FINAL EXAM Flashcards
arthritis that causes P, swelling, tenderness & redness at joint, often big toe
– inflammatory arthritis caused by crystallization of uric acid inside a joint forming a tophi or tophus surrounding joint
– tophus = deposit of monosodium urate crystals with macrophages & lymphocytes
gout
90% affected individuals experience acute attacks in following locations:
-1st MTP joint (big toe), carpal joints, ankles, heels
-knees, wrists, elbows
-fingers
symptoms include: intense joint P, swelling or inflammation & redness, limited ROM, lingering discomfort, fever, chills, headache or nausea, kidney stones or kidney failure may also occur
gout
autoimmune disease that causes abnormal response to synovial cells in synovium of some synovial joints to attack themselves as if they were a foreign invader
– symmetrical polyarticular arthritis, mostly in small joints
– weakness, fever, malaise, joint P
– morning stiffness common
rheumatoid arthritis
5 stages of rheumatoid arthritis
Stage 1: Synovitis
Stage 2: Pannus formation
Stage 3: Cartilage erosion
Stage 4: Fibrosis
Stage 5: Ankylosis
chronic arthritis that affects people with psoriasis 20-30% of time, skin condition & joints
– red patches of skin with silvery scales & also may affect nails
psoriatic arthritis
pain, stiffness & swelling = most common symptoms often in hands & feet, can be anywhere in body
– symptoms range from mild to severe, alternating periods of exacerbation & remission
– destruction & deformity of joints of hands & feet, causing “sausage finger” & loss of mobility of IP joints
– asymmetrical
psoriatic arthritis
degeneration of a joints articular cartilage along high stress lines that causes inflammation
osteoarthritis
joint pain with crepitus
– slow, continual progression over years & decades, joints slowly deteriorate over time
– morning stiffness (<30 minutes) improves
– little inflammation, some swelling
– loss of flexibility
– major weight bearing joints affected: knees & hips with lesser involvement in SH
– Heberden’s nodes commonly found at DIP joints in women
osteoarthritis
joint stiffness, swelling & P triggered by bacterial infection
– P felt in LB, ankles, knees, feet & IP joints
– enthesitis common
– eye & urinary symptoms present in chlamydia infection
– strongly associated with HLA-B27 gene mutation & more common in men
– if involves eyes (uveitis) & follows a chlamydia (urethritis) infection = Reiter’s Syndrome
reactive arthritis
imbalance between bone deposition (bone making) & bone decomposition (bone break down) causing bone tissue to become “porous”
osteoporosis
– pain & disability due to fractures, common sites are vertebral body, hip & wrists
– vertebral bodies compressed causing loss of height & if in thoracic spine, causes kyphosis
– common in aging population especially post menopausal women
osteoporosis
– advanced age, cerebrovascular disease (Alzheimer’s disease caused by damage to brain tissue & vascular dementia caused by damage to blood vessels)
– CNS infections, brain trauma/tumours, vitamin deficiencies, metabolic, endocrine conditions, chronic alcoholism, long-term exposure to aluminum & other metals, multiple sclerosis, syphilis
– Huntington’s disease, Parkinson’s disease, AIDS
dementia
– unknown, associated with advancing age, genetics factors present in 5-10% of cases
– causes abnormal protein clumps called plaques & irregular knots called neurofibrillary tangles to form in nerve cells in brain
Alzheimer’s
quadriplegia causes
cervical spine injury, paralysis of trunk & all extremities, including pelvic organs
paraplegia causes
lower thoracic or lumbar spine injury, paralysis of lower trunk & legs, including pelvic organs
causes of Parkinson’s (primary & secondary)
primary: unknown possibly genetic
secondary: may be by infection, trauma, tumour, atherosclerosis or drug use
minor stretch & tear, no joint instability on passive testing, minimal P & swelling, able to complete ADLs with minor discomfort, can weight bear, bruising absent/ slight
grade 1 sprain
extensive damage to fibers or tendon, but mm not completely ruptured, snapping sound may or may not be present, can sometimes feel gap at injury site, edema, P (moderate) tenderness at site, difficulty with ADLs, loss of strength, heals in 3 – 6 weeks
grade 2 strain
UTI: often E. coli microorganisms (fecal) enter lower urinary tract & ascend upwards through ureter to kidney
– bacteria may travel to kidneys via bloodstream, causes kidneys to swell & may damage them permanently
– associated with kidney stones, pregnancy, medical instrument contamination (catheter, cystoscope), female sexual trauma & men with (benign prostatic hypertrophy BPH)
acute pyelonephritis
escherichia coli bacterial infection most common, 2nd schistosomiasis, these microorganisms ascend through urethra, other microorganisms may enter via bloodstream
urinary tract infection (UTI)
– most commonly complications from streptococcus infection, antibodies produced against strain, then clump up & lodge inside glomerulus causing inflammation, sometimes idiopathic
– other causes: virus (hepatitis B,C, HIV), diabetes, hypertension, lupus
glomerulonephritis
variable in region & intensity, tall stature, thin long extremities, protruding breastbone, crowded teeth, heart murmurs, extreme nearsightedness, curved spine & flat feet
– symptoms may be mild or severe, if affecting aorta, may be life threatening & require surgery
Marfan’s syndrome
– copper accumulates in liver & brain or other organs causing liver disease, neuropsychiatric symptoms or other
– copper can accumulate in eyes called Kayser-Fleischer ring which is a brown ring at edge of iris
– common symptoms include fatigue, lack of appetite, abdominal pain, yellow skin, speech or swallowing difficulty & mm stiffness
Wilson’s disease
– persistent urge to urinate, burning sensation, frequent small amounts of urination, blood in urine (hematuria), cloudy strong smelling urine, pelvic discomfort, pressure & low fever, may spread upwards through ureters to kidneys
cystitis
– aching, burning, or cramping pain in specific area in an extremity
– feels tight with numbness & tingling, weakness, worsens with exercise
compartment syndrome
often triggered by something else
– pain; aching, burning or gnawing, insomnia, visual problems, memory & mood disorders, cognitive disorders, fatigue, morning stiffness – P begins in localized area: NK & SH, becomes more generalized
– often linked to headaches, TMJ disorders, IBS, Crohn’s or ulcerative colitis, anxiety & depression
– sufferers state they are in pain 90% of waking hours
fibromyalgia
tightness of skin of face give it a “mask-like” appearance
– mouth may not open or close completely
– hands appear red, pale & swollen, fingers become tapered & flexed
– skin appears hard, shiny & stretched
– weakness & fatigue also common symptoms
scleroderma
may go deeper & affect internal organs like heart & cause arrhythmias or respiratory failure, renal failure, esophageal or intestinal blockage or perforation and damage to vascular walls (causing Raynaud’s phenomenon) → blood flow to fingers & toes is extremely reduced by vasospasm causing discoloration
scleroderma
mm atrophy & wasting, mm weakness, lack of coordination, progressive deformity with physical & cognitive (5% of time) disability
– child has waddling gait, difficulty climbing stairs or running, falls easily
– child uses arms to push off to rise from sitting to standing, called “Gower’s Sign” → may affect heart and respiratory system which may be fatal
– most deaths occur from respiratory complications
muscular dystrophy
3 types of spina bifida
spina bifida occulta: hidden, mildest & most common, one or more SPs fail to unite leaving open gap posteriorly
myelomeningocele: most severe, SP’s fail to form at multiple locations (usually L-spine) & spinal canal is open exposing meninges, spinal cord & nerves, other tissues – life threatening, also may cause paralysis
meningocele: very rare, just meninges herniate, no cord involvement
Osteosarcoma
Chondrosarcoma
Fibrosarcoma
Malignant fibrous histocytoma
Ewings’ sarcoma
Multiple myeloma
malignant bone tumors
Osteoma
Osteochondroma
Endochondroma
Osteoid osteoma
Giant cell tumour
Aneurysmal bone cyst
Fibrous dysplasia
benign bone tumors
2 types of seizures
partial (60% of cases): seizure activity limited to single area of brain, person does not lose consciousness – often exhibits lack of awareness, not knowing where he or she is/ how much time has passed
generalized (30% of cases): seizure activity involves a diffuse area of brain or whole brain
-absence seizures (petit-mal)
-tonic-clonic seizures (grand-mal)
-unclassified seizures (10%)
types of cerebral palsy
spastic: 65-75%, causes mm to spasm: hypertonicity, which makes gross & fine motor movements difficult
dyskinetic or athetotic: 20-25%, causes uncontrolled movement: normal movements slow/ jerky
ataxic: 5%, gait disturbances & loss of balance
mixed: 13%, combination of above 3 types
types of fractures
Linear: parallel to long axis of bone
Transverse: right angle to bone’s long axis
Spiral: twisting of bone, causing a fracture
Comminuted: two or more fragments of bone from fracture
Impacted: bone/bone fragments crushed into each other
Compression: bone compressed as in vertebral body
Depression: usually of skull
– decrease in mm cell diameter, decrease size of mm
– first stage is flaccidity, where mm lack normal tone, may occur within 3 days of mm inactivity
– common in elderly (about 5% loss per decade after 60) & is called sarcopenia
– also linked to osteoporosis
muscle atrophy or muscle wasting
hepatitis transmission routes
-contaminated food/ water
-blood & bodily fluids
-sexually transmitted
lesion in CNS occurring ABOVE anterior horn of spinal cord or in motor nuclei of a cranial nerve
– ALS, PLS, brain injury, spinal cord injury, MS, stroke, Huntington’s disease
– spastic paralysis, no atrophy, overactive reflexes, tight muscles, clonus, babinski response, mm weakness
UMNL
lesion occurring BELOW anterior horn of spinal cord or in motor nuclei of a cranial nerve
– trauma to peripheral nerves, virus, Guillain-Barre syndrome, botulism, polio, cauda equina or ALS
– flaccid paralysis, severe atrophy, absent reflexes, fasciculations, hypotonia, mm weakness
LMNL
uncontrolled bleeding in brain, may be a subarachnoid (space around brain) or a intracerebral hemorrhage (within brain)
hemorrhage
collection of clotted blood outside a blood vessel in brain, may lead to pressure on brain causing loss of consciousness & permanent brain damage
hematoma
many injuries lead to swelling, skull doesn’t stretch to accommodate swelling so pressure builds up on brain
edema
force hard enough to move your brain inside skull banging against skull (sudden acceleration & deceleration)
– usually temporary symptoms, but repeated may lead to permanent damage
concussion
malignant tumours in breast, most common cancer in women, only 1.1% in men
– tends to metastasize through lymphatic system, with distant metastases in lungs, liver, brain, bones, & adrenal glands
– most common site for tumours to develop is in upper outside quadrant (50%)
– risk factors: increasing age (rare before age of 50), female sex, race (more common in caucasians), hormones (estrogens) & genetic factors (present in 10% of cases)
breast cancer
– malignant tumour in one or both ovaries
– 2nd most common gynecologic cancer
– in women 40-65 years
– often diagnosis late, with early metastasis into abdomen already occurring
– common metastasis sites are uterus & breast tissue
–suppression of ovulation reduces risk
ovarian cancer
– benign tumors (leiomyomas) in uterus composed largely of smooth mm & fibrous tissue, appear only during childbearing years
– masses vary widely in size, most remain small but larger masses may project into uterine cavity or outward into pelvic cavity compressing other tissues
– common locations & types: intramural, submucosal, subserosal, & pedunculated
– may cause infertility
– common during reproductive years & present in approx 30% of women
uterine fibroids
tightening of CT in body like mm, tendon, ligaments or skin, preventing normal movements, often caused by severe burns – skin becomes scarred & loses its elasticity
contracture
break in bone, due to trauma, overuse, microtrauma or stress, risk can be increased by diseases that impair structural integrity of bone like osteoporosis, metastatic or primary bone tumors, infection or autoimmune disease
fracture
solid swelling of clotted blood that collects in tissue, outside of blood vessel – damage to wall of artery, vein or capillary causes blood to leak into adjacent tissues, causes inflammation & bruising
hematoma
tear of mm or tendon, commonly affecting lower back, neck & hamstrings
strain
– grape-like cysts form in kidneys from dilated nephrons & collecting ducts causing them to become enlarged, always bilateral, cysts may also form in liver, pancreas spleen or gonads
– cysts grow & compress nearby tissues causing renal dysfunction or failure
polycystic kidney disease
– inflammation of glomerulus, caused by recent, untreated streptococcus infection, upper respiratory tract infection (URTI) in throat called “strep throat”
– capillaries of glomerulus are swollen & can not filter
glomerulonephritis
chronic P syndrome characterized by heightened P response with diffuse soft tissue pain that feels muscular in nature with multiple tender points
– pain lasts longer than 3 months & is often accompanied by insomnia & memory problems
– total of 18 tender points in body, diagnosis is made if 11 tender to digital palpation
fibromyalgia
– chronic pain syndrome with localized TPs & fascial constrictions in a mm producing P & causing myofascial pain
– TPs tender to touch & may refer pain elsewhere
– may be:
active: P produced by pressure, familiar, constant pain
latent: P produced by pressure, unfamiliar, only when compressed
myofascial pain syndrome (chronic pain syndrome)
– palpation of TPs frequently results in a local twitch response, brief contraction of affected mm in response to palpation
*Jump sign: spontaneous reaction of P causing person to wince, jump or vocalize in response to palpation
myofascial pain syndrome (chronic pain syndrome)
– chronic disease that affects CT & internal organs
– main effect is overproduction & accumulation of collagen leads to fibrosis or scarring and inflammation causing skin & superficial fascia to thicken and harden
scleroderma
– kidney malformed during fetal development
– irregular cysts form making tissue primitive & dysfunctional, often diagnosed during fetal ultrasound screening (around 28 weeks)
spermatocytic renal dysplasia
– hypersensitivity/ immune reaction to gluten in dietary grains in small intestine
– found in wheat, rye, barley, oats
– body reacts to gluten as either a toxin or allergen → causes irritations of mucosal lining of intestinal wall
celiac disease
– inflammation affecting any part of small/ large intestine & may extend through all mucosal layers
– chronic inflammation thickens walls of GI tract, giving it a cobblestone appearance
– normal segments separated by diseased segments, called skip lesions
Crohn’s disease
– pathology of kidneys caused by long standing diabetes
– early on = asymptomatic
– damage is to filtering membrane & proteins leaked through a dysfunctional glomerulus
diabetic neuropathy
– inflammatory disease that causes mm weakness, may be autoimmune, but is not infectious
– involves inflammatory reaction by CT in mm & skin
– may also affect joints, esophagus, lungs & even heart
– related to epstein-barr virus or mononucleosis
dermatomyositis
– bone tissue develops inside mm tissue in an abnormal reaction to a bruise or hematoma formation
– previously traumatized mm tissue with abnormal deposition of calcium, usually in arm or thigh
– fibroblasts replaced by osteoblasts & form disorganized bone tissue
myositis ossificans
chronic inflammation of tendons or ligaments at their insertion sites cause joint erosion, fibrosis and then ossification of joint capsule
ankylosing spondylitis
Tx: antibiotics, antacids & coating agents may be used to relieve symptoms
– surgery may be required for bleeding or perforated ulcers
peptic/ gastric ulcer
Tx: usually descends on its own in first year, if not, an increased risk of testicular cancer therefore, surgical repositioning of testes in scrotum before age 2 is advisable
cryptochordism (undescended testicle)
long term dialysis, no disease causing agent, already have chronic kidney disease, dialysis does not remove all waste products from blood, researchers believe this causes cysts to form
acquired cystic disease
– most common causes are diabetes & hypertension
– also glomerulonephritis, pyelonephritis, PKD, trauma & kidney stones
renal failure
bacteria from STIs: most common-chlamydia or gonorrhea, or infection spread from appendix, or bacterial spread through vagina & cervix
pelvic inflammatory disease
fluctuating hormone (estrogen) levels during menstrual cycle
fibrocystic breast changes
-elevated BP with protein in urine after 20 weeks of pregnancy, resolving post-delivery
-if untreated, can lead to organ damage, fetal complications, & seizures
-affects 5-8% of pregnancies, especially in first-time mothers, older or younger women, & those carrying multiples
preeclampsia
rare (1%), severe form of preeclampsia, involves recurrent seizures, with possible placenta abruption, pulmonary edema & maternal and fetal death
eclampsia
complication: non-erosive, longer duration, more common in elderly, causes thinning & atrophy of gastric mucosa, may lead to ulcers
chronic gastritis
complications: hormones produced by placenta may block insulin action causing rise in blood glucose levels, may have harmful effects on fetus
– fetal complications include excessive growth, respiratory distress syndrome & premature birth
gestational diabetes
complications: loss of consciousness, seizure, vomiting, balance problems, disorientation, unable to focus, loss of mm control, worsening headache, memory loss, mood changes
-hematoma, hemorrhage, concussion, edema, skull fracture
head trauma
blood vessel disease associated with hep B infection
Polyarteritis Nodosa (PAN) or Vasculitis
