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Chapter 58. Osteoarthritis

Student Questions

Which one of the following is characteristic of osteoarthritis (OA)?

A. Symmetric joint pain upon waking or immobility

B. Joint stiffness in the morning lasting less than 30 minutes

C. Elevated white blood cell count (WBC) on synovial fluid aspirate

D. Systemic manifestation of joint pain

Answer: B

Option A: Incorrect. OA generally presents as asymmetric joint pain.

Option B: Correct. Joint stiffness should resolve within 30 minutes after waking.

Option C: Incorrect. The synovial fluid should have a WBC less than 1.5 × 103/mm3 (1.5 × 109/L). Elevated WBC may indicate an infectious etiology.

Option D: Incorrect. OA presents as a localized manifestation of joint pain.

Which of the following is considered a risk factor for OA:

A. Male sex

B. Genetic predisposition

C. Alcohol consumption

D. Smoking

Answer: B

Option A: Incorrect. Female sex is a risk factor for OA, not male sex.

Option B: Correct. Genetic predisposition is a risk factor for OA.

Option C: Incorrect. Alcohol consumption is not a risk factor for OA.

Option D: Incorrect. Smoking is not considered a risk factor for OA.

Which one of the following is the most appropriate approach to prevention of OA in a patient at risk for developing OA?

A. Promote smoking cessation as a lifestyle change

B. Promote a lifestyle that includes physical activity

C. Initiate hyaluronic acid intraarticular injections into the most at-risk joint(s)

D. Initiate glucosamine-chondroitin supplementation

Answer: B

Option A: Incorrect. Smoking cessation is not known to prevent the development of OA.

Option B: Correct. Patients can lower susceptibility to OA by maintaining or achieving a healthy body weight. Caution is warranted with heavy physical activity or repetitive motions, which may increase the risk for OA in susceptible patients.

Option C: Incorrect. There is no evidence to suggest that intraarticular injections prevent OA.

Option D: Incorrect. There is no evidence to suggest that supplementation with glucosamine-chondroitin prevents development of OA.

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