquine?

    <p>Using an Amsler grid every 2 weeks</p> Signup and view all the answers

    What is the recommended starting dosage of hydroxychloroquine?

    <p>200 to 300 mg twice a day</p> Signup and view all the answers

    Which of the following statements about tofacitinib (Xeljanz) is true?

    <p>It is an oral medication, not an injectable</p> Signup and view all the answers

    What is a potential risk associated with taking tofacitinib (Xeljanz)?

    <p>Significant infections due to immune suppression</p> Signup and view all the answers

    Which of the following patient groups may not be suitable candidates for tofacitinib (Xeljanz)?

    <p>Patients with advanced hepatic issues</p> Signup and view all the answers

    What is the primary cause of the pain in osteoarthritis?

    <p>Deterioration of cartilage and bone-on-bone friction</p> Signup and view all the answers

    Which medication is considered the first-line intervention for osteoarthritis pain?

    <p>Acetaminophen</p> Signup and view all the answers

    Why is scheduled dosing of acetaminophen recommended over intermittent dosing?

    <p>Scheduled dosing is more effective for progressive pain and moderate pain levels</p> Signup and view all the answers

    What is the primary reason that the use of opioids has increased for osteoarthritis pain management?

    <p>Opioids were considered a &quot;safer&quot; form of pain relief compared to NSAIDs</p> Signup and view all the answers

    What is the recommended approach for using NSAIDs in osteoarthritis?

    <p>Use the lowest dose necessary to achieve pain relief</p> Signup and view all the answers

    What is the rationale for engaging in slow and steady levels of physical activity for osteoarthritis?

    <p>To increase the generation of synovial fluid</p> Signup and view all the answers

    Why is weight reduction considered a critical intervention for osteoarthritis?

    <p>Excess weight puts extra stress on the joints</p> Signup and view all the answers

    What is the purpose of using topical medications in combination with acetaminophen for osteoarthritis pain?

    <p>To provide additional pain relief at the site of the affected joint</p> Signup and view all the answers

    What is the primary reason that chronic use of NSAIDs is a concern in osteoarthritis patients?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended approach for managing activity levels in osteoarthritis?

    <p>Gradually increase activity levels and avoid overexertion</p> Signup and view all the answers

    What is the main advantage of the newer Hya-Joint Plus preparation compared to the original preparations?

    <p>It requires fewer injections for relief of pain and functional limits</p> Signup and view all the answers

    Which of the following is a potential risk associated with injections of viscous materials like Hya-Joint Plus?

    <p>Joint effusion requiring arthrocentesis to relieve pressure and volume</p> Signup and view all the answers

    What is the Kellgren-Lawrence (KL) grading system used for?

    <p>Gauging the advancement of osteoarthritis</p> Signup and view all the answers

    What is a key characteristic of rheumatoid arthritis (RA) that distinguishes it from osteoarthritis?

    <p>Systemic autoimmune nature of the disease</p> Signup and view all the answers

    What is the typical gender distribution of rheumatoid arthritis (RA)?

    <p>Women outnumber men 6:1 in the younger years, but the ratio becomes equal after age 60</p> Signup and view all the answers

    What is the relationship between smoking and the risk of developing rheumatoid arthritis (RA) according to the text?

    <p>Smoking dramatically increases the risk of developing RA</p> Signup and view all the answers

    How does the use of contraceptives affect the risk of developing rheumatoid arthritis (RA) with a positive rheumatoid factor?

    <p>Contraceptive use for more than 7 years decreases the risk of developing RA with a positive rheumatoid factor</p> Signup and view all the answers

    What is the impact of breastfeeding for more than 1 year on the risk of developing rheumatoid arthritis (RA) with a negative rheumatoid factor?

    <p>Breastfeeding for more than 1 year has no effect on the risk of developing RA with a negative rheumatoid factor</p> Signup and view all the answers

    What is the impact of the introduction of DMARDs and biologics on the prognosis and longevity of patients with rheumatoid arthritis (RA)?

    <p>It has revolutionized the prognosis and longevity of RA patients</p> Signup and view all the answers

    Which of the following is NOT a common symptom or manifestation of rheumatoid arthritis (RA) described in the text?

    <p>Increased bone density</p> Signup and view all the answers

    Which of the following statements about biosimilars is true?

    <p>Biosimilars have a unique four-letter suffix assigned by the FDA.</p> Signup and view all the answers

    What is the purpose of the four-letter suffix assigned to biosimilars by the FDA?

    <p>To prevent switching between different biosimilars without meeting FDA-approved indications.</p> Signup and view all the answers

    Which of the following statements about biosimilars is correct?

    <p>Biosimilars are exempt from Phase II clinical trials during the approval process.</p> Signup and view all the answers

    Which of the following statements about biosimilars is true?

    <p>Biosimilars have a quicker path to FDA approval than the original biologic drugs.</p> Signup and view all the answers

    Which of the following statements about methotrexate is correct?

    <p>Methotrexate is recommended to be started early in treatment, based on best evidence.</p> Signup and view all the answers

    Which of the following statements about combining DMARDs and biologics is true, according to the text?

    <p>The efficacy of combining DMARDs and biologics is still contentious and not well-established.</p> Signup and view all the answers

    Which of the following statements about TNF inhibitors is correct?

    <p>All TNF inhibitors appear to have nearly equivalent efficacy.</p> Signup and view all the answers

    Which of the following statements about the use of biologics in combination with DMARDs is true, according to the text?

    <p>Using biologics in combination with DMARDs may cause more concerning side effects, including sepsis.</p> Signup and view all the answers

    Which of the following statements about tofacitinib is correct?

    <p>Tofacitinib is an oral medication, like the nonbiologic DMARDs.</p> Signup and view all the answers

    Which of the following statements about the screening process for DMARDs and biologics is true, according to the text?

    <p>The pre-prescription screening for contraindications and precautions is based on the specific drug being prescribed.</p> Signup and view all the answers

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