MSK Flashcards
What is the clinical definition of a fall?
An event where a person inadvertently comes to rest on a lower level, such as the ground or floor, without any external force involved.
What percentage of people over 65 experience at least one fall annually ?
Around 30%.
True/False: Falls are the most common cause of injury in people aged over 65.
true
Medical conditions like ______, stroke, and Parkinson’s disease increase fall risk.
Dementia
Name three intrinsic risk factors for falls.
Muscle weakness, poor vision, cognitive impairment.
What are two extrinsic risk factors for falls?
Poor lighting, loose rugs.
What is the primary tool used to assess fall risk in older adults?
The Timed Up and Go (TUG) test.
True/False: Gait and balance assessment are not part of the fall risk evaluation.
False
What are key components of a fall history?
Circumstances of the fall, preceding symptoms, and previous falls.
The ______ test evaluates visual acuity in fall-risk assessment.
Snellen
Name two major complications of falls.
Fractures (e.g., hip fractures) and traumatic brain injury.
True/False: Falls are associated with increased mortality in older adults.
true
What are three key aspects of managing falls in older adults?
Addressing medical conditions, physiotherapy, and home modifications.
______ therapy can be prescribed to improve muscle strength and balance.
Physiotherapy.
Name one medication class to avoid in fall-prone patients.
Benzodiazepines.
True/False: Vitamin D supplementation may help prevent falls in older adults.
true
List two environmental interventions to reduce fall risk.
Installing grab rails and removing trip hazards.
How does exercise reduce fall risk?
By improving strength, coordination, and balance.
What is frailty in geriatrics?
A clinical syndrome of decreased physiological reserve, increasing vulnerability to stressors and poor health outcomes.
Frailty is often described as a state of increased ______ and reduced resilience.
Vulnerability
Which age group is most commonly affected by frailty?
Adults aged 65 and older.
True/False: Frailty prevalence increases with age and affects women more than men.
true
What are the key biological processes contributing to frailty?
Chronic inflammation, sarcopenia, and dysregulation of multiple organ systems.
Frailty is closely associated with ______, the loss of muscle mass and strength.
Sarcopenia
What are the five criteria in Fried’s Frailty Phenotype?
Unintentional weight loss, self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity.
True/False: Meeting three or more of Fried’s criteria defines frailty.
true
Name an alternative tool to diagnose frailty.
The Clinical Frailty Scale (CFS).
List common features of frailty.
Weakness, fatigue, slow mobility, unintentional weight loss, and cognitive decline.
Frail patients are at increased risk of ______ after acute illnesses or surgery.
Decompensation.
What is the primary goal of managing frailty?
To maintain or improve functional independence and quality of life.
True/False: Exercise, particularly resistance and balance training, is a key intervention for frailty.
true
Name two nutritional interventions for frailty.
Protein supplementation and addressing vitamin D deficiency.
Comprehensive ______ assessment (CGA) is essential in frailty management.
Geriatric
List two preventive strategies for frailty.
Regular physical activity and adequate nutrition.
True/False: Early detection and intervention can prevent progression to severe frailty.
true
Screening tools like the ______ can identify frailty in primary care.
Frailty Index.
Name three complications of untreated frailty.
Increased falls, hospitalizations, and mortality.
True/False: Frailty is reversible in its early stages with appropriate interventions.
true
What is osteoporosis?
A condition characterized by low bone mineral density (BMD) and microarchitectural deterioration, leading to increased fracture risk.
True/False: Osteoporosis is more common in men than women.
False. It is more common in postmenopausal women.
Osteoporosis occurs due to an imbalance between bone ______ and bone ______.
Resorption; formation.
Which two cells are involved in the regulation of bone turnover?
Osteoclasts (resorption) and osteoblasts (formation).
True/False: Estrogen deficiency accelerates bone resorption.
true
List five risk factors for osteoporosis.
Age, female gender, postmenopausal status, family history, and corticosteroid use.
True/False: Smoking and alcohol consumption are modifiable risk factors for osteoporosis.
True.
Long-term use of ______ (e.g., prednisolone) is a significant secondary cause of osteoporosis.
Glucocorticoids.
What are the common clinical features of osteoporosis?
Fractures (vertebral, hip, wrist), loss of height, and kyphosis.
True/False: Osteoporosis typically presents with pain even in the absence of fractures.
False. It is usually asymptomatic unless fractures occur.
Vertebral fractures can lead to ______, characterized by a forward curvature of the spine.
Kyphosis.
What investigation is the gold standard for diagnosing osteoporosis?
Dual-energy X-ray absorptiometry (DEXA) scan.
A T-score of ______ or below indicates osteoporosis on a DEXA scan.
-2.5.
True/False: Blood tests, including calcium, vitamin D, and thyroid function tests, are part of the workup to rule out secondary causes of osteoporosis.
true
What is the first-line pharmacological treatment for osteoporosis?
Bisphosphonates (e.g., alendronate).
True/False: Calcium and vitamin D supplementation is recommended for all patients with osteoporosis.
true
______ is a monoclonal antibody that inhibits RANK ligand, reducing bone resorption.
Denosumab.
Name two lifestyle modifications for osteoporosis management.
Weight-bearing exercise and smoking cessation.
What is the most serious complication of osteoporosis?
Hip fractures, which are associated with high morbidity and mortality.
Vertebral fractures can lead to chronic ______ and reduced quality of life.
Back pain.
True/False: Patients with osteoporosis have a higher risk of falls.
true
What are two preventive strategies for osteoporosis?
Adequate calcium and vitamin D intake, and regular weight-bearing exercise.
True/False: Screening with a DEXA scan is recommended for all women over 50.
False. Screening is recommended for women over 65 or those with risk factors.
Secondary prevention involves pharmacological treatment to prevent further ______.
Fractures.
What is the most common cause of lower limb fractures in older adults?
The most common cause is falls, often due to reduced mobility, balance issues, or osteoporosis.
What are the typical types of lower limb fractures seen in the elderly?
Common fractures include hip fractures (femoral neck or intertrochanteric), femoral shaft fractures, and distal femur fractures.
Osteoporosis is a significant risk factor for lower limb fractures in older adults.
true
The risk of lower limb fractures increases with increasing age.
true
A ________ fracture is the most common type of hip fracture in older adults.
Femoral neck
What are the clinical signs of a hip fracture in the elderly?
Clinical signs include pain in the hip or groin, inability to bear weight, shortened and externally rotated leg, and inability to move the affected leg.
A fracture involving the femoral neck is most commonly caused by ________ in elderly patients.
falls
What are the main complications associated with lower limb fractures in older adults?
Complications can include deep vein thrombosis (DVT), pulmonary embolism (PE), pressure ulcers, infection, loss of independence, and mortality.
Fractures of the lower limb in older adults often require long-term rehabilitation and can lead to a significant decline in mobility.
true
What is the initial management of lower limb fractures in elderly patients?
Initial management involves pain control, stabilization of the fracture, and early referral to orthopedic specialists. In some cases, surgical intervention may be necessary.
Non-operative management is often preferred for hip fractures in older patients.
False (Surgical intervention is typically preferred for hip fractures in elderly patients.)
________ is the primary surgical treatment for a femoral neck fracture.
Hip replacement (either partial or total)
What are the types of surgical treatment for femoral fractures in the elderly?
Surgical options include hip replacement (partial or total), internal fixation (screws, nails, plates), and sometimes hemiarthroplasty.
Older adults with lower limb fractures are at higher risk of mortality in the first year after the fracture.
true
What factors influence the prognosis of lower limb fractures in elderly patients?
Prognostic factors include the patient’s age, comorbidities, functional status prior to the fracture, type of fracture, and timeliness of surgical intervention.
The main goal in the management of lower limb fractures in older adults is to ________ and ________.
Restore mobility; prevent complications
Physical therapy is often part of the rehabilitation process following a lower limb fracture in elderly patients.
true
What role does osteoporosis play in the risk of lower limb fractures in the elderly?
Osteoporosis significantly weakens bones, increasing the likelihood of fractures, especially from low-impact trauma such as a fall.
The use of ________ medications is important in the management of osteoporosis to prevent future fractures in elderly patients.
Bisphosphonates or other osteoporosis treatments
A comprehensive geriatric assessment is important in managing elderly patients with lower limb fractures.
true
What is the significance of early mobilization after a lower limb fracture in the elderly?
Early mobilization reduces the risk of complications such as deep vein thrombosis (DVT), pressure ulcers, and muscle atrophy, and it helps improve overall recovery.
