Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adv. Phys & Health Assessment > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

(73 cards)

Start Studying
1
Q

CREST are characteristics of which disease process?

A

Scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does CREST stand for?

A

C- Calcinosis, calcium deposits in skin
R- Raynaud’s
E- Esophageal dysfunction/acid reflux
S- Sclerodactyly, thickening and tight skin on fingers and hands
T- Telangiectasias, dilation of capillaries looks like red freckles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 main forms of scleroderma?

A

Localized- involvement of the skin of face, trunk, and distal limbs

Limited cutaneous system sclerosis - usually combination of CREST

Diffuse cutaneous system sclerosis- rapidly progressive disease with involvement of multiple organ systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs you may see in patient with undiagnosed pulmonary HTN

A

JVD, enlarged RV on xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drug does not improve intestinal hypomotility in scleroderma?

A

metoclopramide (reglan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Corticosteroid use in scleroderma treatment can lead to what?

A

Renal crisis- treatment ACE-i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs improve intestinal hypomotility in scleroderma?

A

Somatostatin analogues - octreotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are potential airway concerns in scleroderma?

A

poor mandibular motion, small mouth opening, limited neck ROM, oral bleeding/friable tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are potential anesthesia CV concerns with scleroderma

A

difficult IV/arterial line access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are potential pulmonary concerns in patients with scleroderma ?

A

Decreased pulmonary compliance and reserve, avoid increasing PVR (hypoxia, hypercarbia, acidosis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which disease process is 3x more likely to have VTE

A

scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the stress dose for steroids?

A

100mg q6hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of dystrophin?

A

Large protein that plays a major role in stabilization of the muscle membrane and signaling between the cytoskeleton and extracellular matrix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the cause of Duchenne Muscular Dystrophy (DMD)?

A

mutation in the dystrophin gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What age is DMD commonly seen and what are the signs?

A

2-5year old (primarily affects boys)

initial symptoms: waddling gait, frequent falling, difficulty climbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dystrophin is a gene located on which chromosome? dominant or recessive?

A

X, recessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DMD is characterized by

A

muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What lab value would be abnormal in DMD?

A

serum CK likely 20-100x higher than normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What EKG characteristics would been seen in patient with DMD?

A

Short PR interval, sinus tachycardia, V1- tall R waves, limb leads deep Q waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What pulmonary complications are seen in DMD?

A

weakened respiratory muscles and cough, loss of pulmonary reserve, increased secretions (aspiration risk), OSA, pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which medications should be avoided during anesthesia of patient with DMD?

A

neuromuscular blockers, volatile anesthetics, precedex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which medication works well for sedation of children?

A

Ketamine - can be given intranasally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the ideal form of anesthesia choice in patients with DMD

A

regional anesthesia - avoids many risks of GA, provides postop analgesia, and facilitates chest physiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Myasthenia gravis is characterized by

A

exacerbations and remissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Myasthenia gravis is a ________ type of disease that targets what?
autoimmune disease, antibodies target alpha-subunit of the ACh receptor at the NMJ
25
What is type 1 myasthenia gravis classification?
Limited to involvement of the extraocular muscles -if confined to extraocular muscles for 2 years, unlikely disease progression
26
What is type 2a myasthenia gravis classification?
slowly progressive, mild form of skeletal muscle weakness (spares respiratory muscles)
27
Which classification of myasthenia gravis responds well to anticholinesterases and corticosteroids?
Type 2a
28
What is type 2b myasthenia gravis classification?
rapidly progressive, more severe form of skeletal muscle weakness (may involve respiratory muscles) -does not respond as well to drug therapy
29
What is type 3 myasthenia gravis classification?
Acute onset and rapid deterioration of skeletal muscle strength within 6months - high mortality rate
30
What is type 4 classification of myasthenia gravis classification?
Severe form of skeletal muscle weakness - progression from type 1 or 2
31
What are common s/sx of myasthenia gravis?
Ptosis, diplopia and dysphagia
32
The Edrophonium/Tensilon test improves myasthenic crisis or cholinergic crisis?
myasthenic crisis, makes cholinergic crisis worse
33
What are signs of cholinergic crisis
SLUDGE salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis
34
What drugs do MG patients typically develop a tolerance to?
Anticholinesterases -1st line of treatment -Pyridostigmine > neostigmine lasts longer, less s/e max dose 120mg q3hr
35
Surgical treatment for myasthenia gravis
Thymectomy - usually performed stage 2a or 2b
36
What immunotherapies are used for short term treatment of MG crisis?
Plasmapharesis , Immunoglobulin
37
Which drug mimics the effects of succinylcholine?
high dose remifentanil
38
Which joints are typically involved in OA?
Weight bearing/high use joints: knees, hips, shoulders. Can also occur in lower cervical and lumbar spine
39
Heberden nodes are
Associated with OA; are bony growths at the distal interphalangeal joints (fingertip joint)
40
Preoperative evaluation of a patient with OA includes
extent of ROM in affected joints and neck, baseline severity of pain, and pain management use (NSAIDS/opiods)
41
What is recommended treatment for OA?
PT and exercise, joint replacement surgery if limited function pain relief- NSAIDS, heat, TENS, acupuncture PRP, Stem cells, prolotherapy
42
What is recommended to avoid in OA?
corticosteroids
43
RA is an autoimmune disease that affects which joints
proximal interphalangeal and metacarpophalangeal joints
44
OA is ______ in the morning, and _______ throughout the day
better, worse
45
RA is _______ in the morning, and ______ throughout the day
worse, better
46
Unlike OA, RA typically has what at the joints?
Synovial inflammation, swelling, increased fluid
47
RA is more common in men or women?
2-3x higher in women
48
RA typically coincides with:
trauma, surgery, childbirth, or exposure to temperature extremes
49
Symmetrical distribution of several joints is characteristic of which disease?
RA; hands, wrists, knees, feet
50
Which joints are not affected by RA?
thoracic and lumbosacral spine
51
Atlantoaxial subluxation is associated with
RA
52
Subluxation of cervical vertebrae (other than atlantooccipital) can occur and cause
migraines, dizziness, vertigo, tinnitus, neck pain w/o movement
53
Atlantoaxial subluxation is ________
separation of the atlanto-odontoid articulation. >3mm distance between anterior arch of atlas and the odontoid process. Odontoid process protrudes into the foramen magnum and exerts pressure on the spinal cord or impairs vertebral artery blood flow
54
What are s/s of cricoarytenoid arthritis
Acute- hoarseness, pain on swallowing, dyspnea, stridor, swelling and redness seen via direct laryngoscopy Chronic- asymptomatic or variable degrees of hoarseness
55
Treatment options for RA include
NSAIDs, corticosteroids, DMARDs (methotrexate), TNF inhibitors, IL-1 inhibitors, surgery
56
Anesthesia concerns for patients with RA include
- Neck ROM d/t atlantoaxial subloxation - Jaw movement limitations d/t TMJ - severe rheumatoid lung disease - protect eyes - may need stress dose steroids
57
Typical manifestations of Systemic Lupus Erythematosus
- Antinuclear antibodies - Malar (butterfly) rash - Discoid lesions- thick and disc shaped (often face or scalp) - Thrombocytopenia - Serositis - Nephritis
58
Death during course of SLE may be due to _____
coronary atherosclerosis - coronary atherosclerosis development accelerated by treatment with steroids
59
Pulmonary concern in patient with SLE
- Vanishing lung (recurrent atelectasis, diaphramatic weakness or phrenic neuropathy) upper airway obstruction s/t: - Recurrent laryngeal nerve palsy - cricoarytenoid arthritis
60
Common hematologic complications with SLE include
hemolytic anemia, thromboembolism, thrombocytopenia, leukopenia
61
Treatment for SLE includes
- NSAIDs or ASA - Antimalarial - hydroxychloroquine, quinacrine - Corticosteroids - Immunosuppressants - methotrexate, azathioprine
62
Malignant Hyperthermia is linked to which genetic mutation
Ryanodine receptor RYR1 gene Dihydropyridine receptor
63
Triggering agents for MH
- inhaled VAs - succinylcholine
64
What is malignant hyperthermia
Hypermetabolic syndrome d/t sustained high levels of sarcoplasmic Ca2+ that rapidly drives skeletal muscle into a hypermetabolic state. Inabiity of Ca2+ pumps and transporters to reduce the unbound sarcoplasmic Ca2+ below the contractile threshold
65
Non-triggering MH agents
- Barbiturates - Propofol - etomidate - benzos - opioids - droperidol - nitrous oxide - Nondepolarizing NMB - Anticholinesterases - Anticholinergics - Sympathomimetics - Local anesthetics - A2 agonists
66
What are the early signs of MH
* hypercarbia and tachypnea * - sinus tachycardia - masseter muscle spasm (biting tube/high airway pressures) - generalized muscle rigidity - peaked T waves - Metabolic and resp acidosis
67
What are the later signs of MH
- hyperthermia - dark urine s/t rhabdo - Elevated CPK - VT/VF - Acute renal failure - cardiovascular collapse - DIC
68
Treatment for MH includes
- D/c all triggering agents - hyperventilate with 100% O2 @10 L/min - Change breathing circuit and soda lime - Dantrolene or Ryanodex - bicarb (to treat acidosis) - CaCl or calcium gluconate (to treat hyperkalemia) - insulin + dextrose (treat hyperkalemia) - Refrigerated IV solution (to cool patient)
69
Dantrolene vials contain how many mg, how should it be diluted?
20mg + 3mg mannitol; dilute with 60mL sterile water
70
Initial dose of dantrolene
2.5mg/kg (total 10mg/k for the average sized patient)
71
MH registry
1-800-MH-HYPER (644-9737)
72
MH testing for pt and family members includes
muscle biopsy contracture testing measuring contraction force of biopsy tissue when exposed to caffeine or halothane

Adv. Phys & Health Assessment (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions