final - bones and body

Question 1

s/s of ankylosing spondylitis

Answer 1

Initially: lower back pain, stiffness
Pain more pronounced when lying down
As calcification develop: spine becomes rigid. Spine movement (flexion, extension and rotation) is impaired
- kyphosis and limited inflation of the lungs

Question 2

Reactive Arthritis

Answer 2

Cant see cant pee cant climb a tree
- caused by previous GI infection or STI

Question 3

Psoriatic Arthritis

Answer 3

Genetic, environmental, immunological factors appear to be involved  T cell mediated immune response
5 subgroups
Less tender than joints of patients with RA

Question 4

most common type of Psoriatic Arthritis

Answer 4

Oligoarticular form—affects four or fewer joints

Question 5

Osteoarthritis

Answer 5

most common arthritis
- primary (age) or secondary (congenital or acquired)
- Affects articulating cartilage
- Damaged joint cartilage tries to heal itself (Creating osteophytes or spurs)

Question 6

Osteoarthritis patho

Answer 6

Chondrocyte injury releases cytokines -> stimulate production/release of proteases that destroy joint structure
Cartilage no longer protects the surface of the bone
Increased friction between articulating bones

Question 7

Gout Syndrome

Answer 7

Increased serum uric acid -> crystals precipitate in the joint -> inflammation
Over production, under excretion
Acute gouty arthritis
Tophi—accumulation of crystalline deposits

Question 8

gout treatments

Answer 8

Colchicine - Prevents macrophages from reaching site thereby decreasing inflammation
Xanthine - blocks conversion or limits amount of uric acid the body makes and decreases amount of uric acid
Probenecid - increase the amount of uric acid excreted by the kidneys
NSAID - lessens pain

Question 9

Complete fracture

Answer 9

broken into two or more pieces

Question 10

Incomplete fracture

Answer 10

partly broken - greenstick fracture (results from bending of short bone in children)

Question 11

Open fracture

Answer 11

fracture resulting when skin in broken - soft tissue damage, nerve damage, blood vessel damage. Higher risk of infection

Question 12

closed fracture

Answer 12

skin is not broken

Question 13

occult fracture

Answer 13

signs and symptoms of fracture but nothing on x-ray

Question 14

Impacted fracture

Answer 14

one end of bone is forced or telescoped into an adjacent bone

Question 15

Pathologic fracture

Answer 15

due to weakness in bone structure  occurs spontaneously or with little stress
(osteoporosis)

Question 16

Stress fracture

Answer 16

results from excessive repeated stress

Question 17

Depressed fracture

Answer 17

broken section of skull is forced inward on the brain

Question 18

Simple

Answer 18

single break in which broken bones maintain alignment

Question 19

Compression

Answer 19

when a number of vertebrae in the spine are broken

Question 20

Comminuted

Answer 20

A fracture in which bone is broken, splintered or crushed into a number of pieces.

Question 21

Colles’ fractures

Answer 21

break in distal radius (extends arm to break fall) backward displacement of wrist

Question 22

Potts fractures

Answer 22

lower fibula due to excessive stress on ankle (stepping down)

Question 23

Smith fracture

Answer 23

inward version of colles’ fracture - is more severe and causes more damage to soft tissue

Question 24

difference in sprain and strain

Answer 24

sTrains: tear in a Tendon
sprains: tear in a ligament

Question 25

Rickets

Answer 25

In children Failure or delay in calcification of cartilaginous growth plate

Question 26

rickets s/s

Answer 26

Soft/weak bones Deformed bones Bowed legs Compression fractures Renal rickets: Osteomalacia in patients with renal disease

Question 27

rickets causes

Answer 27

- Nutritional rickets—inadequate sunlight or intake of vitamin D, calcium, phosphate - Vitamin D–dependent rickets—mutations in the enzyme for active vitamin D or receptor -- Vitamin D–resistant rickets—mutations resulting in decreased serum phosphate

Question 28

Osteoporosis

Answer 28

Metabolic bone disorder  decreased in bone mass/density Bone reabsorption exceeds bone formation - Primary: postmenopausal or idiopathic - Secondary: occurs following primary disorder like Cushing syndrome

Question 29

osteoporosis treatment

Answer 29

Calcium and vitamin D supplements Bisphosphonates (fomamax): inhibits osteoclasts activity Calcitonin and parathyroid hormone Weight baring exercise Hormone replacement therapy

Question 30

Rhabdomyolysis

Answer 30

When muscle is damaged, a protein pigment called myoglobin is released into the bloodstream and filtered out of the body by the kidneys. Myoglobin breaks down into potentially harmful compounds. It may block the structures of the kidney, causing damage such as acute tubular necrosis or kidney failure

Question 31

rhabdo electrolyte imbalances

Answer 31

K leaks out of damaged muscle cells resulting in hyperkalemia, phosphate leaks out causing hyperphosphatemia, also hypocalcemia develops

Question 32

fracture repair

Answer 32

New blood vessels extend into this tissue and is invaded by - Phagocytic cells: remove debris - Fibroblasts: produce new collagen fibers and differentiate into osteoblasts - Condrocytes begin to form cartilage Two ends of bone become splinted together: structure not strong enough to bear weight  preliminary bridge Osteoblasts begin to generate new bone to fill in the gaps and a bony callus is formed  this is new bone not scar tissue Bone is remodeled in response to mechanical stress on the bone

Question 33

Factors affecting bone healing

Answer 33

Amount of local damage Gap side between broken ends: must keep immobile to insure proper healing Secondary problems: infection or foreign material at break site Age, circulatory issues, nutritional status, other disease process (anemia, diabetes)

Question 34

Compartment syndrome

Answer 34

compression of nerves and blood vessels within a muscle compartment due to swelling (fascia). This leads to muscle and nerve damage and problems with blood flow

Question 35

6 Ps of fracture complication and compartment syndrome

Answer 35

Pain, Pallor, Pulselessness (or diminished pulse), Paresthesia, and Paralysis, poikilothermia

Question 36

compartment syndrome cause

Answer 36

usually caused by crush injury or trauma

Question 37

Paget Disease

Answer 37

Progressive bone disease seen in adults over the age of 40. Focal areas of excessive osteoclast mediated bone reabsorption preceding disorganized osteoblast mediated bone repair  overactive osteoclasts and osteoblasts try and keep up Regions of excessive bone turnover. New bone is disorganized. Deformation and fracture are common.

Question 38

paget disease complications

Answer 38

bone expansion and fractures

Question 39

Rheumatoid Arthritis

Answer 39

Autoimmune disorder Synovial inflammation and joint architecture destruction Possible genetic predisposition Rheumatoid factor—antibody against IgG fragments in most patients Pannus—destructive vascular granulation tissue -> destructive to adjacent cartilage and bone

Question 40

Rheumatoid Arthritis treatment

Answer 40

NSAIDs and COX-2 inhibitors Corticosteroids Disease-modifying antirheumatic drugs (DMARDs) Methotrexate, leflunomide (suppress overactive immune system) Biologic agents Infliximab, abatacept, tocilizumab, tofacitinib

Question 41

Rheumatoid Arthritis s/s

Answer 41

joint deformity, splenomegaly, Category Symptoms Joints Symmetrical pain, swelling, stiffness Systemic Fatigue, fever, weight loss Extra-articular Nodules, eye/lung/heart problems, anemia