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Section 14: Rheumatologic Disorders

Risk factors for the development of osteoarthritis (OA) include:

A. Smoking

B. Participation in running

C. Being underweight

D. Advanced age

E. B and D

The answer is D. Participation in sports and advancing age are both independent risk factors for the development of OA. Refer to Etiology section.

Patient education for OA, such as programs in which volunteers regularly contact patients

A. Has not yet been demonstrated to provide benefit to OA patients

B. Is too expensive to recommend for general use by OA patients

C. Should emphasize the “wear and tear” nature of OA as part of the educational message

D. Has been shown to improve pain and functional status of OA patients

E. All of the above

The answer is D. A variety of patient education programs have been shown to improve pain and function in OA patients, including volunteer programs. Refer to Nonpharmacologic therapy section.

Matrix metalloproteinases (MMPs)

A. Are naturally occurring chemokines that work primarily by recruiting neutrophils and macrophages to the inflamed synovium

B. Help trigger degradation of articular cartilage by cleaving peptide bonds in proteoglycans

C. Are stimulated by tissue inhibitors of metalloproteinases (TIMPS)

D. Must be activated before they can ease the pain of OA

E. B and C

The answer is B. MMP’s are an important catalyst to normal cartilage turnover and repair. Refer to Normal Cartilage (Function, Structure and Composition of Cartilage) section.

Which of the following are required for an accurate and appropriate diagnosis of OA?

A. Patient history and physical examination

B. Patient history, physical examination, and radiologic evaluation

C. Physical examination and magnetic resonance imaging

D. Patient history, physical examination, and positive response to pharmacologic treatment

E. Any of the above is accurate and appropriate

The answer is B. A patient history to elicit symptoms, a physical exam to examine the ...

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