Musculoskeletal

Question 1

How do you rank muscle strength?

Answer 1

0 - none, 1 - flicker, 2 - eliminate gravity, 3 - with gravity, 4 - against resistance, 5 - full strength

Question 2

Considerations for MRI imaging

Answer 2

NO metal, very expensive

Question 3

Considerations for CT scan

Answer 3

Contrast dye can be nephrotoxic

Question 4

What does DEXA scan for?

Answer 4

Bone mineral density

Question 5

What is an arthroplasty?

Answer 5

Surgical reconstruction or replacement of joint

Question 6

What does rheumatoid factor tell us?

Answer 6

Assess autoantibodies, assess for connective tissue disease

Question 7

What does ESR tell us?

Answer 7

Non-specific measure for inflammation

Question 8

When is uric acid high?

Answer 8

Gout

Question 9

When is CRP increased?

Answer 9

Inflammation, infection, malignancy

Question 10

First step of fracture healing

Answer 10

Hematoma (first 72 hours)

Question 11

2nd step of fracture healing

Answer 11

Granulation tissue (3-14 days)

Question 12

3rd step of fracture healing

Answer 12

Callus formation (appears on x ray at end of week 2) - network of bone forms

Question 13

4th step of fracture healing

Answer 13

Ossification (3 weeks - 6 months) and cast can be removed

Question 14

5th step of fracture healing

Answer 14

Consolidation - appears repaired on x - ray

Question 15

6th step of fracture healing

Answer 15

Remodeling - union is complete, exercise is beneficial

Question 16

Realignment of bone fragments

Answer 16

Reduction

Question 17

Maintain alignment

Answer 17

Immobilization

Question 18

Use of “hardware” to surgically fix the fracture

Answer 18

Internal fixation

Question 19

Used to stabilize during healing, takes place of casting or traction

Answer 19

External fixation

Question 20

Consideration for external fixation

Answer 20

SIGNIFICANT infection risk

Question 21

Normal intracompartmental readings

Answer 21

0-8 mmHg

Question 22

Compartment syndrome intracompartmental readings

Answer 22

30-40 mmHg

Question 23

6 Ps of compartment syndrome

Answer 23

Pain, pallor, paresthesia, pressure, paralysis, pulselessness

Question 24

Treatment for compartment syndrome

Answer 24

Fasciotomy (HOT DOG)

Question 25

More dangerous - venous thrombosis or fat embolism?

Answer 25

Fat embolism, can travel more easily and cause cardiac arrest

Question 26

Severe bone infection

Answer 26

Osteomyelitis

Question 27

Does osteomyelitis need an open wound to appear?

Answer 27

NO

Question 28

Systemic symptoms of osteomyelitis

Answer 28

Fever, night sweats, chills, malaise, nausea

Question 29

Local symptoms of osteomyelitis

Answer 29

Pain not relieved with medication, worsens with activity, swelling, tenderness, warmth

Question 30

Treatment of osteomyelitis

Answer 30

Long term IV antibiotics, many weeks to months, may require immobilization or debridement

Question 31

Nursing consideration for osteomyelitis

Answer 31

Sterile dressing changes

Question 32

Risks of pelvic fractures

Answer 32

Can cause intra abdominal injury, life-threatening hemorrhage

Question 33

Risks of femur fractures

Answer 33

Common in young adults, considerable blood loss, fat embolus

Question 34

Degenerative bone disease involving degeneration of articular cartilage

Answer 34

Osteoarthritis

Question 35

Before age 50, who is more affected by osteoarthritis?

Answer 35

Men

Question 36

After age 50, who is more affected by osteoarthritis?

Answer 36

Women

Question 37

Inflammation of CT in synovial joints (systemic and chronic)

Answer 37

Rheumatoid arthritis

Question 38

When can rheumatoid arthritis onset?

Answer 38

Any time during the life span

Question 39

Diagnostic studies for RA

Answer 39

ESR, CRP, WBC found in synovial fluid, bone scan

Question 40

Most effective non-pharmacologic treatment for RA

Answer 40

Moist-heat

Question 41

Drug therapy for RA

Answer 41

NSAIDS, prednisone, methotrexate

Question 42

Decrease in bone mass and structural deterioration of bone tissue

Answer 42

Osteoporosis

Question 43

Who should be screened for osteoporosis?

Answer 43

Any women over 65

Question 44

First signs of osteoporosis

Answer 44

Back pain, spontaneous fractures

Question 45

Risk factors for osteoporosis

Answer 45

White/asian, smoking, inactivity, postmenopausal, low Ca diet, low vitamin D, alcohol use, seizure meds and long term use of corticosteroids

Question 46

Gold standard diagnostic test for osteoporosis

Answer 46

Dexascan

Question 47

Z score -1 to - 2.5

Answer 47

Osteopenia

Question 48

Z score < -2.5

Answer 48

Osteporosis