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DPT 740/1: Clin Med 1 > E2- Spinal Malignancy > Flashcards

E2- Spinal Malignancy Flashcards

1
Q

what is multiple myeloma

A

primary malignant tumor in bone marrow

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2
Q

where can spinal malignancy be metasized from

A

breast
lung
prostate
kidney
GI

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3
Q

what structure in the spine is spinal malignancy most commonly at

A

vertebral body

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4
Q

what is the main difference between myelopathy and spinal malignancy

A

myelopathy= C5-T1
malignancy= below T1

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5
Q

what are the S&S of spinal malignancy

A

spinal pain- unfamiliar/severe
bony landmark alterations - fx
unable to lay flat
mechanical pain thats random
tenderness to palpation

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6
Q

what is our referral for spinal malignancy

A

urgent
if spinal cord S&S are present then immobilize and becomes emergency

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7
Q

what is the most common region for myelopathy

why

A

thoracic

due to smaller ratio of canal to cord then other regions

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8
Q

what are the S&S of thoracic myelopathy

A

extreme spinal pain
multisegmental weakness/numbness
spastic or rententive bladder
dtr= hyperactive
UMN +

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9
Q

where is the most common nontraumatic spinal injury

A

T8-L4 levels

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10
Q

what is the most serious spinal injury

A

non traumatic spinal fx

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11
Q

what is the cause for non traumatic spinal fx

A

malignancy
osteoporosis

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12
Q

what are the RF for non traumatic spinal fx

A

osteoporotic
more than 3 months of corticosteriod use
female
older age

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13
Q

what are the low evidence S&S of non traumatic spinal fx

A

unfamiliar/severe pain
tenderness
sudden change in posture
mechanical
rare neuro S&S

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14
Q

what bacteria is most commonly involved with spinal infection

A

mycobacterium TB
Staph aureus
brucella

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15
Q

what is Potts disease and where is it most commonly

A

skeletal TB
thoracic spine

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16
Q

how can spinal infection happen

A

develops 2-3 years after initial air droplet infection into lungs
lungs to vb to disc to adjacent vb

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17
Q

how does a spinal infection spread

A

lymph nodes and blood

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18
Q

what can happen if an abcsess grows in a spinal infection

A

nerve root irritation
vb collapse/fx
cord compression

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19
Q

what can happen if spinal infection goes untreated

A

neuro S&S influence LE coordination including bowel and bladder
increased thoracic kyphosis

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20
Q

what are the early S&S of spinal infection

A

arthritic like back pain and stiffness

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21
Q

how can spinal infection be shown on xray

A

body destruction
TB abscess
loss of height
sclerotic end plate
diminished disc space

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22
Q

what is stable angina

A

occurring with stress, physical or emotional

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23
Q

what is unstable angina

A

occuring at rest

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24
Q

why CAD the cause of angina/MI

A

ischemia or limited circulation with imbalance between supply and demand for the heart

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25
Q

where could pain be distributed with angina/MI

A

chest pain, pressure, tightness, or heaviness
jaw or L arm
referred pain in C4-T4

26
Q

what are atypical S&S of angina/MI especially females

A

intrascapular and R arm pain

27
Q

why can someone with diabetes have less pain with angina/MI

A

decrease circulation so decreased n function

28
Q

what do we do for stable angina

A

<20= urgent
>20= emergency

29
Q

what do we do for unstable angina

A

emergency

30
Q

what is a pulmonary embolism

A

blockage of the pulmonary artery due to a traveling blood clot

31
Q

what are RF for pulmonary embolism

A

DVT
immobility
hx of abdominal/pelvic sx
LE jt replacement
late stage pregnancy
LE fractures

32
Q

why could a femur fracture cause a pulmonary embolism

A

yellow marrow (fat) will act as a clot and could cause a PE

33
Q

where does the obstruction come from for a PE

A

the right side of the heart

34
Q

what is a pulmonary embolism labeled as

A

the great masqueraders
gets diagnosed as other things

35
Q

what are the S&S of PE

A

chest pain- sudden, sharp, stabbing (T2-4)
deep inspiration
coughing
reaching
trunk motion

36
Q

what do we do for a pulmonary embolism

A

utilize CDR
emergency referral

37
Q

what are severe S&S of PE

A

cough that is bloody
painful breathing
palpitations

38
Q

what are the factors of CDR for PE

A

DVT - LE pitting edema, TTP
HR >100
immobilization > 4 wks
prior DVT
bloody cough
malignancy

39
Q

what is GERD

A

backflow of stomach contents into esophagus

40
Q

what causes GERD

A

food
obesity
smoking
hernia
meds

41
Q

what happens with GERD

A

dysfunctional valve between stomach and esophagus allowing backflow
increase acidity and acid volume

42
Q

what is scheuermann disease

A

ant vb wedging of adjacent thoracic vb

43
Q

what can cause scheuermann disease

A

persistent IDD

44
Q

what can scheuermann disease do to the vb

A

abnormal vb end plate mineralization and ossification during growth leads to:
ant vb wedging
disc herniates into vb

45
Q

what are S&S of scheuerman disease

A

excessive and rigid thoracic kyphosis
possible counter hyperlordosis in cervical and lumbar regions

46
Q

what is varicella virus

A

chicken pox first time and shingles second time

47
Q

how is varicella transmitted

A

airborne or direct contact so isolate until lesions are crusted
highly contagious

48
Q

what is the referral method for varicella

A

urgent but emergency if close to the eye

49
Q

what are the S&S of shingles

A

lesions in rose petal shape in dermatomal pattern
pain and itching

50
Q

what are common S&S of pancoast tumors

A

shoulder pain (T2-4)
TOS S&S
UE swelling
paresthesias

51
Q

what S&S does pancoast tumor share with horners syndrome

A

sucken eye
droopy eye
lack of face sweating on one side

52
Q

what is the RF for psoriatic arthritis

A

psoriasis

53
Q

what happens with persistent inflammation of psoarisis

A

targets the entheses and gradually thickens and erodes tissue- DIPs

54
Q

what are the S&S for psoriatic arthritis

A

sausage digit
enthesis

55
Q

how do we treat psoriatic arthritis

A

urgent referral

56
Q

what do PsA and RA have in common

A

swelling and stiffness
damage tissue and organ
autoimmune disease

57
Q

what differs with PsA and RA

A

RA- attacks synovial jt= MCP and wrist and bilateral
PsA- attacks entheses= DIP and unilateral

58
Q

what structures are involved with RA

A

loose connective tissue
synovial membranes

59
Q

what conditions of the wrist can develop due to RA

A

boutonniere deformities
spurring
ulnar drift at wrist
carpal tunnel syndrome

60
Q

how do we treat RA

A

POLICED
orthotics/ergonomic
JM
MET with optimal stresses for cartilage integrity/jt mobility

61
Q

what is the prognosis of RA

A

more management

DPT 740/1: Clin Med 1 (7 decks)

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