Joint fractures and replacement Flashcards

1
Q

Components of FRAX score (risk factors for fractures)

A
  • race (risk higher for whites and asians)
  • age
  • sex
  • low BMI
  • family history
  • smoking
  • steroid treatment
  • RA
  • osteoporosis
  • excess alcohol consumption
  • bone mineral density of femoral neck
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2
Q

Additional components in QFracture score (apart from FRAX)

A
  • T2DM
  • CVS disease
  • Asthma
  • TCA antidepressant use
  • Chronic liver disease
  • GI malabsorption
  • Thyrotoxicosis, Cushing’s
  • menopause
  • Use of HRT
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3
Q

How does HRT affect falls risk?

A

Protective for duration of use, but effects are substantially diminished after stopping

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4
Q

How are hip fractures assessed in ED

A

Inability to do straight leg raise

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5
Q

What to look for when inspecting MSK patient

WADES

A
wasting
asymmetry
dysfunction
erythema
swelling
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6
Q

Osteoporosis definition

A

More than -2.5 SD at femoral neck

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7
Q

Osteopenia definition

A

-1 to -2.5 SD at femoral neck

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8
Q

What drugs are given for osteoporosis

A
  • bisphosphonates
  • calcium supplements
  • vit D supplements
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9
Q

Types of bloods that must be taken prior to joint replacement surgery

A
  • INR
  • Group n save (in case of need of blood transfusion)
  • FBC: check for anaemia (increased risk of needing blood transfusion)
  • UnEs: get baseline for anaesthetist
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10
Q

Causes of low oestrogren in females

A

” Early menopause (before 45y)
“ Anorexia
“ Ovary removal
“ Excessive exercise

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11
Q

Medications that increase falls risks

A

” Steroids
“ anti-epileptics
“ breast cancer drugs (aromatase inhibitors)
“ prostate cancer drugs

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12
Q

Describe compartment syndrome

A
  • High pressure in closed fascial space
  • Causes reduced blood supply
  • Leads to tissue death
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13
Q

Pharmacodynamics of bisphosphonates

A

Encourage osteoclasts to undergo apoptosis (thus reduce breakdown of bone)

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14
Q

Side effects of bisphosphonates

A

Osteonecrosis of the jaw

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