ORS 3 Midterms Flashcards
(177 cards)
1
Q
primary cause of osteoporosis
A
menopause
2
Q
secondary cause of osteoporosis
A
glucocorticoid use
3
Q
modifiable risk factors of osteoporosis
A
sedentary lifestyle
smoking
drinking
low vit. D intake
low calcium intake
4
Q
non-modifiable risk factors of osteoporosis
A
race (caucasian)
previous family hx
premature menopause
5
Q
treatments for osteoporosis
A
alendronic acid
bisphosphonates
hormonal replacement
6
Q
normal T score
A
within 1.0
7
Q
T score of people with osteopenia
A
between 1-2.5
8
Q
T score of people with osteoporosis
A
> 2.5
9
Q
T score of people with severe or established osteoporosis
A
> 2.5 with fracture
10
Q
medication risk factors for osteoporosis
A
Phenytoin therapy
Omeprazole
Glucocorticoids
Vitamin A
11
Q
indications of increased serum calcium
A
primary hyperparathyroidism or other causes of hypercalcemia
12
Q
indications of decreased serum calcium
A
secondary hyperparathyroidism
malabsorption
13
Q
indications of decreased serum phosphate
A
secondary hyperparathyroidism
malabsorption
14
Q
indications of increased serum alkaline phosphate
A
osteomalacia
15
Q
indications of increased serum creatinine
A
renal osteopathy
16
Q
adverse effects of bisphosphonates
A
mild upper GI symptoms
17
Q
> -2.5 BMD score in men
A
osteoporosis
18
Q
-1.5 to -2.5 BMD score in men
A
reduced bone density
19
Q
there is a defect in bone mineralization
A
osteomalacia
20
Q
minerals that are low in osteomalacia
A
vit. D
calcium
phosphorus
21
Q
S/Sx of osteomalacia
A
periarticular tenderness
easily fatigue
Looser’s zone (thru X-ray - pseudofractures)
22
Q
treatment for osteomalacia
A
Vit. D replacement
calcium supplements
sunlight exposure
23
Q
causes of osteomalacia
A
low vit. D
hypophosphatemia
24
Q
tumor-induced osteomalacia
A
hypophosphatemia
25
prevalence of primary hyperparathyroidism
F>M (3:1)
26
hyperparathyroidism results in
loss of bone mass in sites rich in cortical bone
27
how is primary hyperparathyroidism diagnosed?
increased levels of serum calcium
28
causes of secondary hyperparathyroidism
vit. D deficiency
low dietary Ca+
loop diuretic theray
renal insuficiency
29
treatment for secondary hyperparathyroidism
Ca+ supplements
vit. D replacements
30
brittle bone disease
Osteogenesis Imperfecta
31
what is impaired in OI?
inability to quantitatively or qualitatively form collagen
32
what type of collagen is affected in OI?
type I collagen
33
S/Sx of OI
childhood fractures
deafness in adulthood
blue sclera
34
mild manifestations of OI
easily sweating
easy bruising
generalized laxity
35
basal angle landmarks
nasion with the center of the pituitary fossa
anterior border of the foramen magnum with the center of the pituitary fossa
36
normal basal angle
125-143 degrees
37
platybasia angle
> 143 degrees
38
basilar kyphosis angle
<125 degrees
39
treatment for OI
bisphosphonates
teriparatide
gonadal hormones
40
inheritance of type 1 OI
X-linked
41
characteristics of type 1 OI
mild and most common
bones break from mild to mod trauma
most broken bones occur before puberty
normal collagen structure but less than normal is produced
42
characteristics of type 2 OI
most severe
causes death shortly after birth
improperly formed collagen
43
characteristics of type 3 OI
most severe type for those who survive the neonatal period
presents with severe physical disabilities
44
characteristics of type 4 OI
bones break easily
first bone break occurs before puberty
mild to moderate bone deformity
45
presence of numerous bone breaks at birth
OI congenita
46
presence of bone fractures soon after birth
OI tarda
47
type of OI congenita that is compatible with life
Congenita B
48
type of OI congenita that is incompatible with life
Congenita A
49
type of OI tarda wherein fractures occur before walking
Tarda A
50
type of OI tarda wherein fractures occur after walking
Tarda B
51
cause of blue sclera
thinness and transparency of the collagen fibers of the sclera
52
blue sclera is commonly associated with
OI
iron deficiency anemia
53
cause of hyperthyroidism
iatrogenic - overuse of thyroid supplements
54
proptosis or bulging eyes
exophthalmos
55
causes of exophthalmos
extension of inflammation into the orbit
invasion of the orbit by new growth
foreign matter being forced into the orbit
56
cause of exophthalmos in children
orbital cellulitis
57
cause of exophthalmos in adults
thyroid-associated diseases (graves disease ophthalmopathy)
58
glucocorticoid treatment of inflammatory bowel disease results in
calcium and vit. D malabsorption
59
1st biliary cirrhosis manifests in bone as
osteomalacia
osteoporosis
60
Post-gastrectomy manifests in the bone as
osteoporosis
61
Avascular necrosis
Osteonecrosis
62
osteonecrosis primarily affects
weight-bearing joints
63
S/Sx of osteonecrosis
joint-motion induced pain
64
prevalence of osteonecrosis
M>F
65
A degeneration followed by reossification of non-fused epiphyses
osteochondrosis
66
traumatic causes of osteochondrosis
post-ORIF femoral neck fracture
67
atraumatic causes of osteochondrosis
steroids
SLE
sickle cell dse
pregnancy
hyperlipidemia
68
how is osteonecrosis diagnosed through x-ray?
donut lesion
69
a destructive joint disorder initiated by trauma to a neuropathic extremity
Charcot neuropathic osteoarthropathy
70
most common etiology of charcot neuropathic osteoarthropathy
diabetic neuropathy
71
two types of charcot
neuro-traumatic
neurovascular
72
neuropathy and repeated microtrauma produce joint destruction.
neuro-traumatic theory
73
Increased peripheral blood flow results in osteolysis and demineralization.
neurovascular theory
74
clinical manifestation of CNO
erythematous foot with edema and calor
75
treatment for acute CNO
immobilize the foot and restrict WB
76
Pre-charcot/Prodromal stage
CNO stage 0
77
CM of CNO stage 0
red, hot swollen foot
78
Development/destruction stage
CNO stage 1
79
CM of CNO stage 1
erythema
foot edema
elevated temperature
no pain
bony debris at joints
80
coalescence stage
CNO stage 2
81
CM of CNO stage 2
decreased inflammation
new bone formation
coalescence of large fragments
increased stability
82
consolidation stage 3
CNO stage 3
83
CM of CNO stage 3
resolution of inflammation
changes in foot architecture
84
most common site of CNO
tarsometatarsal joints (40%)
85
least common site of CNO
calcaneus (5%)
86
DM results in
increased bone resorption
87
characterized by a combination of clinical findings of severe disabling arthralgia and arthritis, digital clubbing, and periostitis of tubular bones, with or without synovial effusion.
Hypertrophic Osteoarthropathy
88
primary HOA is caused by
Pachydermoperiostosis
89
secondary HOA is caused by
hypertrophic pulmonary ostearthropathy
90
what causes sickle-shaped RBC?
Hemoglobin S
91
Avascular necrosis of the Lunate
Kienbock's
92
Avascular necrosis of the Navicular
Kohler's
93
Avascular necrosis of the vertebral
Kummel's
94
Hyperkyphosis involving the discs and its anterior wedging of equal or more than 5 degrees in 3 or more adjacent vertebral bodies
Scheurman's
95
Avascular necrosis of the femoral head epiphysis
Legg-Calve-Perthes dse
96
Avascular necrosis of the metatarsal head
Freiberg's
97
Most commonly affected in Freiberg's
2nd MTT
98
Spontaneous osteonecrosis of the knee
SONK or Ahlback dse
99
Avascular necrosis of the humeral head
Hass' dse
100
Avascular necrosis of the talus
Dias dse
101
Avascular necrosis of the medial epicondyle
Adams dse
102
Avascular necrosis of the radial epiphysis
Madelung dse
103
Avascular necrosis of the calcaneus
Sever
104
Avascular necrosis of the distal pole of the patella
Sinding-Larsen-Johansson dse
105
Avascular necrosis of the phalangeal epiphysis
Theeman dse
106
Avascular necrosis of the scaphoid
Preiser dse
107
Avascular necrosis of the vertebral end plates
Scheurmann's dse
108
Idiopathic avascular necrosis of the femoral head in adult
Chandler dse
109
Avascular necrosis of the medial malleolus
Breck dse
110
a destructive joint disorder initiated by trauma to a neuropathic extremity
Charcot neuropathic Osteoarthropathy
111
Clinical findings in a pt with Hypertrophic Osteoarthropathy
Severe disabling arthralgia
Arthritis
Digital clubbing
Periostosis of tubular bones
112
Sickle cell disease is characterized by
Osteonecrosis
Osteomyelitis
Arthritis
113
most common form of joint infection in sickle cell disease.
Osteomyelitis
114
An acute vaso-occlusive complication characterized by pain and edema in both hands and feet, frequently with increased local temperature and erythema.
Dactylitis
115
Another name for Dactylitis
Hand-foot syndrome
116
Most common site of joint bleeding
Knees
Elbows
Ankles
117
What does recurrent joint bleeding cause?
Proliferation and inflammation (Hemophilic Synovitis)
118
Protrusion of one or both eyes anteriorly out of the orbit
Exopthalmos
119
Cause of expothalmus
Increase in orbital contents
120
Sclera composition
Collagen (types I-VIII)
Elastin
Proteoglycans
Glycoproteins
121
Factor I
Fibrinogen
122
Factor II
Prothrombin
123
Factor III
Thromboplastin
124
Factor IV
Calcium
125
Factor V
Labile
126
Factor VII
Stable
127
Factor VIII
Anti-hemolitic factor A
128
Factor IX
Anti-hemolitic factor B/Christmas
129
Factor X
Stuart
130
Factor XI
Factor C
131
Factor XII
Hageman/Factor D
132
Factor XIII
Fallen
133
A glycoprotein crucial to primary hemostasis
Von Willebrand Factor
134
Diseases associated with Von Willebrand Factor
Von Willebrand dse
Thrombotic Thromobocytopenic purpura
Bernard-Soulier syndrome
135
Functions of connective tissue
Connect, support, and help bind other tissues
136
Two primary types of connective tissue are
Connective tissue proper
Specialized connective tissue
137
Sub types of connective tisue proper
Dense
Loose
138
Examples of specialized connective tissue
Adipose
Cartilage
Bone
Blood
Reticular tissues
139
Pathogenesis of Hemochromatosis
Substitution of tyrosine for cysteine resulting in increased intestinal absorption leading to iron overload
140
Joints most commonly affected in Hemochromatosis
MCP
RC jt
Ankles
Hips
Elbows
Knees
Shoulders
141
Common s/sx in hemochromatosis
Fatigue
Arthralgias
142
Bronze diabetes
Hemochromatosis
143
High index of suspicion for hemochromatosis
Long-standing unexplained jt pain or OA in pts younger than 55 y/o
144
Dx for Hemochromatosis
Serum Iron
Serum Ferritin
145
Another name for Wilson's dse
Hepatolenticular degeneration
146
Cause of Wilson's
Mutation in copper-transporting ATPase
147
Neurologic manifesations of Wilson's
Dysarthria
Dystonia
Tremors
148
S/Sx of Wilson's
Joint pain and stiffness in knees, wrists or other large joints
149
Distinguishing clinical feature of Wilson's
Kayser-fleischer rings
150
a rare autosomal recessive disorder of homogentisic acid metabolism caused by a deficiency of homogentisic acid oxidase
Alkaptonuria
151
Cause of Alkpatonuria
Deficiency in homogentistic acid oxidase
152
1st s/sx in childhood of Alkpatonuria
Darkened or black urine
153
Clinical manifestations of Alkaptonuria in aging people
Back pain
Valve stenosis
Coronary a. calcificiation
Nephrolithiasis
154
Where can degeneration be found in pts w Alkaptonuria
Lumbar spine
IVD
155
Tx for Alkaptonuria
Vit C
Portein restriction
Jt replacement
156
A heterogenous group of diseases characterized by deposition of plasma proteins in an abnormal, insoluble, fibrillar form
Amyloidosis
157
Most common presentation of Amyloidosis
Congo red stain
158
A type of amyloidosis that affects organs and tissues
AL amyloidosis
159
Secondary amyloidosis
AA amyloidosis
160
Most common organ affected by AA amyloidosis
Kidneys
161
Poorly understood disease of non caseating granuloma development, typically in the lungs and lymph nodes
Sarcoidosis
162
Msk S/Sx of Sarcoidosis
Inflammatory Arthritis
Tenosynovitis
Dactylitis
Myopathy
163
A type of Sarcoidosis that presents with bilat hilar adenopathy with acute erythema nodusm
Lofgren's syndrome
164
Tx for Sarcoidosis
NSAIDS
Steroids
Colchicine
Immunosuppressants
165
An autoimmune diseases that predominantly affects female pts aging 20-30
Systemic Lupus Erythematosus
166
Cause of SLE
Lupus antibodies
167
Organ manifesations of SLE
Nephritis
Hematologic
Serositis
Neurologic
Cutaneous
168
ACR classification criteria
Malar rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Serositis
Renal d/o
Neurologic d/o
Hematologic d/o
169
How many symptoms in the ACR classification must there be to diagnose SLE
4/11
170
An exaggerated vasospastic response to cold temperature or emotional stress
Raynaud's phenomenon
171
Pathogenesis of Raynaud's phenomenon
Vasoconstriction leads to reactive hyperemia
172
an autoimmune disorder that affects the skin and internal organs.
Systemic sclerosis
173
Prevalence of Systemic Sclerosis
Among people aged 30-50 y/o
174
Pathogenesis of Systemic Sclerosis
Excessive deposition of collagen
Non-inflammatory Vasculopathy
Alterations in cellular and humoral immunity
175
Cause of primary vasculitis
Idiopathic
176
Cause of secondary vasculitis
Infection
Drug
Toxin
Inflammatory d/o
Cancer
177
