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Clinical Medicine II > Exam III Study Guide > Flashcards

Exam III Study Guide Flashcards

1
Q

First-degree, grade I AC joint sprain

A

minimal loss of function

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2
Q

Second-degree, grade II AC sprain

A

moderate pain, some dysfunction

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3
Q

Third-degree, grade III AC w/ coracoclavicular ligament injury

A

may have significant dysfunction

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4
Q

AC Joint Sprain Grade I and II rehabilitation

A

Sling 1-2 weeks

Followed by ROM

Once pain-free, add isometric exercises (clavicular and scapular muscles)

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5
Q

AC Joint Sprain Grade III rehabilitation

A

Acute first 2-4 weeks:
-PT to decrease pain and swelling
-Reinforce immobilizer use

Return to function based on pain level and tolerance for activity
-ROM
-Strengthening

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6
Q

Clavicle Fracture rehabilitation

A

Most are treated non-surgically with sling use x 3-4 weeks

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7
Q

Clavicle Fracture ORIF indications

A

-Open fractures
-Displaced fractures with impending –skin compromise
-Neurovascular compromise
-Widely displaced mid-clavicular fractures

Sling following surgery for 6 weeks

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8
Q

Humerus Fracture rehabilitation

A

Minimally or non-displaced fracture management
-Sling

-Early PROM within 14 days (avoid adhesive capsulitis)

-AROM at 4-6 weeks

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9
Q

Fractures of the humeral neck

A

-Most common displaced humeral fracture
-Closed reduction or ORIF

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10
Q

Fractures of greater tuberosity

A

-Occur with shoulder dislocation
-ORIF if displaced

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11
Q

Benign suffix

A

-oma

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12
Q

Malignant suffix

A

-sarcoma

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13
Q

Osteochondroma

A

Cartilage-capped bony spur/outgrowth on bone surface

Usually occurs at end of long-bone growth plates, interfering with joint function
Most commonly form at knee or shoulder

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14
Q

Osteochondroma symptoms

A

-A hard, immobile, detectable mass that is painless
-Loss of joint ROM
-Soreness of the adjacent muscles
-Limb length discrepancies
-Pressure or irritation with exercise
-Possibility for changes in blood flow

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15
Q

Osteoid Osteoma

A

Benign skeletal neoplasm consisting of a nidus of osteoid tissue in the cortex

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16
Q

Osteoid Osteoma symptoms

A

-Pain at night
-Pain with activity
-Pain relieved with NSAIDs
-Can affect bone growth in individuals with open growth plates

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17
Q

Osteoblastoma

A

Benign, but larger than osteoid osteoma and likely to grow, usually in the vertebral column (unlike osteoid osteoma) or long bones along diaphysis

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18
Q

Osteoblastoma symptoms

A

Pain for several months
-Not as severe as osteoid osteoma
-Less likely to be relieved with NSAIDs
-Poorly localized

-Possible scoliosis
-Nerve root impingement

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19
Q

Endochondroma

A

Cartilage cyst found in bone marrow, often found incidentally

Usually found in metacarpals/metatarsals but also found in humerus and femur

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20
Q

Endochondroma symptoms

A

-Mostly asymptomatic
-Possible fractures of the affected bone
-Enlargement of affected finger

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21
Q

Chondroblastoma

A

Slow growing tumor usually at epiphyseal plate, usually femur/tibia/humerus

Benign, but locally aggressive and usually must be excised

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22
Q

Chondroblastoma symptoms

A

-Localized pain
-Limited joint motion
-Swelling at end of long bones
-Tenderness at end of long bones

23
Q

Hemangioma

A

Growth of the endothelial cells that line blood vessels

May involve skin, showing up in neonates
-Self-resolving or permanent

Some involve vertebral bodies
-10% of pop
-Females > males between 40 and 60 years

24
Q

Giant Cell Tumor of Bone

A

Wide age distribution

Historically considered benign
Today, low-grade malignant

Center of the epiphysis (i.e. right next to joints) of long bones

Develop slowly

25
Q

Giant Cell Tumor of Bone symptoms

A

-Mild pain that progresses with tumor growth
-Limited range of motion (proximity to the joint space)
-Swelling (large growth)
-Pathologic fracture

26
Q

Malignant Neoplasms

A

Capacity to expand and travel

Spread by
-Local invasion
-Blood

27
Q

Sarcomas

A

Develop in connective and supportive tissue

28
Q

Osteoblastic pathogenesis of bone tumors

A

-Neoplastic cells produce osteoid
-Known as tumor bone or neoplastic bone

29
Q

Osteolytic pathogenesis of bone tumors

A

Neoplastic cells incite local osteoclastic resorption of bone

30
Q

Chordoma

A

Develop from notochord, Slow-growing, locally aggressive, poor long-term prognosis

31
Q

Osteosarcoma

A

Most common primary malignant bone tumor

Develops in the metaphysis
-Distal end of the femur
-Proximal end of the tibia, fibula
-Proximal end of humerus

Mainly osteoblastic
Extremely malignant
Radiation resistant

32
Q

Chondrosarcoma

A

Relatively slow growing tumor of cartilage, pelvic and shoulder girdles, Men in their 40s to 60s (esp. primary)

33
Q

Ewing’s Sarcoma

A

Non-osteogenic primary tumor, 2nd most common in children (10-15 years of age), Favors long tubular bones, Early metastasis to the lung

34
Q

Multiple myeloma (plasma cell myeloma)

A

Common clusters of signs/symptoms = CRAB
Calcium (elevated)
Renal failure
Anemia
Bone lesions

35
Q

Multiple myeloma common complications

A

Headache
Vision Changes
Radicular pain
Neuropathy
Loss of bowel and bladder control
Paraplegia
hypercalcemia

36
Q

Spinal Metastasis

A

From lung, breast, prostate, kidney

To thoracic, lumbosacral and cervical spine

37
Q

Spinal Metastasis presenting symptoms

A

Weakness, sensory loss, bowel and bladder sphincter disturbance

38
Q

1st Trimester changes

A

first 12 weeks after the first day of the last menstrual period
Breast enlargement
Avg. wt gain 5 lbs
May start to see increase lordosis at 10- 12 weeks

39
Q

Second Trimester changes

A

Week 13 to week 27, Uterus will expand to 4x in size from week 12 to 27, rectus abdominis increasing in length and diastasis recti may be forming

40
Q

Third Trimester changes

A

week 27-40 +, increased fatigue, heartburn, upper respiratory breathing, swelling , hemorrhoids

41
Q

Pelvic girdle syndrome

A

daily pain in all 3 joints with positive pain provocation tests

42
Q

Synphysiolysis

A

daily pain in synthesis pubis only- positive pain provocation

43
Q

One- sided SI syndrome

A

Daily pain one SI joint with positive provocation tests

44
Q

Double sided SI syndrome

A

Daily pain B SI joint with positive provocation tests

45
Q

Miscellaneous pelvic pain syndrome

A

daily pain in one or more pelvic joints with inconsistent objective findings

46
Q

Pelvic joint pain treatment contraindications

A

-Intravaginal treatment
-Intrarectal only with specific OB clearance
-Assymetrical LE movements
-E-stim or Ultrasound for pain control
-Watch for DR

47
Q

Perineal injury first degree laceration

A

vaginal mucosa and perineal skin (no suturing)

48
Q

perineal injury second - degree laceration

A

involves muscles of the perineal body without transgressing the anal sphincter

49
Q

perineal injury Third degree laceration

A

laceration of anal sphincter

50
Q

perineal injury Fourth degree laceration

A

laceration of rectal mucosa

51
Q

causes of osteoporosis

A

Estrogen loss
Corticosteroids
Loss of weight bearing, bed rest
Hyperparathyroidism, hyperthyroidism, chronic renal failure

52
Q

osteoporosis pathogenesis

A

Combination of increased bone reabsorption and decreased bone formation

Imbalance between osteoclastic and osteoblastic function

Greatest effect on trabecular bone (vertebrae) and metaphysis of long bones

53
Q

PICO and PICO(T)

A

Population
Intervention
Comparison
Outcome
(T)ime

PICO is a checklist to help you stay both focused and comprehensive when seeking evidence addressing specific clinical questions

Clinical Medicine II (5 decks)

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