musculoskeletal part 3 (2)

Question 1

what is osteomyelitis

Answer 1

infection of the long bones (lower extremity)

Question 2

is osteomyelitis acute or chronic

Answer 2

could be either

Question 3

what ages is osteomyelitis seen in?

Answer 3

1-12 y.o.

Question 4

what gender is osteomyelitis usually seen in?

Answer 4

boys more than girls (more trauma)

Question 5

causes of osteomyelitis?

Answer 5

trauma/surgery
infections (bacterial, respiratory, UTI)

Question 6

can osteomyelitis spread?

Answer 6

yes, if not caught early enough

Question 7

case study
-9 y.o. with hx of football injury, pain in upper shin, swelling, limited mobility, fever

what is diagnosis?

Answer 7

osteomyelitis

Question 8

how is a sports injury ruled out when considering osteomyelitis

Answer 8

labs, xray, MRI, bone scan

Question 9

describe treatment of osteomyelitis

Answer 9

antibiotics first, then prep for PICC if unsuccessful after a week or so

Question 10

how long will a patient have to be on IV antibiotics for osteomyelitis

Answer 10

3-6 weeks, oral if improvement

Question 11

complications from osteeomyelitis

Answer 11

disruption of growth plate, joint damage, recurrent infection

Question 12

what is the term for brittle bone syndrome

Answer 12

osteogenesis imperfecta

Question 13

what is a connective tissue disorder that primarily affects the bones, bones more likely to fracture

Answer 13

osteogenesis imperfecta

Question 14

pathophys behind osteogenesis imperfecta

Answer 14

biochemical defect in collagen production

Question 15

is osteogenesis imperfecta genetically transmitted?

Answer 15

yes

Question 16

how would you change a diaper in a baby with osteogenesis imperfecta

Answer 16

be extra careful, slow and support body

Question 17

which of the following are clinical manifestations of osteogenesis imperfecta?
1. blue sclera
2. multiple/frequent fractures
3. increased flexibility
4. large anterior fontanel
5. short stature

Answer 17

all

Question 18

what are the 2 drugs used for osteogenesis imperfecta

Answer 18

pamidronate!!!
zolidronic acid

Question 19

what is the action of pamidronate?

Answer 19

osteogenesis imperfecta
bisphosphonates slow normal bone breakdown, allow mass to increase

Question 20

action of zolidronic acid?

Answer 20

osteogenesis imperfecta
decreases fractures and pain

Question 21

diet of osteogenesis imperfecta patients

Answer 21

high vitamins D & C, high calcium

Question 22

what should be screened in a osteogenesis imperfecta case

Answer 22

potential abuse

Question 23

what should be avoided in a diet with osteogenesis imperfecta

Answer 23

too many calories to stay ligher (easier on bones) (may resemble abuse)

Question 24

which 2 things make up muscular dystrophy?

Answer 24

muscle fiber degeneration and muscle wasting

Question 25

what is the age of onset of muscular dystrophy

Answer 25

birth or gradual

Question 26

what is the most common type of muscular dystrophy, only seen in males

Answer 26

duchenne

Question 27

which of the following are symptoms of duchenne muscular dystrophy? 1. muscle weakness of lower extremities 2. small, underdeveloped calf muscles 3. occurs in early childhood 4. child trips or toe walks 5. disease progresses up body

Answer 27

1,3,4,5

Question 28

are the upper or lower extremities affected by duchenne muscular dystrophy?

Answer 28

lower

Question 29

what do calves of someone with duchenne muscular dystrophy look like?

Answer 29

enlarged (connective tissue)

Question 30

what are other conditions that can occur with duchenne muscular dystrophy?

Answer 30

scoliosis, cardiomyopathy, resp distress

Question 31

what is the common cause of death for those with duchenne muscular dystrophy?

Answer 31

resp infection or cardiac failure

Question 32

which of the following tests are used to confirm a diagnosis of duchenne muscular dystrophy? 1. serum enzyme assay 2. muscle biopsy 3. electromyography 4. CBC

Answer 32

1,2,3

Question 33

treatment of duchenne muscular dystrophy?

Answer 33

steroids ti preserve function, no others researching gene therapy

Question 34

what is the most common way a fracture is reduced?

Answer 34

closed reduction (cast)

Question 35

what is a condition in the soft tissue of an extremity with increased pressure in a limited space (cast)

Answer 35

comaprtment syndrome

Question 36

how long after tissue ischemia does compartment syndrome start?

Answer 36

30 minutes after tissue ischemia

Question 37

what is treamtment of campartment syndrome

Answer 37

removal of cast immediately

Question 38

what is a cast cutter like

Answer 38

loud, tickles, can cut to the skin, produces heat

Question 39

what is the purpose of traction

Answer 39

immobilization

Question 40

which of the following are included in nursing care of fractures? 1. circ/neuro assessment 2. pain assessment 3. maintain alignment 4. pin care 5. decreased fiber

Answer 40

1,2,3,4