Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Advanced Health Assessment > Musculoskeletal disorders > Flashcards

Musculoskeletal disorders Flashcards

(76 cards)

Start Studying
1
Q

DMD is most common in what population?

A

male 2-5yo

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

How do you diagnose DMD?

A

you’ll see the patient falling, can not walk up stairs, waddling gait

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

pseudo-hypertrophy muscular dystrophy will have a ___ CK lab value

A

High
- leads to hyperkalemia and kidney failure

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

Muscular dystrophy EKG

A

prolongs PR interval
Tall R waves
Large Q waves in the limb leads

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

Muscular dystrophy pulmonary symptoms

A

weak cough, OSA, pulm HTN

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

How does having a weak cough alter anesthesia plan?

A
  • don’t over sedate
  • may was to avoid NMB (you want to use suggamedex)
  • Patient will usually need to stay on the ventilator for a prolonged time
  • will try and do a regional anesthetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Muscular dystrophy patients are at increased risk of _____

A

aspiration due to delayed gastric emptying

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

avoid using _____ in Muscular dystrophy patients

A

Sux (no reversal)
- these patients have an increase risk of malignant hyperthermia (careful with volatiles)

this can also add to the hyperkalemia

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

What is a good medication for sedating a pediatric patient short term?

A

ketamine (disassociation) short term

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

Myasthenia Gravis is a _____

A

chronic autoimmune disorder developed in later adult hood

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

Getting up and walking around can cause exhaustion in a pt with _______

A

Myasthenia Gravis

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

Classifications of MG

A

type 1 involves the eyes and type 4 is a severe disbility

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

Symptoms of MG
Eyes
Secretions
Speaking
Movement
Cardiac

A

Ptosis, diplopia, and dysphagia​

Dysarthria and difficulty handling saliva​

Isolated respiratory failure ​

Arm, leg, or trunk muscle weakness​

Myocarditis​

Autoimmune diseases associated ​

RA, SLE, pernicious anemia, hyperthyroidism ​

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

MG crisis usually happens when a patient is ____

A

traveling

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

MG crisis presents with severe ___

A

muscle weakness
- looks like cholinergic crisis

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

What medications have cholinergic effects?

A

scopolamine
glycopyrolate
zofran
phenergen

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

Tensilon Test

A

Give 1-2 mg of edrophonium and if the muscle weakness gets better it is MG and not cholinergic crisis

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

What can you give to take out the muscle tone in a patient without using a NMB?

A

Robaxin, Spinal anesthesia

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

Treatment of MG

A

thymectomy
- this is a big surgery and can help with remission and wont need biologic agents. but this takes a while until you show improvement

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

What medications do MG patients usually take

A

corticosteroids (give the stress dose)
immunosuppressant
immunoglobuliln
plasmapheresis

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

_____ is a great alternative to sux in MG

A

Remifentanyl

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

Osteoarthritis is largely in what three joints?

A

knees, hips, shoulders

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

What causes Osteoarthritis ?

A

repetitive mechanical stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Osteoarthritis vs rheumatoid arthritis symptoms

A

Osteoarthritis will have overuse of the joints while RA doesnt require that
- you will he heberden nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Osteoarthritis treatment
exercise and PT pain relief such as heat, NSAIDS, TENs unit, acupuncture, injection of stem cells, put dextrose in the joint, inject platelet rich plasma
26
Osteoarthritis may cause ____ ____ ___ ____ during intubation
limited range of motion
27
Rheumatoid arthritis tends to mainly affect what joints?
interphalangeal and metacarpophalangeal joints (hands and feet)
28
What medications are RA usually on?
immunosuppressant's - viruses can be devastating to these patients
29
RA is more common in ____ than _____
females than males
30
is RA usually a single joint or multiple joints?
Could be both
31
RA patients feel worse in the _____
morning
32
Osteoarthritis patients feel worse ____
in the evening
33
_____ in RA can cause pain on opening their mouth
TMJ - heat or PT can help with this
34
RA is rarely seen in what place in the spine?
T and L usually in the cervical spine
35
Atlantoaxial subluxation is common in what patients?
Down syndrome or RA
36
cricoarytenoid arthritis symptoms
Acute – hoarseness, dyspnea, and stridor w/ tenderness over the larynx; swelling and redness of arytenoids​ Chronic – asymptomatic or variable degrees of hoarseness, dyspnea, and upper airway obstruction ​ Very high risk for vocal cord paralysis​
37
cricoarytenoid arthritis may cause what after intubation?
swelling and the patient may need to stay intubated
38
RA symptoms CV Pulmonary Hematology
CV: Pericarditis, accelerated coronary atherosclerosis​ Pulmonary: Restrictive lung changes, movement of the chest wall can cause pain​ Hematology: Anemia, neutropenia, elevated platelets​ Keratoconjunctivitis sicca and xerostomia​
39
RA medications for treatment
DMARDS (methotrexate) TNF inhibitors and IL-1 inhibitors work better than DMARDS but take a long time TNF have severe side effects and will move to IL-1
40
Anesthesia concerns with RA
Airway ​ - Atlantoaxial subluxation​ - TMJ limitation – video laryngescope​ - Cricoarytenoid joints​ Severe rheumatoid lung disease ​ Protect eyes ​ Stress dose​ steroids
41
How would a lupus patient present with avascular necrosis?
pain in the hip, thigh, knee
42
Lupus symptoms CNS CV Pulmonary Renal Liver NM Hematology Skin
Polyarthritis and dermatitis ​ Symmetrical arthritis ​ No spinal involvement​ Avascular necrosis of femoral head or condyle​ Hip pain, difficulty walking – need CT or MRI​ CNS: Cognitive dysfunction, psychological changes​ CV: Pericarditis, coronary atherosclerosis, Raynaud’s​ Pulmonary: Lupus pneumonia, restrictive lung disease, vanishing lung syndrome (diaphragm will move up into the chest) pleural effusions, hypoxic​ Renal: Glomerulonephritis, decreased GFR ​ GI/Liver: ABD pain, pancreatitis, elevated liver enzymes​ NM: Skeletal muscle weakness ​ Hematology: Thromboembolism, thrombocytopenia, hemolytic anemia ​ Skin: Butterfly-shaped malar rash, discoid lesions, alopecia​
43
Vanishing lung syndrome in lupus
diaphragm is moved up into the chest
44
Antimalarial drugs are used for what autoimmune disorder?
lupus Hydroxychloroquine and quinacrine​
45
Recurrent laryngeal nerve palsy presentation
hoarseness, unilateral If bilateral the patient wont be able to breath
46
What is the genetic mutations in malignant hyperthermia?
Ryanodine receptor - RYR1 gene​ Dihydropyridine receptor​
47
What happens with calcium in MH?
uncontrolled elevation of calcium in the sarcoplasmic
48
If the patient has a high RR and the CO2 is still rising worry about _____
MH
49
How to treat MH
1. stop whatever caused is. If it is a volatile agent then take them off the vent entirely and hyperventilate the patient. Then get a new anesthesia machine 2. Give Dantrolene (usually will have to give 10-20 vials) 3. cool them off internally and externally
50
what is the initial dose of dantrolene
2.5mg/kg to 10mg/kg
51
Who can you call during an MH case?
Not ghost busters 1-800-MH-HYPER
52
What is soda lime?
it absorbs the CO2
53
Tensolin test improves what disease
MG
54
What is not a common manifestation of SLE?
asymmetric rash
55
The mortality rate of MH is _____
50%
56
What agents are triggers for MH (2)
Anectine and isoflurane
57
Horners syndrome occurs as a result of what blockade?
Stellate Ganglion is blocked with inter scalene block
58
CREST syndrome stands for what?
Calcinosis, raynauds, esophageal dysfunction, sclerodactyl, telangiectasis This would be limited cutaneous scleroderma
59
Involvement of the skin of the face, trunk, and distal limbs​ is _____ scleroderma
localized, others include Limited cutaneous system sclerosis - Usually a combination of scleroderma features; CREST syndrome​ Diffuse cutaneous system sclerosis - Rapidly progressive disease, with generalized skin involvement and cardiovascular complications with vascular involvement, coronary artery disease, cardiomyopathy, and hypertension​
60
what disease is characterized by excessive deposit of collagen in the extracellular
Scleroderma ​
61
Why do you have to be cautious of Aline placement in pts with scleroderma?
because they could already have radial or ulnar neuropathy and this can make it worsewh
62
what induction drug is recommended for scleroderma
etomidate
63
in scleroderma renal crisis is precipitated by ____
corticosteroids
64
___ will not work for the treatment of GI motility issues in pt with scleroderma
reglan Somatostatin analogues such as octreotide are effective in improving small intestine hypomotility,
65
What drugs are used to treat the raynauds associated with scleroderma?
CCB
66
What are airway considerations with scleroderma patients?
Mandibular motion, small mouth opening, neck ROM, oral bleeding, atlantooccipital sublux
67
Scleroderma pt have an increased risk of _______
bleeding
68
VTE is very common in pt with scleroderm. What can be done to prevent this?
5000 heparin​ Walk them​ Pressure stockings​
69
Which gases do you want to try an avoid with MD?
halogenated!!! Which is literally all of our gases
70
why dont you want to over sedate a patient with MD?
Because they already have a weak cough, you will make the respiratory reflexes worse
71
80% of receptors in the NMJ can be lost in ___
MG
72
In MG skeletal muscles innervated by _____ are especially vulnerable to weakness
Cranial nerves Skeletal muscles innervated by cranial nerves (ocular, pharyngeal, and laryngeal muscles) are especially vulnerable
73
Which muscular disease can have stroke like symptoms?
MG
74
What antibiotics are contraindicated in MG patients and why?
ABX mycins (gentamicin, streptomycin, tobramycin)​ contraindicated in myasthenia gravis.It can cause clinically significant muscle weakness in myasthenia patients resulting in respiratory depression.​
75
fusiform swelling is described in what disease?
RA
76

Advanced Health Assessment (13 decks)

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