Hip fractures

Question 1

osteroarthritis

Answer 1

non inflammatory narrowing/ wearing away of joint cartilage
typically idiopathic

Question 2

how is OA different from RA

Answer 2

non-inflammatory
stiffness will go away with use
assymetrical
does not cause fatigue

Question 3

S/S of OA

Answer 3

Joint pain, diasability and loss of function
crepitation/ grating
joint deformity, bowlegged, knock knees

Question 4

heberdens and boucahrds nodes

Answer 4

in hand joints, red, swollen, tender

Question 5

varus defomity

Answer 5

bowlegged- medial knee

Question 6

valgus deformity

Answer 6

knock knee, lateral knee

Question 7

assessing for OA

Answer 7

X-ray/CT for cushion seperation
NO labs, synovial fluid prescence

Question 8

OA treatment

Answer 8

NO cure, pain treatment, to increase mobility
NSAIDs but with risk in elderly population
topicals, steroids esp for inflammation
resurfacing
arthroplasty
Ice, weight loss, physical therapy

Question 9

why are hip problems a big problem with eldery

Answer 9

have high change of breaking: falling w/ osteoporosis, neoplasm, steroid use, visual impairment
with surgeyr, may not have strength to recover, or do PT

Question 10

Intracapsular fracture

Answer 10

inside the joint

Question 11

Extracapsular fracture

Answer 11

outside joint

Question 12

intertrochanteric

Answer 12

usually mild trauma, falls

Question 13

subtrochantric

Answer 13

takes greater trauma, like accident

Question 14

Displacement

Answer 14

bones unaligned with a fracture

Question 15

stage of bone healing

Answer 15

fracture hematoma (1-3days), granulation tissure (3-14 days)
callus formation (2 weeks)
ossification (3 weeks- 6mo)
consolidation (1 yr)
remodeling

Question 16

manifestation

Answer 16

now weight bearing
external rotation, shortened leg on affected side
hip defomirty with displacement
groin/ hip pain
spasm
ecchymosis

Question 17

diagnosing hip fracture

Answer 17

x-ray, CT, bone scan, MRI, fluoroscopy, myelogram

Question 18

closed reduction

Answer 18

no cutting or opening of skin

Question 19

open reduction

Answer 19

surgically putting bone back into place

Question 20

compartment syndrome

Answer 20

fluid and edema causing lack of blood flow
treated with fasciotomy to open space for fluid

Question 21

6 ps of cast care

Answer 21

pain
pallor
paresthesia (pins/needles)
paralysis
pulselessness
poikilothermia (cold)

Question 22

Fat embolus

Answer 22

from a long bone fracture
fatty acids from bone marrow can travel in bloodstream to lung
similar to PE

Question 23

DVT with fracture

Answer 23

from blood clots and immobility
VTE prophylaxis

Question 24

infection with casts

Answer 24

hotspots- can be sign of infection
foul smelling soon after casting

Question 25

hip casts

Answer 25

mosty in peds pts

Question 26

superior mesenteric artery syndrome

Answer 26

compression of small intestine due to hip cast around abdomen, causes lack of blood flow: bloating, distension, can lead to necrosis

Question 27

Traction

Answer 27

to align fracture and decrease muscle spasm bucks: boot attached to weight, skeletal: pins in fracture

Question 28

smoking effect on fractures

Answer 28

heavily increase healing time, with low blood flow to the bones

Question 29

why are H/H labs important to draw post surgery

Answer 29

hemoglobin, hematocrit, can mark signs of bleeding

Question 30

post op fracture care with hip pinning

Answer 30

non weight bearing initially, work with P/OT for early ADLs Dry dressing on incision VTE prophylaxis with heparin/ lovenox bridged/ sent home with warfarin/coumadin assistive devices prevent constipation/urinary retention fall precautions

Question 31

hip arthroplasty

Answer 31

fully weight bearing post op Hib abduction pillow preventing dislocation. No crossing of legs, dont let knees go past 90 degrees

Question 32

pradaxa

Answer 32

new gen anticoag thrombin inhibitor antidote praxbind

Question 33

xarelto

Answer 33

factor Xa inhibitor antidose andexxa IV bolus/drip

Question 34

Eliquis

Answer 34

inhibits factor Xa antidote andexxa

Question 35

Warfarin/ coumadin

Answer 35

inhibits synthesis of vitamin K Oral use Monitor INR values- 2-3 anitdote: K last longer