Clin Med- Pathologies Related to Low Back III

Question 1

Nephrolithiasis is also known as what?

Answer 1

aka kidney stones or renal calculi

Question 2

Nephrolithiasis involves the urinary system structures, which are?

Answer 2

kidneys, ureters, bladder, and urethra

Question 3

Nephrolithiasis involves the urinary system functions:

______ waste

Retain essential substances for _______ and _______

Stimulates _______ production

______ _________ regulation

Coverts Vitamin ______ (absorbs Ca2+) to its active form

Answer 3

removes

electrolytes; pH

RBC

Blood pressure

D

Question 4

With nephrolithiasis, the etiology and risk factors include:

Disorders that lead to _________ of Ca2+ and uric acid (ex. hyperthyroidism)

Not primarily drinking _____

Obesity

High animal _____ intake

Answer 4

hyperexcretion

water

protein

Question 5

_________ is the 3rd MOST common UT disorder behind infections and prostate conditions

Answer 5

Nephrolithiasis

Question 6

The pathogenesis of nephrolithiasis- hard mass of salts composed of _____ > ____ _____ and other minerals deposited in urinary system as follows

Answer 6

Ca2+; uric acid

Question 7

With Nephrolithiasis, there will be referred P! into the ___-____ dermatomes

Answer 7

T10; L1

Question 8

The progression of nephrolithiasis…

May begin with ________ unilateral LBP

Could progress to acute/_____ back and (between ribs and iliac crests) and possibly ______ P!

Answer 8

intermittent

severe

abdominal

Question 9

The clinical S&S of nephrolithiasis:

• Radiating P! to the _____ and _______ regions
• ________ dysfunction
• Unrelenting P!
• __& ____ due to P! severity
  _ ________ (urinary or kidney) could occur

Answer 9

groin; perianal

bladder

N & V

infections

Question 10

With nephrolithiasis and the Murphy percussion test:

You would place a ____ and _______ fisted percussion over the 12th costovertebral angle

WNL = __________

P! may also be present with bladder _______/________

Answer 10

firm; closed

painless

palpation; percussion

Question 11

With nephrolithiasis, this is a ______ but possible _____ referral depending on pain severity

Answer 11

urgent; emergent

Question 12

Pertaining to osteoporosis, bone mass peaks between ____-_____ years old

Answer 12

25;35

Question 13

With osteoporsois, the skeleton is _______ active and undergoes continous ______ throughout life with an annual turnover of bone

Answer 13

metabolically; remodeling

Question 14

With osteoporosis, remodeling with the bone is neccesary because it maintains the _________ integrity of the skeleton

Answer 14

structural

Question 15

With osteoporosis, remodeling with the bone is neccesary because it serves as the metabolic demands as a storehouse of _____ and ________

Answer 15

Ca2+ and phosphorus

Question 16

_______ is a persistent, progressive metabolic disease

Answer 16

Osteoporosis

Question 17

Osteoporosis is characterized by:

Low bone ______

Impaired bone _____

Decreased bone _______

Enhanced risk of ________

Answer 17

mass

quality

strength

fractures

Question 18

What is the MOST common types/etiology with osteoporosis?

Answer 18

aging

Question 19

What is the seondary type/etiology with osteoporosis?

Answer 19

consequence of disease or medication

Question 20

With osteoprosis is NOT often a ______ diagnosis; ____% goes undiagnosed

Answer 20

presenting; 70

Question 21

With osteoporosis, it has an ______ number in younger individuals

Answer 21

increasing

Question 22

What is the MOST common METABOLIC BONE disease?

Answer 22

Osteoporosis

Question 23

________ or low bone mass is a precursor to osteoporosis

Answer 23

Osteopenia

Question 24

Osteoporosis is expeced to increase with ______ population

Answer 24

aging

Question 25

___________ is highest in post-menopausal biological women with estrogen deficit and Scandanavian ancestry

Answer 25

Osteoporosis

Question 26

_____ % of biological women and ____% of biological men over 50 yrs. will suffer an osteoporotic fx

Answer 26

33; 20

Question 27

What are some risk factors for osteoporosis? Lower ______ and ______ levels

Answer 27

hormone; estrogen

Question 28

With lower estrogen levels, it limits the release of ______ into the blood and absorption

Answer 28

calcium

Question 29

Lower estrogen (osteoporosis) is associated with ______ and abnormal menses

Answer 29

menopause

Question 30

With osteoporosis, lower ______ in men also limits the release of calcium into the blood

Answer 30

testosterone

Question 31

With osteoporosis risk factors and genetics, this plays a role with _______ hormone for calcium balance and bone stature

Answer 31

parathyroid

Question 32

Social ______ play a role in osteoporosis risk factors, such as > 2 beers per day, > 300 mg caffeine a day

Answer 32

habits

Question 33

Risk factors for osteoporosis: _______ inactivity _______ alters hormone levels ≥ 3 months of __________ use Tobacco Low Vitamin _____

Answer 33

physical depression corticosteroid D

Question 34

People with risk factors for osteoporosis should have a _____ scan if they meet the criteria

Answer 34

DEXA

Question 35

Pathogenesis of osteoporosis- PRIMARILY a _______ disorder as osteoclastic> osteoblastic activity

Answer 35

metabolic

Question 36

Pathogenesis of osteoporosis- SECONARILY an _______ disorder due to other conditions that limit calcium regulation and sex hormones for bone health

Answer 36

endocrine

Question 37

Osteoporosis is the loss of inner _______ bone

Answer 37

cancellous

Question 38

With osteoporosis: wedging, compression, and fx of vertebral body MOST often in lower ______ and upper _______ regions

Answer 38

thoracic; lumbar

Question 39

With osteoporosis, femurs, ribs, and radius are also common areas for ______

Answer 39

fractures

Question 40

With osteoporosis, ___-______ fractures occur MORE often

Answer 40

non-traumatic

Question 41

With osteoporosis, what might you observe with your patient? Forward _______ ______ Loss of _______ Increased thoracic and lumbar _______ _______ posture

Answer 41

head posture height kyphosis Slouched

Question 42

With osteoporosis, a fx can occur with a benign ______ activity such as bending or coughing

Answer 42

flexion

Question 43

Clinical manifestation S&S Osteoporosis Fx S&S Severe back pain potentially between mid ____ and _____ lumbar region with FLX, compression, and valsalva stresses

Answer 43

thoracic; upper

Question 44

With osteoporosis, P! may refer to _____ and abdominal region

Answer 44

flanks

Question 45

With osteoporosis, and ROM there will be pain and limitation primarily with ______ BUT possibly all directions

Answer 45

FLX

Question 46

With osteoporosis and resisted tests, there will be pain and ________ with what direction mainly?

Answer 46

weakness, FLX

Question 47

Osteoporosis stress test findings: P! with ______ and relief with ______ P! with ______ pressures

Answer 47

compression; distx; PA

Question 48

With osteoporosis, neuro is often _____ but possible in more severe cases

Answer 48

-

Question 49

Biomechanical exam- special tests Osteoporosis: ________ test ______ sign- inability to lie supine due to P!

Answer 49

percussion supine

Question 50

__________ clinical manifestations S&S More hx with Roman’s CPR >52 yrs. of age No, LE P! BMI < 22 No regular exercise Biological female Criteria for compression fx

Answer 50

osteoporosis

Question 51

If you suspsect a fx with osteoporosis most likely a ______ referral ______ referral if neuro symptoms or inability to walk

Answer 51

urgent emergent

Question 52

With PT Rx and osteoporosis: MOST osteoporotic fx are stable and able to tolerate ____ due to ________ structure so proceed based on symptoms

Answer 52

Rx; ligamentous

Question 53

With PT Rx and osteoporosis, you should minimize ______ ______ compression

Answer 53

vertebral body

Question 54

What is the MET focus for osteoporosis? _______ integrity- maintenance or improving density _______ and resistance training

Answer 54

Bone Walking

Question 55

What activity could help with osteoprosis the BEST? A. plyometrics B. JM C. balance activities

Answer 55

C.

Question 56

With osteoporosis and MT, be cautious with _____ particurlaly higher grades or > 3 months of _________ use

Answer 56

JM; corticosteroid use

Question 57

With osteoporosis, you may utilize JM to normalize _____ and stresses throughout the spine

Answer 57

motion

Question 58

With osteoporosis, majority will heal after _____ to _____ weeks of Rx with subsequent decline in pain

Answer 58

8; 12

Question 59

With osteoporosis and MD Rx, a good treatment for some patients with acute/subacute back pain is ________ ________

Answer 59

percutaneous vertebroplasty

Question 60

With osteoporosis and MD Rx, percutaneous vertebroplasty with the addition of _______ vs none provided better subjective outcomes starting at 6 months and lasting out to two years following sx

Answer 60

exercises

Question 61

_________ is when the bone softens without the loss of bone mass or brittleness as with osteoporosis

Answer 61

osteomalacia

Question 62

Osteomalacia is a _______ disease

Answer 62

metabolic

Question 63

Etioligic factors with osteomalacia: Insufficient intestinal ______ absorption due to lack of calcium absorption or low vitamin D Increased _______ loss

Answer 63

Ca2+ phosphate

Question 64

With Osteomalacia, increased phosphate loss could be due to... ______ conditions long term _____ use ___________ disorder that alters calcium balance

Answer 64

kidney antacid hyperparathyroidism

Question 65

Risk factors for Osteomalacia: Lack of dietary or sunlight vitamin _____ Malabsorption conditions including age that affect _____ and ______ functions ________ that alter Vit. D, Ca2+ , or phosphate i.e., antacids and anticonvulsants

Answer 65

D digestive; metabolic medications

Question 66

Pathogenesis of osteomalacia: Lack of bone _______, Ca2+, and phosphates that lead to ____ bones with possible fx but more likely bending NO affect on _______

Answer 66

minerals; soft osteocytes

Question 67

With osteomalacia, it primarily effects which bones?

Answer 67

vertebra and femur

Question 68

Clinical manifestations S&S with osteomalacia: ____ _____ pain and _____ and LE pain, aggravated by WB Myalgia/______ proximal muscle ______ and polyneuropathy altered ______ and increased falls

Answer 68

LBP; pelvic arthralgia weakness gait

Question 69

Osteomalacia progressive deformities: Increased thoracic _____ Genu _____- bow legged

Answer 69

kyphosis varum

Question 70

Osteomalacia is an _______ referral unless it worsens neurologically or causes the inability to walk

Answer 70

urgent