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Flashcards in Bone disease Deck (87)
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This porous bone disease is a chronic, progressive metabolic bone disease characterized by low bone mass and structural deterioration of bone tissue leading to increased bone fragility is defined as:

osteoporosis (silent thief)


The occurrence of bone fxs due to osteoporosis in females and males are:

1-2 in women, 1-8 in males


Why are women commonly affected w/osteoporosis:

low Ca intake, smaller frame, rapid bone reabsorption during menopause, pregnancy/breastfeeding, longevity


Risk factors for osteoporosis are:

Family hx, smoking/drinking, inactive lifestyle, low Ca/D diet, lone term use in corticosteroids


Normally, the rate of bone deposition and reabsorption (both defined as remodeling) are equal to each other. In osteoporosis:

bone reabsorption is greater than deposition


Bone mass is determined:

70% heredity, nutrition, exercise, hormone function


Where do osteoporosis occur:

spine (dowager's hump), hips, and wrists


What are the clinical manifestations of osteoporosis:

Back pain, loss of height, spinal deformities (kyphosis)


When can a x-ray detect osteoporosis:

Goes undetected until 25-40 % of Ca is lost


What are the diagnostic studies for osteoporosis:

X-ray, bone mineral density (BMD) utilizing quantitative UZ on the knee, heel, shin, or using a dual-energy X-ray absorptiometry (DEXA) on the spine, hips, and forearm


Dual-energy x-ray absorptiometry (sound waves) are read as:

T-scores and will read bone density as either: normal, osteopenia, or osteoporosis


How do primary interventions effect osteoporosis:

Primary intervention retains bone health by: diet rich in Ca/D, weight-bearing exercises, no smokin, decreased EtOH intake, 20 min exposure to sun for D, bone density testing


Why should Ca supplements be spread out throughout the day and when should they be taken when taking abx:

Body won't absorb more than 500 mg of Ca at one time, and supplements should be taken after 2-4 hrs after abx tx


What is the daily amount of Ca needed for women:

1000 mg for premenopausal, 1500 mg post menopause


How do secondary interventions effect osteoporosis and includes what type of medications:

Secondary intervention ATTAINS optimal bone health by: HRT-hormone replacement therapy; Calcitonin (decrease reabsorption), Bisphosphonates (reduce reabsorption), Selective estrogen Receptor (SERMs reduces reabsorption), teriparatide (for men w/increased risk of fx, increase action of osteoblasts), Denosumab (for women at increased risk of fx)


What are the types of bisphosphonates and how should they be taken:

Fosamax, Boniva, Reclasts (FBR) should be taken w/full glass of water, 30 min before food/meds, remain upright for 30 min


How do secondary intervention effect osteoporosis and includes what type of procedures or braces:

Secondary intervention ATTAINS optimal bone health by: thoracic-lumber-sacral-orthosis brace; Vetebroplasty (cement is injected for stabilization); kyphoplasty (bladder bag is inserted/inflated and then cement is injected)


How do tertiary interventions effect osteoporosis:

Tertiary interventions MAINTAIN optimal bone health by: incorporating primary/secondary interventions, reporting new pain sites, emphasizing safety to prevent fx: FALLS


A severe infection of the bone, bone marrow, and surrounding soft tissue that's usually caused by S. aureus is defined as:



How can S. aureus cause osteomyelitis by indirect entry:

indirect entry: affects boys 12 or younger as a result from blunt trauma, adults w/vascular insufficiency (DM) or GU and respiratory infections


How can S. aureus cause osteomyelitis by direct entry:

open wound allowing entrance for microorganisms


Osteomyelitis infections occur by:

increased pressure (d/t # of organisms), ischemia/vascular compromise (caused by pressure), cortical devascularization (infection moving in deeper to bone), and sequestrum (bone death and medium bed for S.aureus)


Osteomyelitis that's less than 1 mo and includes local and systemic manifestations is called:

Acute osteomyelitis


Systemic manifestations of osteomyelitis include:

Fever, night sweats, chills, restlessness, nausea


Local manifestations of osteomyelitis includes:

Bone pain, swelling, tenderness, warmth, decreased movement, drainage during late stages


Osteomyelitis that is longer than a 1 mo and has more local manifestation than systemic is called:

chronic osteomyelitis d/t inadequate tx of acute osteomyelitis


What are the dx studies for osteomyelitis:

Bone/soft tissue biopsy, blood/wound cultures, increased WBCs and ESRs (erythrocyte sedimentation rate), radiologic signs appear after 10 days via bone scans/MRI/CT


What are the types of osteomyelitis txs:

IV/oral abx, surgical interventions (amputation, abx beads, debridement, grafting), wound vac, splinting of extremity


The primary interventions for osteomyelitis are:

control infection, teach local and systemic manifestation of infection, involve family in care, have pt report manifestations


Secondary interventions for osteomyelitis are:

immobilization, avoid manipulation, pain relief, dressing types, maintain proper alignment, avoid heat/activity to area, teach abx therapy, provide mental support