Chronic MS Conditions Flashcards

Question

structural vs nonstructural scoliosis

Answer 1

deformities of bones in spinal column | poor posture, differences in leg length, tumors, adaption to pain

Answer 2

thoracic curve

Answer 3

outward & lateral spine curvature

Answer 4

vertebral column turned on its axis

Answer 5

curvature of spin to left & thoracolumbar scoliosis | r/t both thoracic and lumbar regions

Answer 6

mild: 10-20 degrees mod: 20-40 degrees severe: over 40 degrees

Answer 7

``` spinal curvature to one side uneven hips/shoulders differences in leg lenghth tiredness of spine prominent shoulder blade rib bump ```

Answer 8

heart/lung problems | paralysis

Answer 9

``` adam forward bend test x-ray MRI CT bone scan ```

Answer 10

pain management (OTC or prescription NSAIDs) PT (mild) brace (moderate): Milwaukee [high curvatures} Boston [low/thoracic curves] spinal fusion surgery (over 40)

Answer 11

characterized by decreased mineralization of newlyformed bone usually deficiency or abnormal metabolism of vitamin D

Answer 12

``` dietary deficiency (vit D/ca) intestinal malabsorption lack of sunlight renal & liver disease following a parathyroidectomy supplement vit D/Ca ```

Answer 13

800-1200 mg/day increased for pregnancy, growing children, menopausal women 4.5-5.5

Answer 14

dangerous EKG changes heart block decreased odium permeability on cell membranes

Answer 15

``` muscle cramps tetany + chvostek/trousseaus torsades arrhythmias ```

Answer 16

calcium acetate calcium carbonate / chloride/citrate/gluconate/lactate SE: only w/ IV admin hypotension/bradycardia/dysrhythmias, cardiac arrest, confusion, delirium, coma contra: ventricular fibrillation or using ceftriaxone in neonates don't give with digoxin or tetracyclines or calcium channel blockers, magnesium competes w/ absorption C

Answer 17

600 mg/day | 20-100 ng/ml

Answer 18

enable normal mineralization of gone & prevents hypocalcemia tetany needed for bone growth/remodeling prevents rickets in children/osteomalcia in adults helps w/ cell growth, neuromuscular, immune fx, reduction of inflammation

Answer 19

``` female smoker age sedentary lifestyle alcohol use ```

Answer 20

calcium regulator active form of vitamin D3 promotes intestinal absorption of calcium, elevates serum levels of calcium tx rickets/hypoparathyroidism/impaired kidney fx SE: ha, weakness, dry mouth , thirst, increased urination, muscle, bone pain Contra: hypercalcemia, vitamin D toxicity interx: thiazide diuretics can worsen hypercalcemia, w/ digoxin = dysrhythmias C

Answer 21

softening of bones due to demineralization thin, fragile bones deficiency of vitamin D

Answer 22

bone pain | fractures of vertebrae, hips, wrist

Answer 23

labs ^ alkaline phophatase ^ parathyroid hormones

Answer 24

calcium vit D sunlight

Answer 25

children's vit D deficiency = poor mineralization in growing = skeletal deformities inadequate sunlight or vit D

Answer 26

``` bowed legs, knock-knees pigeon breast (protrusion of sternum) thinning & soft skull late closing of fontanelles poor musculature/weakness ```

Answer 27

diet/sunlight | calcitriol

Answer 28

``` decrease in bone density (leads to fractures) eating disorders, metabolism issues chemo glucocorticoids radiation history white/asian thin body structures limited physical activity smoking drinking (cola and alcohol) ```

Answer 29

usually asymptomatic until fracture limited pain hormonal changes if woman/in menopause

Answer 30

bone mass low | DEXA scan

Answer 31

increased calcium vit D increased wight-bearing exercises smoking cessation reduction of drinking

Answer 32

dual-energy X-ray not a true density T-scores calculated by comparing to range of "normal" assesses presence/extent of osteoporosis normal: +1 SD low bone mass (osteopenia) BMD > 1D and < 2.5 SD osteoporosis: BMD > 2.5 SD

Answer 33

low bone density | low intake of nutrients or b/c of aging

Answer 34

menopause/decreased bone formation due to aging

Answer 35

disease process, renal hypercalciuria, drug related

Answer 36

``` nutrition (CA/D) exercise prevent falls medications weight-bearing exercise ERT calcitonin bisphosphonates ```

Answer 37

decreased bone mass, low nutrients/aging vs bone softening/lack of calcification lack of calcium/estrogen/testosterone vs lack of vit D bone loss and fractures vs fractures normal parathyroid hormone vs high/normal normal alk phos vs high alk phos

Answer 38

calcium/vitamin D biphosphonates (most common, decreases enzyme important to bone turnover) selective estrogen receptor modulators (SERMs) [decrease bone resorption] calcitonin (increases bone density) oral calcium mimic, human PTH teriparatide

Answer 39

``` metabolic disorder bone resorption faster than bone formation creates new bone that is weak/brittle genetic disorder usually older age, northern european ```

Answer 40

``` pain enlarged bones deformed bones fractures damaged joint cartilage DX: fracture, x-ray, blood test ```

Answer 41

``` bisphosphonates calcitonin calcium vitamin D exercise surgery ```

Answer 42

bisphosphonates blocks bone resorption and increases bone density TX osteoporosis/paget's se: d/n/v, gi irritation, altered taste, pathologic fractures w/ long-term use contra: osteomalacia, abnormalities in esophagus, renal impairment, heart failure, liver disease interx: CA, iron, antacids w/ aluminum/magnesium X

Answer 43

SERM decreases bone resorption, lowers cholesterol/LDL TX: osteoporosis in postmenopausal women SE: hot flashes, migraine, HA, flu-like, endometrial disorder, breast pain, vaginal bleeding, fetal harm in pregnancy BBW: ^ risk for venous thromboembolism/pulmonary embolism, stroke and MI contra: estrogen-containing meds Interx: decreases warfarin effect X

Answer 44

abnormal ossification of cartilaginous tissue usually children in growth spurts if playing sports w/ jumping = most at risk overuse injury = separation of proximal patellar tendon insertion = callous formed = pronouned tubercle = painful lump below kneecap

Answer 45

time & rest usually resolves on own once bones stop growing can stay as non-painful growth

Answer 46

idiopathic avascular necrosis of proximal femoral head compromises blood supply insidious onset (can happen after injury to hip) usually unilateral

Answer 47

``` age, stage, amount of hip damage petrie cast (hip-spica) or surgery ```

Answer 48

``` gigantism (^ GH = excessie growth) acromegaly (adult ^ GH = overgrowth of bony areas ie face/feet/hands) pituitary dwarfism (short long bones, max stature 4 ft) ```

Answer 49

``` most common form of arthritis wear & tear on joints = break down of cartilage causes bone to rub on bone mechanical disease spurs ```

Answer 50

men: hips/knees/spin women: hips/knees/hands hard labor/repetitive motion obesity age

Answer 51

localized in one-two joints | generalized is 3+

Answer 52

underlying condition

Answer 53

``` mild symptoms worsen over time pain associated w/ joint degeneration (worsened by activity/relieved by rest) stiffness with prolonged inactivity tenderness swelling effusion crepitus bone spurs dx: x-ray ```

Answer 54

alter load in painful joint/improve function of joint protectors avoid activities that aggravate condition improve strength/conditioning use a brace/splint/cane/crutch OTC analgesics prescription NSAIDs topical analgesics cortisone injections hyaluronic acid injections various non-pharmacologic therapies (heat/cold/assistive tech) surgery

Answer 55

chronic systemic authoimmune disorder progressive arthritis, production of rheumatoid factor, extra-articular manifestation caues unknown usually females, age 20 - 50, genetics antibodies bine with proteins/tissue = immune complexes = inflammation = enzymes damage joint more = pannus forms = osteoclasts cause underyling bone to demineralize

Answer 56

break in bone

Answer 57

``` joint swelling, stiffness (morning), warmth, tenderness, pain usually symmetrical (if not tx) hand/wrist/knee/ankle most common systemic: fatigue, anorexia, weight loss, weakness, low-grade fever rheumatoid nodules pleural effusion vasculitis pericarditis enlarged spleen ```

Answer 58

``` NSAIDs low-dose oral corticosteroids DMARDs intraarticular steroid injection CAM ```

Answer 59

from RA, | v-bend that is stuck

Answer 60

from RA | bent downwards finger like a swan neck

Answer 61

disease modifying antirheumatic drugs can slow/modify progression of tissue damage begin w/ non biologic is worsens after 3 mo add 2nd DMARD then 3 if needed

Answer 62

DMARD immunosuppressant, suppresses rheumatoid factor TX: RA, lupus erythematosus, malaria SE: anorexia, GI issues, alopecia, HA, mood changes, torsades, severe hypoglycemia, anemia, retinal disorder, angioedema contra: visual changes with anti-malarials interx: antacids decrease absorption, hepatoxic meds, alcohol, no digoxin D

Answer 63

folic acid antagonist (blocks synthesis of folic acid = immunosuppressant) TX: RA/SLE/UC/Psoriasis SE: heptatoxicity, hemorragic perforation (enteritis), opportunstic infections SJS BBW: NSAIDS, embryo-fetal toxicity contra: anemia, thrombocytopenia interx: NSAIDS (fatal myelosuppression), aspirin (decreases effect of metho), live vaccines (decreases antibody response) X avoid live virus vaccines

Answer 64

non-inflammatory vs autoimmune inflammatory HLA A1/B8 vs HLA DR4 DR1 degenerative vs systemic autoimmune disease articular cartilage vs synovial tissue weight-bearing joints vs small joints asymmetrical, nodes, improves with rest vs symmetrical, migratory, deformities, improves with use narrowing of joint space vs narrowing of joint space, bone erosion and fusion of joints slightly elevated alk phosphatase vs positive rheumatoid factor w/ rheumatoid nodules ^ ESR

Answer 65

``` group of diseases affecting joints ankylosing spondylities reactive arthritis psoriatic arthritis enteropathic arthritis presence of enthesistis (site where ligament/tendon inserts to bone) HLA-B27 gene ```

Answer 66

low back pain morning stiffness of back or neck gen fatigue

Answer 67

autoimmune inflammatory disease affecting spine bone overgrowth usually white males <40

Answer 68

adults: stiffness, chronic low back pain moves to upper back, spinal joint fuse, can affect hips/chest wall/heels/iritis children: begins in hips/knees/heels/big toe before moving to spine

Answer 69

pain management NSAIDs DMARDs

Answer 70

reactive arthritis complex syndrome: arthritis, conjunctivitis, urethritis triggered by exposure to infection (STD: chlamydia)

Answer 71

``` pain swelling & inflammation of sacroiliac joint finger/toe swelling fever weight loss skin rash eye infection dysuria ```

Answer 72

tx ABX pain management NSAIDs

Answer 73

idiopathic associated w/ psoriasis scaly red patches on skin, pitting/thickening/yellowing nails adults: hip/sacroiliac joint, edema in toes/fingers children: stiffness/swelling/pain in joint

Answer 74

NSAIDs | DMARDS (methotrexate)

Answer 75

no specific cause but w/ genetic marker chronic inflammatory autoimmune disease in juveniles joint inflammation resulting in decreased mobility/swelling/pain DX: ESR, antibody testing, rheumatoid factor, anti-ccp, x-ray, CT, MRI, U/S, synovial biopsy

Answer 76

``` NSAIDs DMARDs biologic agents intra-articular/oral corticosteroids PT OT surgery ```

Answer 77

increased serum uric acid > crystals in joint > inflammation tophi (accumulation of crystalline deposits) Gouty nephropathy (uric acid kidney stones) TX: allopurinol

Answer 78

high: alcohol, anchovies, sardines, mussels, herring, codfish, scallops, trout, haddock, bacon, turkey veal, venison, organ meats moderate: beef, chicken, duck, pork, ham, crab, lobster, oysters, shrimp

Answer 79

anti-gout decreases production of uric acid by inhibiting enzyme SE: SJS, toxic epidermal necrolysis, hypersensitivity syndrome, GI retinopathy, thrombocytopenia, acute renal failure interx: alcohol (inhibits renal excretion of uric acid), ampicillin & amoxicillin (^ risk of skin rashes), warfarin (enhanced anticoagulant), thiazides/ACE Inhibitors (ototoxicity), high purine foods (decreases effectiveness)