ch 26 - common musculoskeletal concerns Flashcards
(30 cards)
age related musculoskeletal changes
- thinner vertebral discs
- bone calcium loss
- atrophic cartilage and muscle
- decreased skeletal muscle
- painful joints due to less fluid and movement
what group is at highest risk for developing osteoporosis
postmenopausal white women
major RF osteoporosis
- white and asian
- low body weight
- estrogen deficiency
- inadequate calcium and vit d intake
- lack of weight bearing exercises
- excess alcohol use
- smoking
- eating disorders
how is Dx of osteoporosis made
- following fragility fracture
- DEXA scan
S+S osteoporosis
- loss of height of 3+ cm
- unexplained back pain
assessment tool for ten year probability of fracture with osteoporosis
FRAX tool
med instructions for bisphosphonates
- empty stomach with full glass of water first thing in morning
- remain upright for 30 mins after, don’t eat/drink
- take 2 hours before PPI
recommendations for older adults to prevent/slow down osteoporosis
- calcium and vit d supplements
- weight bearing and resistance exercises
- meds (bisphosphonates, SERMs, RANKL)
most commonly affected joints by osteoarthritis (4)
- knees
- hips
- hands
- spine
inflammatory process affecting joints; thinning of cartilage and deterioration of joints
osteoarthritis (OA)
modifiable RF for OA
- obesity
- joint injury
- knee pain
- job requiring excessive mechanical stress
- muscle weakness
nonmodifiable RF for OA
- female
- age 50-75
- race
- family h/o
S+S OA
- stiffness with inactivity
- morning stiffness
- osteophytes (heberdens and bouchards nodes)
S+S RA
- stiffness more than 20-30 mins after rest
- affects proximal joints
Tx RA
DMARDs
Tx OA
- heat
- exercise
- NSAIDs
S+S gout
- sudden acute pain
- inflammation especially in big toe
Tx gout
NSAIDs
short Tx steroids or colchicine
systemic inflammatory disorder affecting joints; pain, swelling, loss of function, fatigue
rheumatoid arthritis (RA)
RF for RA
- older age
- female
- smoking
- obesity
inflammatory arthritis with uric acid crystal deposits in tissues and fluid; typically affects big toe
gout
RF for gout
- h/o organ transplant
- male
- overweight
- alcohol abuse
- excessive purine consumption
- lead toxicity
- renal insufficiency
- HTN
- hypothyroidism
- meds (diuretics, salicylates, niacin, cyclosporin, levodopa)
what meds increase the risk for gout
- diuretics
- salicylates
- niacin
- cyclosporin
- levodopa
complication of gout
renal failure
