Med surg test 1

Question 1

KYPHOSIS

Answer 1

OSTEOPOROSIS- dowager’s hump, excessive curvature of thoracic spine, tends to progress with age, lateral

Question 2

BONE HEALING he gave callous captain oliver cooked ravioli

Answer 2

FRACTURE HEMATOMA bleeding at broken ends of bone with hematoma formation
GRANULATION organization of hematoma into granulation tissue
CALLUS FORMATION Ca+, PO4, Mg+ are deposited into the fracture area, starting post-1-wk OSSIFICATION of the callus begins within 2-3 weeks (osteoblastic proliferation)
CONSOLIDATION callus continues to develop and the distance between bone fragments lessens. REMODELING excess tissue and dead bone are absorbed by osteoclasts, new bone is laid down by osteoblasts, completing union.

Question 3

dowager’s hump

Answer 3

OSTEOPOROSIS

Question 4

DEXA - numbers

Answer 4

NORMAL 2.5 to -1; OSTEOPENIA -1 to -2.5; OSTEOPOROSIS -2.5 or more

Question 5

RA - swan & BOUTONNIERE (boot w/ your thumb)

Answer 5

BOUTONNIERE deformity of thumb (PIP flexion and DIP hyperextension) SWAN-NECK deformity at tips of fingers (DIP flexion and PIP hyperextension)

Question 6

SULFASALAZINE (RA) (Ray don’t inflame sulfa)

Answer 6

most commonly paired w/ methotrexate, suppresses inflammatory system

Question 7

POLYMYOSITIS (poly is both weak and inflammed)

Answer 7

POLYMYOSITIS uncommon inflammatory disease that causes muscle weakness affecting both sides of your body. Difficult to climb stairs, rise from a seated position, lift objects or reach overhead.

Question 8

DERMATOMYOSITIS - metabolic or inflammatory? (derma is always inflammed)

Answer 8

inflammatory disease marked by muscle weakness and skin rash.

Question 9

SEPTIC ARTHRITIS - most common pathogen - you know this

Answer 9

caused by infection, bacteria, virus, mycobacteria, fungi that invade
the joint cavity via traveling through bloodstream, trauma, or sx incision. Staphylococcus aureus is most causative.

Question 10

REITER’S SYNDROME (reiter’s reacts) - and what does it include? (reiter’s muc)

Answer 10

(reactive arthritis) symptom complex that includes urethritis,
conjunctivitis, and mucocutaneous lesions.

Question 11

+ HLA-B27 ↑ risk of developing (B52 is reactive)

Answer 11

reactive arthritis after sexual contact or exposure to certain GI pathogens.

Question 12

Lyme - Most common feature - (Lyme w/ erythema)

Answer 12

erythema migrans rash in 80% of patients

Question 13

ANKYLOSING SPONDYLITIS (Anky inflammed)

Answer 13

chronic inflammatory disease that primarily affects
the axial skeleton, sacroiliac joints, intervertebral disc spaces, and costovertebral articulation.

Question 14

lyme - s/sx (what about joints?)

Answer 14

erythema migrans rash at site of tick bite within 1-mo. post-exposure. Arthritis is second most common, along with acute, fever-like symptoms: low-grade fever, HA, neck stiffness, fatigue, loss of appetite, migratory joint and muscle pain

Question 15

lyme - treatment

Answer 15

Doxycycline, cefuroxime, and amoxicillin for early-stage infection and preventing later stages active lesions are tx w/ oral ABX
neuro or cardia complications may need IV therapy w/ ceftriaxone or PCN

Question 16

lyme - diagnosis (lyme disease in the west)

Answer 16

2-step lab testing w/ enzyme immunoassay and Western blot test.

Question 17

CARPAL TUNNEL SYNDROME

Answer 17

caused by compression of the median nerve. associated w/ continuous wrist movement. pressure from trauma or edema d/t tenosynovitis, cancer,
RA, or soft tissue masses. Hormones may be involved.

Question 18

CARPAL TUNNEL SYNDROME - risk (think swelling)

Answer 18

DB, PVD, RA because of swelling that changes blood flow to the nerve and narrows tunnel

Question 19

CARPAL TUNNEL SYNDROME - s/sx

Answer 19

impaired sensation, pain, numbness, or weakness of median nerve

Question 20

CARPAL TUNNEL SYNDROME - TINEL’S SIGN (Tinel tap)

Answer 20

TINEL’S SIGN tapping over the median nerve, + response is tingling sensation over hand.

Question 21

CARPAL TUNNEL SYNDROME - PHALEN’S SIGN (phalen fell)

Answer 21

allowing wrists to fall freely into maximum flexion and maintain position for >60 seconds, + response is sensation of tingling in the distribution of median nerve over hand.

Question 22

CREST SYNDROME

Answer 22

chronic hardening and tightening of the skin and connective
tissues. Skin tightness caused by swelling.

CALCINOSIS
RAYNAUD’S
ESOPHAGEAL DYSFUNCTION
SCLERODACTYLY
TELANGIECTASIA

Question 23

MULTIPLE MYELOMA (think myeloma)

Answer 23

MULTIPLE MYELOMA plasma cell myeloma, most frequent occurring primary tumor arising in bone.

Question 24

OSTEOGENIC SARCOMA - occurs in what bones (sarcoma is metaphysical)

Answer 24

OSTEOGENIC SARCOMA (osteosarcoma) highly malignant primary neoplasm, occurs in metaphysical region of long bones.

Question 25

OSTEOCLASTOMA - what bones?

Answer 25

OSTEOCLASTOMA giant cell tumors arising from cancellous ends of long bones

Question 26

EWING’S SARCOMA (wings in the middle)

Answer 26

EWING’S SARCOMA bone neoplasm affecting medullary cavity of long bones

Question 27

OPEN REDUCTION INTERNAL FIXATION (ORIF) (open is open)

Answer 27

OPEN REDUCTION INTERNAL FIXATION (ORIF) correction of bone alignment through a surgical incision. Internal fixation w/ wires, screw, pines, plates, and/ or intramedullary rods, or nails. RISKS infection, complication associated w/ anesthesia, and effects of pre-existing conditions.

Question 28

CLOSED REDUCTION

Answer 28

CLOSED REDUCTION non-surgical, manual realignment of bone fragments to their anatomic position. Traction and counetrtraction are manually applied to the bone fragments to restore position, length, and alignment.

Question 29

FIXATORS

Answer 29

FIXATORS internal/ external metal pins and wires that are attached to bone then internal/ external rods to stabilize the factor while it heals

Question 30

LAMINECTOMY (lame lumbar)

Answer 30

LAMINECTOMY tradition sx for lumbar disc disease, involving sx excision of part of the vertebrae to remove the protruding disc. often outpatient, but may need 1-3 days at hospital.

Question 31

POSITIONING POST-LAMINECTOMY

Answer 31

POSITIONING POST-LAMINECTOMY maintain proper alignment of the spine, prone position, some may be able to dangle the legs at the side of the bed, stand, or even ambulate the day of sx; most need opioids (morphine IV) for 24-48hrs., once fluids are introduced → hydrocodone or oxycodone. valium may be used for muscle relaxation. REPORT severe headache or leak of CSF.

Question 32

dermatomyosis - s/sx (derma is dusky)

Answer 32

S/S dusky red rash on face and eyelids, and in areas around the nails, knuckles, elbows, knees, chest, and back.

Question 33

septic arthritis - risk factors

Answer 33

disease w/ ↓ host resistance (RA, SLE), corticosteroids or immunosuppressives, debilitating chronic illness (DB).

Question 34

reiter’s syndrome - who gets it?

Answer 34

OCCURS MOST OFTEN IN MEN.

Question 35

reiter’s syndrome - remission?

Answer 35

Most patients have complete remission w/ return of full joint function within a few month. Few develop chronic arthritis.

Question 36

reiter’s syndrome - cause (Reiter STD)

Answer 36

RESULT OF EXPOSURE TO SPECIFIC GU or GI TRACT INFECTIONS (Chlamydia trachomatis, Shigella, Salmonella, Campylobacter, or Yersinia)

Question 37

ankylosing spondlytis - MOA (fused ankles)

Answer 37

Joints and adjacent tissue inflammation → formation of granulation tissue (pannus) and dense fibrous scars that can cause joint fusion.

Question 38

ankylosing spondlytis - what parts of the body? (Ankle LHENK)

Answer 38

Inflammation can affect eyes, lungs, heart, kidneys, and peripheral NS.

Question 39

ankylosing spondlytis - who gets it? and susceptibility? (Men have ankles and b52)

Answer 39

MEN 3x more likely to develop, usually dx in 30s
HLA-B27 ↑ susceptibility

Question 40

CALCINOSIS

Answer 40

painful deposits of Ca+ in skin of fingers, forearms, pressure points

Question 41

RAYNAUD’S (Ray is a spaz)

Answer 41

intermittent vasospasm of fingertips in response to cold or stress

Question 42

ESOPHAGEAL DYSFUNCTION

Answer 42

difficulty swallowing d/t internal scarring

Question 43

SCLERODACTYLY (sclero is tight)

Answer 43

tightening of skin on fingers and toes

Question 44

TELANGIECTASIA (Tengly red hands)

Answer 44

red spots on hands, forearms, palms, face, and lips from capillary dilationchronic hardening and tightening of the skin and connective
tissues. Skin tightness caused by swelling.

Question 45

multiple myeloma - s/sx (think cancer)

Answer 45

S/S recurrent infections, anorexia, fatigue, weight loss, back pain, poor prognosis

Question 46

multiple myeloma - treatment (my cells)

Answer 46

TX aggressive cell therapy may prolong survival

Question 47

osteogenic sarcoma - MOST COMMON malignant bone tumor in (genic children)

Answer 47

children/ young adults TX chemo following amputation ↑ 5-year survival rate

Question 48

osteoclastoma - who gets it and s/sx (clas is a young woman)

Answer 48

most common in FEMALES 20-35. S/S swelling, local pain

Question 49

Ewing sarcoma - who gets it? (wings is young)

Answer 49

seen in males 30 and younger (especially 5-15 y/o)

Question 50

Ewing sarcoma - treatment

Answer 50

TX surgical resection, radiation, chemo ↑ 5-year survival rate