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hosa pathophysiology > Musculoskeletal Diseases and Disorders > Flashcards

Musculoskeletal Diseases and Disorders Flashcards

1
Q

What are the etiologies of lordosis?

A

excessive weight gain (obesity, tumor, pregnancy), excessive bone growth, osteoporosis -> spine posture compensates

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2
Q

What are the clinical features of lordosis?

A

S/S:

  • exaggerated inward bend of lumbar spine
  • asymptomatic or lower back pain

DIAGNOSTIC TESTS:

  • visual examination reveals bend
  • radiographic studies reveals extent of lordosis
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3
Q

What’s the treatment and prognosis of lordosis?

A

TREATMENT:
- encourage weight loss, ab exercises, corrective brace

PROGNOSIS:
- responds well to treatment

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4
Q

What are the etiologies of kyphosis?

A

developmental deformities, osteoporosis, ankylosing spondylitis -> excess curvature of thoracic spine

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5
Q

What are the clinical features of kyphosis?

A

S/S:
- exaggerated posterior thoracic curve, mild pain

DIAGNOSTIC TESTS
- deformity seen through visual examination and radiographic studies

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6
Q

What’s the treatment and prognosis of kyphosis?

A

TREATMENT:

  • exercise, corrective brace
  • possible spinal fusion
  • (if osteoporosis) vertebroplasty

PROGNOSIS:
- may respond well to therapy

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7
Q

What are the etiologies of scoliosis?

A

possible genetic factors, osteoporosis, muscle degeneration -> sideways bend of spine

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8
Q

What are the clinical features of scoliosis?

A

S/S:

  • lateral curve of spine
  • back pain, fatigue

DIAGNOSTIC TESTS:
- visual examination and radiographic studies reveal extent of curvature

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9
Q

What’s the treatment and prognosis of scoliosis?

A

TREATMENT:

  • physical exercises with corrective braces
  • possible spinal fusion

PROGNOSIS:
- best with earliest diagnosis and treatment

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10
Q

What are the etiologies of osteoarthritis?

A

age-related degeneration and continuous friction of joints -> inflammation and loss of cartilage

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11
Q

What are the clinical features of osteoarthritis?

A

S/S:

  • joint stiffness and aching, crepitation
  • Herberden nodes (ostephytes at phalangeal distal joints)

DIAGNOSTIC TESTS:
- radiographic studies may reveal severity of degeneration

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12
Q

What’s the treatment and prognosis of osteoarthritis?

A

TREATMENT:

  • physical therapy
  • NSAIDs, corticosteroids, analgesics, muscle relaxants

PROGNOSIS:
- best with earliest diagnosis and treatment

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13
Q

What are the etiologies of Lyme disease

A

Borrelia burgdorferi bacterium transmitted via tick bite -> infection of internal organs?

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14
Q

What are the clinical features of Lyme disease/

A

S/S:

  • characteristic bullseye rash, arthritis and flu-like symptoms
  • neruologic conditions, paralysis, encephalitis, carditis

DIAGNOSTIC TESTS:
- blood tests positive for Lyme antibodies

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15
Q

What’s the treatment and prognosis of Lyme disease?

A

TREATMENT:

  • doxycycline, antipyretics
  • NSAIDs for arthritis

PROGNOSIS:
- best with earliest diagnosis and treatment, later stages may leave residual cardiac or neural damage

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16
Q

What are the etiologies of bursitis?

A

cumulative trauma, infection -> inflammation of bursae of synovial joint

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17
Q

What are the clinical features of bursiitis?

A

S/S:
- tenderness, pain with movement, limited ROM, edema

DIAGNOSTIC TESTS:

  • radiography may reveal severity of bursitis and possible calcificaiton
  • aspiration can rule out septic arthritis
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18
Q

Whats the treatment and prognosis of bursitis?

A

TREATMENT:

  • NSAIDs, corticosteroid injections, exercises
  • surgical excision of any calcifications

PROGNOSIS:
- excellent :DD with treatment

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19
Q

What are the etiologies of osteomyelitis?

A

(usually) staphylococcal aureus infects proximal humerus or tibia through direct wound or systemic infection -> subperiosteal abscess may form and fragment bone

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20
Q

What are the clinical features of osteomyelitis?

A

S/S:

  • fever, malaise, sweating
  • swelling, redness, and pain at site of infection

DIAGNOSTIC TESTS:

  • aspiration may reveal pathogen
  • radiography may reveal extent of infection
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21
Q

What’s the treatment and prognosis of osteomyelitis?

A

TREATMENT:

  • long-term antibiotics
  • possible surgical drainage and/or bone graft

PROGNOSIS:
- curable, but risk of long-term bone deformities

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22
Q

What are the etiologies of gout?

A

inherited uric acid cycle defects, kidney dysfunction, cytotoxic chemotherapy -> buildup of uric acid in joints

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23
Q

What are the clinical features of gout?

A

S/S:
- excruciating pain in synovial joints, slight fever, nausea, renal calculi

DIAGNOSTIC TESTS:
- aspiration reveals uric acid crystals

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24
Q

What’s the treatment and prognosis of gout?

A

TREATMENT:

  • NSAIDs, corticosteroids, colchicine
  • low-purine diet

PROGNOSIS:
- good with treatmment, risk of bone and joint damage without

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25
Q

What are the clinical featurs of Paget’s disease (or osteitis deformans)?

A

S/S:
- susceptibility to fractures, local bone pain that’s prominent at night, possible deafness

DIAGNOSTIC TESTS:

  • blood tests show elevated alkaline phosphatase
  • urinalysis reveals elevated hydroxyproline
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26
Q

What’s the treatment and prognosis of Paget’s disease (or osteitis deformans)?

A

TREATMENT:

  • calcitonin, biphosphinate drugs
  • high-vitamin D, high-calcium, high-protein diet

PROGNOSIS:

  • generally good, especially if treated early
  • slight risk of osteosarcoma
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27
Q

What’s the etiology of Marfan syndrome?

A

autosomal dominant gene on chromosome 15 -> defect of fibrillin protein

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28
Q

What are the clinical features of Marfan syndrome?

A

S/S:
- abnormally long extremities, subluxation of lens, hear and vascular anomalies, hyperextensible joints

DIAGNOSTIC TESTS:

  • family history, presence of signs/symptoms may indicate syndomre
  • echocardiogram may identify aortic abnormalities
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29
Q

What’s the treatment and prognosis of Marfan syndrome?

A

TREATMENT:

  • growth hormone blockers
  • possible aortic bypass graft surgery
  • possible valve replacement

PROGNOSIS:
- heart and vascular defects carry high risk of complications

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30
Q

What are the etiologies of bone cancers?

A
  • (if primary) growth spurts, being male, Pagets disease, or prior radiation/chemotherapy -> osteosarcoma, chondrosarcoma, or Ewing sarcoma
  • (if secondary) Paget’s disease, prior radiation/chemotherapy, other cancers -> metastasis to bone
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31
Q

What are the clinical features of bone cancers?

A

S/S:

  • asymptomatic OR localized pain, swelling, pathologic fractures
  • (if Ewing) fever, fatigue, anemia

DIAGNOSTIC TESTS:

  • radiographic (CT, MRI, PET, radionuclide scanning) studies reveal tumor
  • “sunburst” if osteosarcoma, “onion-skin” if Ewing’s
  • biopsy reveals type and histology
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32
Q

What’s the treatment and prognosis of bone cancers?

A

TREATMENT:

  • surgical resection or amputation
  • chemotherapy and/or radiation therapy

PROGNOSIS:
- poor if high-grade, large tumor size, and metastatic

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33
Q

What are the risk factors of muscle tumors?

A

being older than 50, prior radiation therapy, carcinogen exposure -> leiomyoma or rhabdomyoma (benign) or leiosarcoma or rhabdosarcoma (malignant, less common)

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33
Q

What are the etiologies of muscle tumors?

A

being older than 50, prior radiation therapy, carcinogen exposure -> leiomyoma or rhabdomyoma (benign) or leiosarcoma or rhabdosarcoma (malignant, less common)

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34
Q

What are the clinical features of muscle tumors?

A

S/S:
- asymptomatic OR present lump, erythema, pain

DIAGNOSTIC TESTS:

  • preferably, MRI reveals tumor
  • biopsy reveals histology
  • radiographic studies reveal metastasis
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35
Q

What’s the treatment and prognosis of muscle tumors?

A

TREATMENT:

  • surgical resection
  • radiation and possible chemotherapy therapy (if sarcoma)

PROGNOSIS:
- poor if tumor is deep, large, and metastatic

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36
Q

What are the etiologies of osteoporosis?

A

dietary deficiencies, malabsorption, low estrogen, low testosterone, alcohol abuse, smoking, certain medications -> imbalance of osteogenesis to bone resorption

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37
Q

What are the clinical features of osteoporosis?

A

S/S:

  • asymptomatic until fractures
  • possible loss of height

DIAGNOSTIC TESTS:

  • DEXA reveals porous bones
  • blood serum tests urinalysis indicate excessive bone resorption
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37
Q

What’s the treatment and prognosis of osteoporosis?

A

TREATMENT:

  • calcium supplements, phosphate supplements, and vitamin D supplements
  • androgen replacement therapy

PROGNOSIS:
- varies with etiology, but usually responds well to appropriate treatments

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38
Q

What are the etiologies of osteomalacia (and rickets)?

A

dietary deficiency of vitamin D, malabsorption of vD, inadequate sunlight exposure -> improper mineralization and osteogenesis

39
Q

What are the clinical features of osteomalacia (and rickets)?

A

S/S:

  • fatigue, bone pain, loss of height, bowing of legs
  • (if rickets) impacted growth

DIAGNOSTIC TESTS:
- blood tests reveal low calcium, alkaline phosphatase, and vitamin D levels

40
Q

What’s the treatment and prognosis of osteomalacia?

A

TREATMENT:
- vitamin D, calcium, and calcitonin supplementation

PROGNOSIS
- depends greatly on early diagnosis and treatment

41
Q

What are the etiologies of hallux valgus?

A

genetic factors, flat feet, improperly fitting shoes, rheumatoid arthritis -> enlargement of first metatarsophalangeal (MTP) joint

42
Q

What are the clinical features of hallux valgus?

A

S/S:
- enlargement of first MTP joint, inflammation, pain

DIAGNOSTIC TESTS:
- signs/symptoms may be present, physical examination reveals inward bend

43
Q

What’s the treatment and prognosis of hallux valgus?

A

TREATMENT:

  • orthopedic interventions, NSAIDs. corticosteroids
  • possible bunionectomy

PROGNOSIS:

  • relieved by treatment
  • risk of secondary toe deformities
44
Q

What are the etiologies of hallux rigidus?

A

injury or osteoarthritis of MTP joint -> osteophytes restrict ROM

45
Q

What are the clinical features of hallux rigidus?

A

S/S:
- pain, limiited ROM, swelling

DIAGNOSTIC TESTS:
- physical examincation reveals enlarged and tender 1st MTP joint

46
Q

What’s the treatment and prognosis of hallux rigidus?

A

TREATMENT:

  • orthopedic interventions, antiinflammatory drugs
  • cheilectomy
  • arthrodesis

PROGNOSIS:
- responds well to treatment

47
Q

What are the etiologies of hammer toe?

A

congenital long second metatarsal bone, ill-fitting shoes, rheumatoid arthritis -> hyperextension of MTP joint and flexion of PIP joint

48
Q

What are the clinical features of a hammer toe?

A

S/S:
- pain, inflammation, frequent abrasions, tyloma and helome formation

DIAGNOSTIC TESTS:
- signs/symptoms present and physical examination suggests hammer toe

48
Q

What’s the treatment and prognosis of a hammer toe?

A

TREATMENT:

  • (if early) orthopedic intervention sufficient
  • possible arthroplasty or athrodesis

PROGNOSIS:
- usually responds very well to treatment

49
Q

What are the types of fractures and their usual mechanism of injury?

A
  • Colles: (fracture of distal radius) falling on hand of outstretched arm
  • LeFort: (bilateral horizontal fracture of maxilla) usually from facial impact during MVA
  • Pott: (fracture of distal fibula) usually from rolling ankle during fall
50
Q

What are the clinical features of a fracture?

A

S/S:
- pain, edema, discoloration, loss of function

DIAGNOSTIC TESTS:
- radionuclide bone scan or MRI may help define fracture

50
Q

What’s the treatment and prognosis of a fracture?

A

TREATMENT:

  • (if simple) reduction and immobilization, possible internal fixation
  • (if compound) debridement, reduction, immobilization, and internal fixation

PROGNOSIS:

  • varies with affected bone and extent of injury
  • risk of stunted growth if child
51
Q

What are the etiologies of strains and sprains?

A

acute trauma or cumulative trauma -> overstretching of tendon or muscle (strain) or tear of ligament (sprain)

52
Q

What are the clinical features of strains and sprains?

A

S/S:
- pain, warmth, discoloration, edema, loss of function

DIAGNOSTIC TESTS:

  • physical examination indicated sprain or strain
  • radiographic studies rule out fracture
53
Q

What’s the treatment and prognosis of a strain or sprain

A

TREATMENT:

  • RICE (rest, icepacks, compression, elevation)
  • possible analgesics or antiinflammatory drugs

PROGNOSIS:
- best with rehabilitative program, may heal within 2-4 weeks

54
Q

What are the etiologies of a dislocation?

A

trauma tears joint ligaments, congenital weakness -> displacement of bone from joint

55
Q

What are the clinical features of a dislocation?

A

S/S:
- pain, edema, ecchymosis, loss of function

DIAGNOSTIC TESTS:

  • physical examination indicates dislocation
  • radiographic studies may define dislocation and identify possible fractures
56
Q

What’s the treatment and prognosis of a dislocation?

A

TREATMENT:
- reduction and possible surgical intervention

PROGNOSIS:
- depends on exent of tissue damage, may increase risk of future osteoarthritis

57
Q

What are the etiologies of adhesive capsulitis?

A

bursitis, tendinitis, inflammatory conditions -> secondary scarring of shoulder joint capsule

58
Q

What are the clinical features of adhesive capsulitis?

A

S/S:
- pain and stiffness of shouler

DIAGNOSTIC TESTS:
- signs/symptoms indicate adhesive capsulitis

59
Q

What’s the treatment and prognosis of adhesive capsulitis?

A

TREATMENT:
- ROM exercisies, analgesics, antiinflammatory agents

PROGNOSIS:
- best with early detection and treatment, usually self-limiting

60
Q

What are the clinical features of a severed tendon?

A

S/S:
- severe pain, ecchymosis, edema, loss of function

DIAGNOSTIC TESTS:
- physical examination indicates severed tendon

61
Q

What’s the treatment and prognosis of a severed tendon?

A

TREATMENT:
- tenorrhaphy, physical rehabilitaiton

PROGNOSIS:

  • varies with extent of injury and tendon affected
  • risk of secondary infection
62
Q

What are the etiologies of shin splints?

A

cumulative trauma and overpronation -> excessive stress on tendons, muslces, and ligaments of lower leg

63
Q

What are the clinical features of shin splints?

A

S/S:
- pain, edema, and warmth of inner tibia

DIAGNOSTIC TESTS:
- physical examination indicates shin splints

64
Q

What’s the treatment and prognosis of shin splints?

A

TREATMENT:

  • rest, cold and/or heat application, compression, and elevation
  • orthopedic interventions, physical therapy, possible analgesics and antinflammitary agents

PROGNOSIS:

  • good with proper rest and recovery
  • complication of stress fracture if neglected
65
Q

What are the etiologies of plantar fasciitis (or a calcaneal spur)?

A

cumulative trauma, flat feet, family history -> inflammation of plantar fascia -> development of cancaneal spur

66
Q

What are the clinical features of plantar fasciitis (or a calcaneal spur)?

A

S/S:
- dull-sharp pain, prominent during first waking steps

DIAGNOSTIC TESTS:

  • physical examination indicated plantar fasciitis
  • radiographic studies may confirm calcaneal spur
67
Q

What’s the treatment and prognosis of plantar fasciitis (or a calcaneal spur)?

A

TREATMENT:

  • rest. ice application, analgesics or antiinflammatory drugs
  • orthotics and physical rehabilitation

PROGNOSIS:
- usually responds great to conservative management

68
Q

What are the etiologies of a ganglion?

A

repetitive minor injuries -> cyst forms around joint capsule

69
Q

What are the clinical features of a ganglion?

A

S/S:
- small soft or firm cyst, painless or painful with movement

DIAGNOSTIC TESTS:
- apparent with palpation

70
Q

What’s the treatment and prognosis of a ganglion?

A

TREATMENT:
- possible aspiration or ganglionectomy

PROGNOSIS:
- usually do not require treatment

71
Q

What’s the usual mechanism of injury of a torn meniscus?

A

suddent rotation of leg during knee flexion -> tearing of semilunar knee cartilage (usually medial meniscus) with possible ACL or PCL tear

72
Q

What are the clinical featurs of a torn meniscus?

A

S/S:
- sharp pain, crepitations, limited ROM

DIAGNOSTIC TESTS:
- preferably, MRI confirms and defines meniscus tear

73
Q

What’s the treatment and prognosis of a torn meniscus?

A

TREATMENT:

  • RICE, analgesic or antiinflammatory drugs, physical rehabilitation
  • possible arthroscopic surgery or meniscectomy
74
Q

What are the etiologies of a rotator cuff tear?

A

degenerative changes, cumulative trauma, cortisone injections -> tears in supraspinatus, infraspinatus, subcapularis, or teres minor tendon

75
Q

What are the clinical features of a rotator cuff tear?

A

S/S:
- snapping noise, pain, limited ROM (varies with affected tendons)

DIAGNOSITC TESTS:
- MRI or arthrogram reveals torn rotator cuff

76
Q

What’s the treatment and prognosis of a rotator cuff tear?

A

TREATMENT:

  • RICE, analgesics and antiinflammatory drugs, possible surgical intervention
  • physical rehabilitiation

PROGNOSIS:
- minor tears respond well to conservative treatment, major tears may require surgery

77
Q

What are the etiologies of rheumatoid arthritis?

A

unclear, possible genetic factors, triggered by infection -> autoimmune inflammation of synovial membranes

78
Q

What are the clinical features of rheumatoid arthritis?

A

S/S:
- persistent fever, malaise, joint stiffness, joint pain, erythema, and edema

DIAGNOSTIC TESTS:
- elevated rheumatoid factor found through blood tests

79
Q

What’s the treatment and prognosis of rheumatoid arthritis?

A

TREATMENT:

  • antiinflammatory drugs
  • disease-modifying antirheumatic drugs (DMARDs)

PROGNOSIS:
- severe joint damage may occur without early diagnosis and aggressive treatment

80
Q

What are some suspected etiologies of juvenile rheumatoid arthritis (or JRA)?

A

hereditary factors, being female -> autoimmune activity of joints beginning in early childhood

81
Q

What are the clinical features of juvenile rheumatoid arthritis?

A

S/S:

  • fever, fatigue, malaise, anorexia, systemic rash, possible stunted growth
  • (if pauciarticular) pain, edema, and erythema of <5 joints
  • (if polyarticular) pain, edema, and erythema of >5 joints

DIAGNOSTIC TESTS:
- eleveated rheumatoid factor found through blood tests

82
Q

What’s the treatment and prognosis of juvenile rheumatoid arthritis?

A

TREATMENT:
- antiinflammatory drugs, disease-modifiable antirheumatic drugs (DMARDs)

PROGNOSIS:
- children may grow up to lead normal lives with early diagnosis and aggressive treatment

83
Q

What’s the suspected etiology of ankylosing spondylitis?

A

inheritance of human leukocyte antigen (HLA)-B27, along with other genes -> inflammation and progressive ossification of spine

84
Q

What are the clinical features of ankylosing spondylitis?

A

S/S:
- fever, fatigue, malaise, back pain and stiffness, eventual kyphosis

DIAGNOSTIC TESTS:
- no rheumatoid factor but elevated inflammatory markers found through blood tests

85
Q

What’s the treatment and prognosis of ankylosing spondylitis?

A

TREATMENT:
- exercises, antiinflammatory drugs

PROGNOSIS:
- episodic in nature, complications may include deformities and systemic changes

86
Q

What’s the etiology of Duchenne’s muscular dystrophy (or DMD)?

A

X-linked recessive genes -> defective dystrophin protein -> defective myocyte cytoskeleton

87
Q

What are the clinical features of Duchenne’s muscular dystrophy?

A

S/S:
- (early onset) muscular atrophy, spinal deformities, recurrent sinopulmonary infections, contractures

DIAGNOSTIC TESTS:

  • DMD indicated through EMG and muscle biopsy
  • elevated creatine found through blood tests
88
Q

What’s the treatment and prognosis of Duchenne’s muscular dystrophy (or DMD)?

A

TREATMENT:
- corticosteroids, physical therapy

PROGNOSIS:
- death may occur 10 to 15 years after onset

89
Q

What’s the suspected cause of polymyositis?

A

autoimmune activity -> WBCs target muscle cells

90
Q

What are the clinical features of polymyositis?

A

S/S:
- weakness of muscles near trunk, dermatomyositis

DIAGNOSTIC TESTS:

  • elevated creatine found through blood tests
  • polyomyositis indicated through EMG and muscle biopsy
91
Q

What’s the treatment and prognosis of polymyositis?

A

TREATMENT:
- corticosteroids, immunosuppressive drugs, exercise

PROGNOSIS:
- episodic in nature, but a good outlook is seen with early treatment

92
Q

What are some physiologic features of myasthenia gravis?

A

thymus hyperplasia, autoantibodies against acetylcholine receptors -> faulty neuromuscular juntion

93
Q

What are the clinical features of myasthenia gravis?

A

S/S:
- (exacerbated by stress, sunlight, cold, and infections) muscular weakness restored by rest, eventual paralysis

DIAGNOSTIC TESTS:

  • muscle function improved by Tensilon test
  • acetylcholine antibodies found through blood tests
94
Q

What’s the treatment and prognosis of myasthenia gravis?

A

TREATMENT:

  • pyriodstigmine bromide, corticosteroids, immunosuppressive drugs
  • thymectomy

PROGNOSIS:
- episodic in nature, risk of myasthenic crisis

hosa pathophysiology (13 decks)

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