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Clinical Review Quiz

Review Questions: Osteoarthritis

David J. Jacofsky, MD, Meredith L. Anderson, MD, and Luther Horn Wolff, III, MD

Dr Jacofsky is chairman of the Center of Orthopaedic Research and Education, Sun City, AZ. Dr. Anderson is an orthopaedic surgery resident, Mayo Clinic, Rochester, MN; Dr. Wolff is an orthopaedic surgery resident, Hughston Clinic, Columbus, GA.

The questions below are based on the article “Osteoarthritis”.

Choose the single best answer for each question.

1. Which of the following is seen in the earliest phases of osteoarthritis?
  1. Increased water content and increased proteoglycan synthesis in cartilage
  2. Increased water content and decreased proteoglycan synthesis in cartilage
  3. Decreased water content and decreased proteoglycan synthesis in cartilage
  4. Decreased water content and increased proteoglycan synthesis in cartilage
  5. Increased water content and normal proteoglycan synthesis in cartilage
Click here to compare your answer.


2. Which of the following is usually seen in noninflammatory arthritis?

  1. Cloudy synovial fluid that is thin and nonviscous
  2. Elevated C-reactive protein level
  3. Erythrocyte sedimentation rate greater than 40 mm/h
  4. Rheumatoid factor titer greater than 1:40
  5. Synovial fluid leukocyte count of less than 2000/mm3
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3. What is the mechanism of action of topical capsaicin cream?
  1. Absorbed and hydrolyzed into salicylic acid and subsequently converted into salicyluric acid
  2. Acts as an antioxidant to decrease free radical formation and inflammation
  3. Directly increases production of proteoglycans from chondrocytes
  4. Impairs production of interleukin-10 to decrease inflammation
  5. Impairs the function of nociceptive nerve fibers through substance P depletion
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4. Which of the following procedures would be the best approach to treat a patient with isolated osteoarthritis of the medial compartment and no malalignment who has failed nonoperative measures?

  1. Distal femoral osteotomy
  2. Meniscal transplantation
  3. Total knee replacement
  4. Unicompartmental knee replacement
  5. Upper tibial osteotomy
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5. All of the following are elevated in the synovial fluid of patients with osteoarthritis EXCEPT

  1. Collagenases
  2. Hyaluronic acid
  3. Interleukin-1
  4. Prostaglandins
  5. Tumor necrosis factor
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