DISH - AAA Flashcards
How is diffuse idiopathic skeletal hyperostosis (DISH) different from ankylosing spondylitis (AS)?
older ages
minimal to no SI jt involvement
no age related joint or disc changes
ossifications on ALL
no HLA rheumatic factor
relatively P!less or mild symptoms
incidental discover
what is the 2nd most common arthritis to OA?
DISH
DISH most commonly affects what parts of the body?
spine
right side of thoracic region
lumbar region
who is more susceptible to DISH?
people with Type II diabetes
males 50-70 years old
what is the cause of DISH?
unknown
how does DISH develop?
ossification or bony outgrowths at entheses, particularly in spine, but NOT bridging joints
S&S of DISH
may be asymptomatic and discovered incidentally from x rays
back P! and stiffness, esp w prolonged positions or repetitive motions
age appropriate spinal mobility
possible neuro symptoms if stenosis
what kind of referral is DISH?
urgent MD referral
what may show up and what won’t show up on imaging for DISH?
ossifications along anterolateral aspect in at least 4 successive vertebral bodies
no disc or joint degeneration like with age related changes
no fusion at facets or SI jt
no osteoporosis
what two systems are affected by prostate cancer?
urinary
reproductive
* prostate is a reproductive gland below the bladder that aids sperm function
what is the cause of prostate cancer?
unknown
what are risk factors for prostate cancer?
age and ethnicity
genetics
chemical exposure
high fat, red meat diet
obesity
alcohol consumption
who is more at risk for getting prostate cancer?
only males typically > 65 years old
2nd most common cancer and death in American men
African Americans > European Americans
pathogenesis of prostate cancer:
disorganized gland cells infiltrate the prostate
S&S of prostate cancer:
cancer S&S
often asymptomatic and variable in early stages
lumbopelvic P!
primary tumor
– bladder and/or sexual dysfunction
– more common metastatic tumor
what are things you can do to possibly detect early prostate cancer?
check bowel and bladder status
inquire about Prostate Specific Antigen (PSA) screening yearly after 55 years old
pelvic floor muscle training has an overall benefit for bladder dysfunction
what kind of referral is prostate cancer?
urgent MD referral
what structures and functions are affected by nephrolithiasis (kidney stones)
kidneys, ureters, bladder, urethra
urinary system functions
– filter fluid from renal blood flow (remove waste, retain essential substances for fluid and contents balance)
– stimulates RBC production
– blood pressure regulation
– coverts vitamin D to its active form
what are causes / risk factors of nephrolithiasis?
disorders that lead to hyperexcretion of calcium (hypercalciuria, hyperthyroidism)
not primarily drinking water
obesity
high animal protein
what is the 3rd most common urinary tract disorder behind infections and prostate conditions?
nephrolithiasis
what are the 3 locations where stones can form?
kidney/ureteropelvic junction
iliac vessels
bladder/ureterovesical junction
pathogenesis of nephrolithiasis
hard mass of salts composed of calcium > uric acid and other minerals
S&S of nephrolithiasis
referred P! into T10-L1 dermatomes
– begin w intermittent unilateral LBP
– progress to acute/severe back, flank, possibly abdominal P!
radiating P! to groin and perianal regions
bladder dysfunction
eventually unrelenting P!
N&V due to P! severity
infection (kidney or urinary tract) –> so infection S&S
how would a PT determine the referral for nephrolithiasis?
*Urgent but possibly emergent referral depending on P, severity
w/ Murphy percussion test over kidney
– one firm and closed fisted percussion over 12th costovertebral angle
– WNL = painless
P! may be present with bladder palpation/percussion
what type of referral for nephrolithiasis?
urgent but possibly emergent referral depending on pain severity
what is pancreatitis?
serious inflammation of pancreas
function of pancreas:
- exocrine gland - secretes enzymes for digestion, converting food/fluid to fuel
- endocrine gland - releases insulin for sugar regulation
may be acute (reversible) or chronic
what are causes of pancreatitis?
chronic alcohol consumption and smoking
high triglycerides that render insulin and receptors unless = diabetes
obesity
trauma (direct impact)
genetics
infectious agents
pathogenesis of pancreatitis?
alcohol toxicity to pancreas cells
gallbladder bile refluxes into pancreas causing inflammation and possible fibrosis
S&S of pancreatitis
sharp right upper quadrant P! that radiates to the TL region
worsened by fatty meals or drinking alcohol due to difficult digestion
P! relieved with knees closer to chest
N&V
possibly jaundiced
Grey-Turner sign - swollen flanks
Cullen sign - swollen umbilicus
may progress to infection S&S and vital and mental status changes
may lead to scarring in TL region and be unmodifiable to JMs
what type of referral for pancreatitis?
urgent and possibly emergent MD referral depending on severity
what are aneurysms?
weakenings in a vessel wall
most common site for an abdominal aortic aneurysm?
males _____ females
Increasing freq. due to ________
aorta
>
aging population
what are risk factors for AAA?
smoking
> 50 years of age
males
vascular diseases (atherosclerosis and collagen disorder - weakens vessel walls)
genetics - family hx of AAA
what are causes of AAA?
trauma
vascular disease
infection
pathogenesis of AAA
weakening and loss of elastin in vessel walls
what would your findings be in the Hx of AAA?
Hx including:
- asymptomatic and identified during assessment of unrelated condition
- most often LBP but possibly abdominal or flank P! esp w activity
- searing, ripping, or tearing back or abdominal P!
what would you observe in someone with an AAA
abdominal heartbeat
what would you palpate in someone with AAA
non tender palpable mass that pulses typically just left of midline from umbilicus
what is more diagnostic of AAA than palpation?
bruit with auscultation over abdominal aorta
why would there be absent or diminished pulses elsewhere with someone with AAA?
altering the path of circulation
eddy - backflow, gets stuck
what kind of condition is AAA? what type of referral?
do not want to miss condition
emergency referral - most die before getting to hospital
