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MSK > METABOLIC DISORDERS/GENETIC INF DISEASES > Flashcards

METABOLIC DISORDERS/GENETIC INF DISEASES Flashcards

last lecture

1
Q

Metabolic disorders occur from abnormal physiological processes of the ____ and ____ system

A

nervous and endocrine system

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2
Q

True or false: the skeleton is a metabolically active organ that finishes remodeling at 25-35 years

A

false: undergoes continuous remodeling throughout life
*resorption and formation

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3
Q

Bone mass reaches peak levels between ages __and ____

A

25-35 years
after this time, rate of resorption begins to exceed rate of formation

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4
Q

metabolic bone diseases are characterized by loss of bone ____and ___

A

density and strength

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5
Q

What is the most serious, potentially life threatening, costly complication of metabolic bone disease

A

fracture

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6
Q

kyphosis due to metabolic bone disease could affect what

A

cardiopulmonary function

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7
Q

what is osteomalacia

A

softening of bones

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8
Q

what is osteopenia

A

low bone mass

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9
Q

osteopetrosis

A

increased bone density

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10
Q

osteoporosis

A

systemic disease decreases bone density

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11
Q

Secondary osteoporosis is due to

A

(Metabolic) Diseases, meds (increase bone reabsorption), other conditions

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12
Q

Osteoporosis is defined as what?

A

Chronic, progressive disease with low bone mass, impaired bone quality, decreased bone strength, enhanced risk of fractures

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13
Q

Primary osteoporosis is due to what?

A

Age related physiological changes!
-long term calcium deficiency
-declining gonadal/adrenal function
-progressive estrogen deficiency
-sedentary lifestyle

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14
Q

Is primary or secondary osteoporosis more common?

A

Primary osteoporosis

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15
Q

Risk factors for osteoporosis

A

Hormonal status
Genetics
Sedentary
Tobacco, alcohol
Meds
Depression (sedentary?)
Diet/nutrition

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16
Q

Bone strength is based on what two factors?

A

Bone density
Bone quality

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17
Q

Without weight bearing/mechanical stimuli, you pee out more ____ and bone density _____

A

Calcium (calcium excretion increases)
Bone density decreases

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18
Q

What are the most common presenting features of osteoporosis?

A

Loss of height
Postural changes
Back pain
Fractures

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19
Q

Where is muscular pain/trigger points in people with osteoporosis?

A

Lower back para spinals
Rhomboid muscles

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20
Q

What is an unrecognized early sign of osteoporosis?

A

Stress fractures
VERTEBRAL COMPRESSION FRACTURES ARE MOST COMMON OSTEOPOROSIS RELATED SPINAL FRACTURES

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21
Q

What are the most common spinal fractures in osteoporosis?

A

Vertebral compression fractures

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22
Q

MEDICAL MANAGEMENT SLIDE: STUDY

A
23
Q

Osteomalacia is what?

A

Soft bone (lack of mineralization without loss of bone matrix)
Due to lack of calcium, vitamin D, phosphate

*known as adult rickets

24
Q

What is paget disease?

A

Increased bone resorption (by osteoclasts)
Excessive, unorganized new bone formation (by osteoblasts)

Normal bone marrow replaced by vascular and fibrous tissue

25
Q

What is the second most common metabolic bone disease?

A

Osteitis deformans/pagets disease
(Big bones that are weak)

26
Q

What is developmental dysplasia of the hip?

A

A genetic/developmental disorder
Affects infants/kids
*developmental hip disorder happening DYNAMICALLY in utero and 1st year of life

27
Q

Developmental dysplasia of the hip can be

A

Unilateral
Bilateral
Occur in 3 forms of varying severity

28
Q
  1. Unstable hip dysplasia is what?
A

Hip positioned normally, can be dislocated with manipulation

29
Q

Subluxation or incomplete dislocation DDH is what?

A

Femoral head is in contact with acetabulum, but head of femur is partially displaced/uncovered

30
Q

complete dislocation in DDH is what?

A

Femoral head is totally outside acetabulum

31
Q

What does DDH look like in newborns-1 year old

A

Ortolani/Barlow signs
Positive Galeazzie sign in asymmetric cases

Physical asymmetry in ROM (as limitation of hip abduction)
Asymmetry in butt fold (higher on affected side)
Extra skin folds
Leg length discrepancy

32
Q

In ambulating kids, what does DDH look like?

A

Bilateral dysplasia-compensated trendelenburg
(Lean to weight bearing side, compensate for weak glute med)

33
Q

Osteogenesis imperfecta is what?

A

Brittle bone disease
Generalized connective tissue disorder: skeletal fragility
Growth deficiency

(Growth retardation, long bone and spinal deformities)

34
Q

Osteogenesis imperfecta may be evident at birth in severe forms because

A

fractures/deformities in utero (long bone and spinal deformities)

35
Q

when do less severe forms of OI become evident?

A

when child begins to walk and fractures happen

36
Q

what is common in children with osteogenesis imperfecta?

A

short stature (abnorm epiphysial growth plates, deformity after fx, osteoporosis, vertebral collapse)

37
Q

what are other clinical features of OI?

A

LE more than UE
bruise easily
lax ligmanets
thin skin
hypermobility
hearing impairments
scoliosis
deformed teeth and pectus
cardiovascular complications

38
Q

What is osteomyelitis caused by?

A

inflammation of bone by infectious organism (bacteria, also fungi, parasites, viruses)

39
Q

what areas are most affected with osteomyelitis?

A

arms, legs, spine, pelvis

40
Q

acute osteomyelitis is usually seen in

A

children, older adults, IV drug abusers
(new infection, rapid destructive pyogenic infection through open wound or GI…leads to speticemia/septic infectious joint)

41
Q

subacute/chronic osteomyelitis is usually seen in

A

adults secondary to open injury to bone/soft tissue around it

42
Q

chronic osteomyelitis is result from

A

persistent bone infection or acute disease undiagnosed

43
Q

what is the primary cause of prosthetic failure?

A

Implant infection (acutely in 1st month post op or months/years after)

44
Q

nearly 80% of prosthetic infections are due to what bacteria?

A

staphylococcus

45
Q

______ infections occur around the time of surgery and are probably caused by contaminated instruments at the surgical site

A

perioperative infections

46
Q

hematogenous infections are due to

A

primary infection elsewhere in body

47
Q

continguous infections occur secondary to

A

nearby infections

48
Q

Other types of prostheses or implants susceptible to infection include

A

internal fixation of the spine, breast implants, penile implants, dental implants, cardiac implants, other orthopedic devices and hardware, shunts, and even contact lenses.

49
Q

what may be the only symptom of prosthetic/implant infection?

A

persistent joint pain
acute symptoms: could be fever, joint pain, warmth, redness

50
Q

what is spondylodiscitis?

A

infection affecting vertebral spine

51
Q

what is the most common site for spinal infection?

A

intervertebral disk

52
Q

classic signs in children of spondylodiscitis

A

fever and spinal pain
*young children: back pain, refusal to walk, pain with hip extension
*abdominal pain and weight loss, maybe can’t flex lower back

53
Q

in adults, what would spondylodiscitis look like?

A

spinal pain, radiating into lower extremities involving multiple nerve levels
*worse with activity, rest does not relieve pain
*unusual postures and movement patterns in adults

MSK (8 decks)

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