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Clin Med I-II > DISH - AAA > Flashcards

DISH - AAA Flashcards

1
Q

How is diffuse idiopathic skeletal hyperostosis (DISH) different from ankylosing spondylitis (AS)?

A

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

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2
Q

what is the 2nd most common arthritis to OA?

A

DISH

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3
Q

DISH most commonly affects what parts of the body?

A

spine
right side of thoracic region
lumbar region

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4
Q

who is more susceptible to DISH?

A

people with Type II diabetes
males 50-70 years old

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5
Q

what is the cause of DISH?

A

unknown

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6
Q

how does DISH develop?

A

ossification or bony outgrowths at entheses, particularly in spine, but NOT bridging joints

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7
Q

S&S of DISH

A

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

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8
Q

what kind of referral is DISH?

A

urgent MD referral

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9
Q

what may show up and what won’t show up on imaging for DISH?

A

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

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10
Q

what two systems are affected by prostate cancer?

A

urinary
reproductive
* prostate is a reproductive gland below the bladder that aids sperm function

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11
Q

what is the cause of prostate cancer?

A

unknown

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12
Q

what are risk factors for prostate cancer?

A

age and ethnicity
genetics
chemical exposure
high fat, red meat diet
obesity
alcohol consumption

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13
Q

who is more at risk for getting prostate cancer?

A

only males typically > 65 years old
2nd most common cancer and death in American men
African Americans > European Americans

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14
Q

pathogenesis of prostate cancer:

A

disorganized gland cells infiltrate the prostate

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15
Q

S&S of prostate cancer:

A

cancer S&S
often asymptomatic and variable in early stages
lumbopelvic P!
primary tumor
– bladder and/or sexual dysfunction
– more common metastatic tumor

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16
Q

what are things you can do to possibly detect early prostate cancer?

A

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

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17
Q

what kind of referral is prostate cancer?

A

urgent MD referral

18
Q

what structures and functions are affected by nephrolithiasis (kidney stones)

A

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

19
Q

what are causes / risk factors of nephrolithiasis?

A

disorders that lead to hyperexcretion of calcium (hypercalciuria, hyperthyroidism)
not primarily drinking water
obesity
high animal protein

20
Q

what is the 3rd most common urinary tract disorder behind infections and prostate conditions?

A

nephrolithiasis

21
Q

what are the 3 locations where stones can form?

A

kidney/ureteropelvic junction
iliac vessels
bladder/ureterovesical junction

22
Q

pathogenesis of nephrolithiasis

A

hard mass of salts composed of calcium > uric acid and other minerals

23
Q

S&S of nephrolithiasis

A

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

24
Q

how would a PT determine the referral for nephrolithiasis?

A

*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

25
Q

what type of referral for nephrolithiasis?

A

urgent but possibly emergent referral depending on pain severity

26
Q

what is pancreatitis?

A

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

27
Q

what are causes of pancreatitis?

A

chronic alcohol consumption and smoking
high triglycerides that render insulin and receptors unless = diabetes
obesity
trauma (direct impact)
genetics
infectious agents

28
Q

pathogenesis of pancreatitis?

A

alcohol toxicity to pancreas cells
gallbladder bile refluxes into pancreas causing inflammation and possible fibrosis

29
Q

S&S of pancreatitis

A

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

30
Q

what type of referral for pancreatitis?

A

urgent and possibly emergent MD referral depending on severity

31
Q

what are aneurysms?

A

weakenings in a vessel wall

32
Q

most common site for an abdominal aortic aneurysm?
males _____ females
Increasing freq. due to ________

A

aorta
>
aging population

33
Q

what are risk factors for AAA?

A

smoking
> 50 years of age
males
vascular diseases (atherosclerosis and collagen disorder - weakens vessel walls)
genetics - family hx of AAA

34
Q

what are causes of AAA?

A

trauma
vascular disease
infection

35
Q

pathogenesis of AAA

A

weakening and loss of elastin in vessel walls

36
Q

what would your findings be in the Hx of AAA?

A

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!

37
Q

what would you observe in someone with an AAA

A

abdominal heartbeat

38
Q

what would you palpate in someone with AAA

A

non tender palpable mass that pulses typically just left of midline from umbilicus

39
Q

what is more diagnostic of AAA than palpation?

A

bruit with auscultation over abdominal aorta

40
Q

why would there be absent or diminished pulses elsewhere with someone with AAA?

A

altering the path of circulation
eddy - backflow, gets stuck

41
Q

what kind of condition is AAA? what type of referral?

A

do not want to miss condition
emergency referral - most die before getting to hospital

Clin Med I-II (21 decks)

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