Anesthesia, Gout, JIA, and Osteoarthritis Review

Comprehensive vocabulary flashcards covering anesthesia classes, gout diagnosis and management, pseudogout, juvenile idiopathic arthritis subtypes, and osteoarthritis characteristics based on the lecture notes.

Anesthesia

Medical procedure performed by administering drugs that cause loss of sensation.

Local Anesthesia

Loss of sensation to a limited part of the body without loss of consciousness, commonly using sodium channel blockers.

Epinephrine (in Local Anesthesia)

Additive to local anesthesia solutions that constricts local blood vessels to prolong the duration of action of the anesthetic.

Esters (Anesthetic class)

The first class of local anesthetics used, such as cocaine.

Amides (Anesthetic class)

Local anesthetics that largely replaced esters because they produce fewer side effects and last longer.

General Anesthesia

Administration of drugs causing loss of sensation to the entire body and loss of consciousness by depressing nervous activity in the brain.

Surgical Anesthesia

Stage of general anesthesia characterized by muscular paralysis, stabilization of cardiovascular and respiratory functions, and slowed eye movements.

Inhaled Anesthetics

Anesthetics that prevent the flow of sodium into neurons in the CNS, delaying nerve impulses and reducing neural activity.

Neuromuscular Blockers

Adjuncts to anesthesia that cause paralysis without loss of consciousness.

Sevoflurane (Ultane)

Volatile ether anesthetic with a sweet smell that acts as a potent bronchodilator, ideal for inhalational induction.

Desflurane (Suprane)

Volatile ether anesthetic with poor blood solubility resulting in rapid onset and offset, requiring a specialized pressurized vaporizer due to its low boiling point.

Isoflurane (Forane)

Volatile ether anesthetic that acts as a potent vasodilator, maintains cardiac output, and suppresses convulsive activities.

Halothane (Fluothane)

Alkane volatile anesthetic that sensitizes the heart to catecholamines and carries a risk of rare but fatal Halothane Hepatitis.

Nitrous Oxide ("Laughing Gas")

Inhalation agent acting via NMDA antagonism that provides analgesia but has a high minimum alveolar concentration ($\text{MAC} = 105\%$) preventing its use as a sole anesthetic.

Compound A

Nephrotoxic substance formed when Sevoflurane is exposed to certain dehydrated $\text{CO}_2$ absorbents.

Diffusion Hypoxia

Condition occurring when rapid elimination of $\text{N}_2\text{O}$ dilutes alveolar $\text{O}_2$ and $\text{CO}_2$.

Etomidate

Intravenous anesthetic that binds GABA receptors to enhance GABA effects, providing cardiovascular stability, but contraindicated in septic shock.

Ketamine

Intravenous NMDA receptor antagonist that produces dissociative anesthesia and potent anesthesia without respiratory depression, while increasing heart rate and cardiac output.

Propofol

Widely used intravenous GABA-enhancing anesthetic with rapid onset and rapid recovery, with potential side effects of respiratory depression and bradycardia.

Thiopental

Intravenous GABA-enhancing anesthetic known for decreasing intracranial pressure.

Malignant Hyperthermia

Fatal hypermetabolic condition triggered by volatile flurane anesthetics; treated with dantrolene.

Gout

Crystal-induced inflammatory arthritis caused by the deposition of monosodium urate crystals in joints and tissues.

Monosodium Urate Crystals

Needle-shaped crystals with negative birefringence under compensated polarized light microscopy, characteristic of gout.

Calcium Pyrophosphate Crystals

Rhomboid-shaped crystals with positive birefringence under compensated polarized light microscopy, characteristic of pseudogout (CPPD disease).

Podagra

Sudden, acute joint pain starting at the first metatarsophalangeal (MTP) joint of the big toe, characteristic of a gout attack.

Tophi

Chalky deposits of sodium urate crystals in joints and tissues seen in chronic tophaceous gout.

Synovial Fluid Needle Aspiration

The gold standard diagnostic method for confirming gout by analyzing joint fluid.

Double Contour Sign

Ultrasound finding in gout demonstrating urate crystals coating cartilage surfaces.

Colchicine

Medication given within 24 hours of gout onset ($1.2\,\text{mg}$ followed by $0.6\,\text{mg}$ in 1 hour); common side effects include diarrhea, nausea, and vomiting.

Allopurinol

Urate Lowering Therapy (ULT) starting at $50\text{--}100\,\text{mg}$ daily and titrated over 2--5 weeks to reach serum uric acid levels below $6.0\,\text{mg/dL}$.

Septic Arthritis

Joint infection red-flag condition with fever ($>100.4^\circ\text{F}$), chills, rigor, and toxic appearance; must be ruled out before treating for gout.

Juvenile Idiopathic Arthritis (JIA)

The most common pediatric rheumatology disease, defined as joint inflammation lasting longer than 6 weeks in patients under age 16.

Systemic JIA

JIA subtype characterized by fever, rash, lymphadenopathy, hepatosplenomegaly, elevated WBC/ferritin, and excellent response to IL-1 and IL-6 inhibitors.

Oligoarticular JIA

JIA subtype affecting 4 or fewer joints, most common in young females (peak age 2–3), frequently positive for low-titer ANA, and highly responsive to methotrexate and TNF inhibitors.

Polyarticular JIA

JIA subtype affecting 5 or more joints in a symmetrical distribution, with peaks at ages 2–5 and 10–14.

Osteoarthritis (OA)

Mechanical joint disorder resulting from breakdown of cartilage and changes to underlying bone due to cumulative joint stress, without systemic symptoms.

Heberden's Nodules

Bony enlargements located at the distal interphalangeal (DIP) joints in osteoarthritis.

Bouchard's Nodules

Bony enlargements located at the proximal interphalangeal (PIP) joints in osteoarthritis.

Crepitus

Crunching sound or feeling during joint movement caused by irregular cartilage surfaces in osteoarthritis.

Duloxetine (Cymbalta)

Pharmacologic treatment for knee osteoarthritis prescribed at $30\,\text{mg/day}$ for 7 days then increased to $60\,\text{mg/day}$.