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DPT 740/1: Clin Med 1 > Exam 3- Knee/Ankle Patho > Flashcards

Exam 3- Knee/Ankle Patho Flashcards

1
Q

what conditions do we need 2 of to be at risk of DVT

A

venous stasis
hypercoagulability
damage to venous wall

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2
Q

what is a DVT

A

partial or complete occlusion of a vein by a clot

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3
Q

what are situations that lead to a DVT

A

prior DVT
hx of cancer, CHF, or lupus
major infection, sx, or trauma
present chemo
oral contraceptive or hormone therapy
clotting disorder
> 60 yrs

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4
Q

where is DVT most common

A

LE deep veins

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5
Q

what is most preventable hospital related death

A

DVT

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6
Q

what is the most common cause of death/readmission after TKA/THA

A

DVT

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7
Q

what is the pathology of a DVT

A

greater exposure to platelets and clotting factors to damage venous walls

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8
Q

what can help prevent DVT

A

early and regular exercise
anticoagulants
compression stocking
avoid SAD
eliminate persistent smoking and drinking

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9
Q

what are S&S of DVT

A

gradual onset of dull ache, tightness, and pain in the calf with RF
worse with walking and dependent positions
less relief with rest and elevation

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10
Q

what are the review components of DVT

A

increased calf girth
calf pain and tenderness
redness and warmth

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11
Q

what could a DVT lead to

A

pulmonary embolism

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12
Q

what is the referral for DVT

A

emergency >3
urgent <2

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13
Q

what is a pulmonary embolism

A

DVT that moves and lodges into a smaller arteries the lungs

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14
Q

what are S&S of pulmonary embolism

A

SOB, wheezing, rapid breath
sudden sharp stabbing chest pain
mechanical motion

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15
Q

what is the referral for pulmonary embolism

A

urgent <2/6
emergency >2/6

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16
Q

what is PAD

A

ischemia leading to symptoms in the most distal area from blocked a

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17
Q

what are RF/etiology of PAD

A

> 45 yrs of age
family hx of MI or sudden death before 55
smoker
sedentary
metabolic syndrome

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18
Q

what is the pathology of PAD

A

narrowing of blood vessels limiting circulation

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19
Q

what are S&S of PAD

A

LE pain, calf, activity and elevated
unilateral or bilateral
relieved with rest and dependent position

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20
Q

what are the differences between DVT and PAD

A

DVT- pain with dependent, relief with elevation
PAD- pain with elevation, relief with dependent

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21
Q

what are the review components of PAD

A

loss of pulse
TTP
muscle atrophy and weakness- MMT
loss of hair- ob
cool and bluish skin- ob
bruit on auscultation
ankle brachial index

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22
Q

when is the ankle brachial index invalid

A

hx of HTN

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23
Q

how do you perform ankle brachial index

A

assess post tib and brachial systolic BP in all extremities
divide ankle/brachial

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24
Q

what does >.9 and >1.4 ABI mean

A

> .9= PAD
1.4= poorly compressed vv

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25
Q

how could you differentiate calf pain due to PAD and stenosis

A

bicycle test

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26
Q

what is the referral for PAD

A

urgent

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27
Q

what is osteochondritis dissecans

A

damage to subchondral bone

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28
Q

where is osteochondritis dissecans most common at

A

younger boys
medial femoral condyle and talus

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29
Q

what can cause osteochondritis dissecans

A

jt RT or shear trauma

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30
Q

what is the pathology of osteochondritis dissecans

A

ischemia then separation of subchondral from convex and WB bones

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31
Q

what are S&S of osteochondritis dissecans

A

persistent severe pain
jt locking, catching, and swelling
hypermobility plus ARJC
cannot progress to WB

32
Q

what are review components of osteochondritis dissecans

A

ROM- limited and painful with ext
RST- weak and painful end range ext
comp +
TTP at femoral condyle

33
Q

what is the referral for osteochondritis dissecans

A

urgent

34
Q

what factors can play a role in healing for osteochondritis dissecans

A

higher BMI
passive restraints
m imbalances
impaired proprioception

35
Q

what is the management for an unstable lesion for osteochondritis dissecans

A

sx for resurfacing or fixation

36
Q

what is the management for stable lesion for osteochondritis dissecans

A

rx for instability with ARJC

37
Q

what are RF for reactive arthritis

A

IV drug users
high sexual activity
infrequent pelvic exams
weaker immune system

38
Q

where does septic arthritis infection come from

A

site of primary infection

39
Q

where are acute infection come from

A

remote site from primary infection

40
Q

where is reactive arthritis most common

A

larger LE jt- knee and ankle

41
Q

what can cause reactive arthritis

A

respiratory infection
GI, urinary, and colon infection

42
Q

what is the pathology of reactive arthritis

A

bacteria stimulates antibodies creating inflammation and tissue damage

43
Q

what are S&S of reactive arthritis

A

infection S&S
autoimmune S&S

44
Q

what are review components of reactive arthritis

A

ob- redness, swelling
vitals- temp
ARJC S&S
palpation- TTP, warm, swollen tender lymph nodes

45
Q

what is the referral for reactive arthritis

A

urgent

46
Q

what is diabetes mellitus

A

chronic systemic disorder characterized by hyperglycemia and abnormal metabolism

47
Q

what is insulin

A

released from pancreas
lowers blood sugar
stores fat

48
Q

what is type 1 diabetes

A

auto immunity affecting the pancreas that produces insulin
deficiency of insulin production

49
Q

what is type 2 diabetes

A

excessive dietary sugar and other simple carbohydrates limits effect of insulin

50
Q

how can more sugar affect insulin

A

more sugar = more insulin production = more fat

51
Q

what are cardinal S&S for diabetes

A

frequent urination
dry mouth
excessive thirst
decreased skin turgor
blurry vision
weakness/fatigue

52
Q

what are the neuropathies diabetes can cause

A

sensory
motor
autonomic

53
Q

how is sensory affected by diabetes

A

peripheral n hyposensitivity or numbness
less aware of heart attack

54
Q

how is motor affected by diabetes

A

weakness of mm due to innervation of peripheral n

55
Q

how is autonomic affected by diabetes

A

diminished pulses
necrosis
poor healing
stroke
cardiac dz

56
Q

what can diabetes lead to if not managed well

A

kidney dz and blindness
cognitive dysfunction- alzheimers (type 3)

57
Q

what are the review components of diabetes

A

ob- charcot foot, dry mouth, cognitive decline, fruity breath
ROM- limited and painful
RST- possible weakness
neuro- diminshed sensation, + dural
palaption- diminished pulses

58
Q

due to persistent inflammation and impaired circulation of diabetes, what are these pts more susceptible to

A

carpal tunnel syndrome
adhesive capsulitis
trigger finger
delayed healing
nociplastic pain

59
Q

why should diabetics exercise 3 10 minute bouts

A

eat, burn sugar, eat, burn sugar

60
Q

why should diabetics wait 1-2 hrs after a meal to workout

A

meals increase blood sugar and insulin and exercise work to decrease blood sugar

61
Q

what education can be given to diabetic pts

A

wear accommodating shoes and socks
examine feet
avoid alcohol and cortisone shots

62
Q

what is systemic inflammation a primary contributor to

A

diabetes
HTN
high triglycerides
low HDL
being overweight

63
Q

what is gout

A

metabolic disorder with elevated levels of uric acid and deposition of urate crystals

64
Q

where is the most common site for gout

A

1st MTP
most common crystallopathy

65
Q

what are the RF for gout

A

family hx
decreased renal function
high fructose SAD
high nitrogen diets

66
Q

what can cause gout

A

genetic

67
Q

what is the pathology of gout

A

uric acid typically forms from breaking down cellular waste in the bloodstream
kidneys unable to process uric acid

68
Q

what are the symptoms of gout

A

sudden onset of severe jt pain
night or morning
increasing frequency

69
Q

when do symptoms of gout start

A

10-12 yrs of hyperuricemia

70
Q

what are the review components of gout

A

ob- redness, swelling
palpation- warmth, fever
ROM- limited and painful, ext
RST- possible weak
CM- consistent block

71
Q

what can we do to help pt with gout

A

education on causes and RF

72
Q

what is osteomyelitis

A

inflammation of bone

73
Q

where is osteomyelitis most common

A

tarsal
metatarsal
tibia
femur

74
Q

what are RF for osteomyelitis

A

immunosuppression
chronic illness (diabetes)
IV drug use
jt replacement

75
Q

what can cause osteomyelitis

A

microorganism binds to cartilage
spreads quickly through metaphysis

76
Q

what are S&S of osteomyelitis

A

gradual onset of deep achy pain/stiffness
infection S&S
localized and progressive pain
limits motion and WB

77
Q

what are the review components of osteomyelitis

A

ob- painful asymmetric gait, red and swollen
temperature- warmth, fever
ROM- limited and painful, ext
RST- possible weak
CM- consistent block

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

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