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Flashcards in Overview of falls and instability Deck (55):
1

Indicators for potentially having a fall

unstable balance on standing
use of > 4 meds
hip weakness

2

are falls a normal aspect of aging?

No

3

what is a good previous indicator of a fall

a previous fall

4

is someone has dysequilibrium what should you think

neuromuscular dz
stroke
cerebellar dz

5

if it is vertigo what should you suspect

drugs
depression
vestibular neuronitis
benign positional vertigo
otitis media

6

what is fainting, lightheadedness, feeling that loss of consciousness is imminent

pre-syncope

7

difficulty initiating gait and festination

parkinson

8

foot drop indiactes what?

anterior tibialis weakness or reduced knee flexion

9

do you just tx a patient for osteoporosis?

Nope, make sure there isn't a secondary cause

10

what is a potential screening for osteoporosis that is super cheap and has no radiation?

Quantitative ultrasonography of the calcaneus (if its positive must get a DEXA)

11

is osteoporosis reversible?

No, but you can stop the progression

12

ADRs of bisphosphonates

osteocencorsis on the jaw and atypical femur fractures

13

is hormone replacement therapy used for osteoporosis?

Nope

14

enlargement at DIP

Heberden’s nodes

15

enlargement at the PIP

Bouchard’s nodes

16

usually over age 50
Women 2x more than men
Morning stiffness > 1 hour
Shoulder and hip girdles

Polymyalgia rheumatica

17

tx for polymyalgia rheumatica

steroids

18

tx for temporal arteritis (giant cell arteritis)

temporal artery biopsy

19

do you wait for tx for giant cell arteritis?

never

20

Temporal HA, blindness
ESR, CRP highly elevated

giant cell arteritis

21

Tx for giant cell arteritis

Temporal artery biopsy

22

tx for giant cell arteritis?

steroids

23

what 2 conditions are highly associated

polymyalgia rheumatica
giant cell arteritis

24

are wound surface cultures helpful?

No

25

how many hip fractures remain in the nursing home 1 year after fracture?

30%

26

how many people will develop a pressure ulcer after a hip fracture?

30%

27

What are the 5 most common places for fractures following a fall?

hip
femur
humerus
wrist
ribs

28

What type of hematoma is a consequence of falls?

subdural hematoma

29

What are 3 reasons falls are underreported?

Injury minimal
"normal" with aging
fear of restriction in activities or institutionalization

30

What 3 drug levels should you get for a fall?

Digoxin, anticoags, ETOH

31

What vitamin deficiency could play a part in a fall?

Vitamin D level

32

If someone is dizzy, you should suspect what 5 things?

Vertigo (ear, drug toxicities, depression)
Dysequilibrium (neuromuscular disease, stroke, cerebellar dz)
Presyncope
Mixed dizziness
Nonspecific dizziness

33

5 causes of presyncope

Cerebral hypo-perfusion
Orthostatic HPOTN
Cardiac arrhythmias
CHF
Vasovagal episodes

34

Sudden, transient loss of consciousness characterized by unresponsiveness and loss of postural control, followed by spontaneous and typically complete recovery

Syncope

35

What test should you get if there is any LOC?

head CT

36

If there is gait initiation failure, what do you suspect?

high level sensorimotor disorder (frontal lobe or white matter)

37

Why would there be short step length?

fear of falling, neuro or MSS problem

38

Pelvic muscle weakness or unable to bend the knee or hemiplegia causes what?

circumdunction

39

A bone density between -1 to -2.5 means

osteopenia

40

A bone density above >1.0 means

Normal Bone Mineral Density

41

What bone density value means osteoporosis?

<-2.5

42

Can men get osteoporosis?

yes

43

What is type 1 and type 2 idiopathic osteoporosis?

type 1- postmenopausal
Type 2- age associated or senile

44

4 endocrine disorders that are causes of osteoporosis

cushing, DM, hyperparathryoidism, hyperthyroidism

45

When should men be screened for osteoporosis?

>70 y/o
10% weight loss, physical inactivity, steroid use, androgen deprivation therapy, previous fragility fracture)

46

What is the gold standard for osteoporosis diagnosis?

Dual-Energy X-ray Aborptiometry (Lumbar spine, hip, and proximal femur)

47

Can any treatment reverse established osteoporosis?

No

48

What should you supplement with if on corticosteroids?

Ca and Vit D

49

First line Tx for osteoporosis

Bisphosphonates

50

What should you treat with if bisphosphonates have failed?

PTH hormone

51

ADRs of SERM

increased risk of DVT and hot flashes

52

What's the most common presentation of pain?

OA

53

Stiffness after period of inactivity which is alleviated within 30 minutes of activity. Episodes of severe pain, tenderness of joints WITHOUT INFLAMMATION

OA

54

Heberden's and Bouchard's nodes associated with what?

OA

55

Morning stiffness > 1hour

polymyalgia rheumatica