Exam #3 Chronic MSK Disorders Flashcards
Osteopenia Defintion
- Decrease in bone density
- Can lead to fractures
Osteopenia Causes
- Chronic eating disorders or issues with metabolism
- Chemotherapy
- Glucocorticoids
- Radiation exposure
- Family history of low bone density
- White / Asian
- Thin
- Limited physical activity, smoking, drinking cola based beverages, high alcohol intake
Osteopenia S/S
- Causes no signs / symptoms
- Only detected during diagnostic test
- ^ DEXA scan
- Recommended for women 65+
Osteopenia Treatment
- Diet Therapy of
- Calcium & Vit D
- Weight bearing exercises
- Smoking cessation
- Reduction of cola based and alcoholic beverages
Osteoporosis Definition
- Low bone density due to low intake of nutrients for bone growth or increase in bone resorption when aging
- Primary: Menopause, Decreased bone formation from aging
- Secondary: Disease process, effect of drug
Osteoporosis Diagnosis and Treatment
- Diagnosis using DEXA scan
- Serum bone G1a level
Treatment: - Calcium & Vit D
- Exercise
- Prevent falls
- Medications
- Decrease ETOH and caffeine
Calcium Supplements
Citrate, Carbonate, Acetate
MOA: Maintenance of MSK, neurologic and cardiovascular function
Contradictions: Hypercalcemia, renal calculi, kidney disease
Interactions: Glucorticoids, thiazide, calcium
Education:
- May cause cardiac arrest in high doses
- 4 hrs between thyroid hormone
- 1 hr between tetracylcine and calcium
- Digoxin and parenteral calcium can lead to severe bradycardia
Selective Estrogen Receptor Modulator
: Tamoxifen, Raloxifene
MOA: Decreases bone reabsoprtion, slowing bone loss and perseveres bone mineral density
Uses: Postmenopausal osteoporosis
Complications:
- DVT ( Stop every 2 hrs in long periods of travel )
- Hot flashes
Education:
- Bone density scans every 12-18 months
- Monitor for DVT
- With / without food
Biophosphonates
: Alendronate
MOA: Decrease bone resorption by inhibiting the activity of osteoclasts in osteoporosis
Complications;
- Esophagitis
- GI
- MSK pain
- Visual disturbances
- Kidney toxicity w IV
- Osteonecrosis of jaw
Interaction: Decreased absorption with calcium, iron, mag, antacids, OJ, caffeine
Calcitonin
MOA: Lowers blood calcium levels by suppressing osteoclast activity in the bones and increasing the amount of calcium excreted in the urine
Complications: Nausea, nasal dryness, hypocalcemia
Contradiciton: Hypersensitivity to the medication or fish protein
Interactions: Lithium, glucocorticoids
Osteomyelitis Definition
- Bone infection: Occurs after penetrating wound from blood infection, skin breakdown
Osteomyelitis Causes & S/S
Causes: Bacteria, fungi, parasites, worms, viruses
S/S: Bone pain, drainage, swelling, redness, warmth, tenderness, lymph node swelling, fever w chills, tachycardia
Osteomyelitis Diagnosis & Treatment
Diagnosis: Xray, bone scan, MRI, WBC count, blood cultures, bone biopsy
Treatment: Antibiotics, surgery for severe, drainage tubes
Bone Tumors
- Develop when cells within a bone divide uncontrollably forming a lump or mass of abnormal tissue
Risk: Abnormal growth of tissue
Bone Tumors Targeted Age Group
- Occurs in children and young adults up to 30!
Bone tumor vast majority….
- Affected by growth hormones
- Stop growing when child stops growing
Benign Bone Tumors
- Pain
- Local Swelling
- Fever
Malignant Bone Tumors
- Deep bone pain
- Skin over mass warm, erythematous
Osteoarthritis
- Develops as wear and tear on joints break down cartilage in joint, causing bone to rub on bone. Pain worsened by activity and relieved by rest.
Osteoarthritis Risk Factors
- Older age
- 60% Women
- Men: Hips, knees, spine
- Women: Hips, knees, hands
- Hard labor
- Heavy lifting
- Bending
- Repetitive motion
- Obesity
Osteoarthritis Medical Conditions that put you at risk?
- Malformed joints
- Defective cartilage
- Diabetes
- Hypothyroidism
- Gout
- Paget Disease
Osteoarthritis Causes
- Changes slowly start to develop to joints;
- Synovium
- Subchondral bone
- Cartilage
Typically involves: - Weight bearing joints of hips and knees
- Digits of hands and big toe
- Cervical and lumbar spine
Osteoarthritis S/S
- Mild –> Worsens
- Worsened by activity, improves with rest
- Tenderness to touch
- Effusion: Swelling related to excess fluid
- Crepitus: Crackling or grating of joints
- Bone spurs
- Decreased range of motion
Osteoarthritis Complications
- Increased risk for falling:
- Joint pain
- Stiffness
- Unsteady gait
