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Written Prep > Multisystem Conditions > Flashcards

Multisystem Conditions Flashcards

1
Q

__ in 5 Canadians will get cancer, __ in 4 will die from cancer

A

2;1

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2
Q

Top 3 cancers in males?

A
  1. prostate
  2. lung
  3. colon
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3
Q

Top 3 cancers in females?

A
  1. breast
  2. lung
  3. colon
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4
Q

Top 3 cancer mortality male?

A
  1. lung
  2. colorectal
  3. prostrate
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5
Q

Top 3 cancer mortality female?

A
  1. lung
  2. breast
  3. colon
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6
Q

TMN cancer staging system?

A 
T = tumour (Tx, T0, T1-4)
N = nodes (lymph) - Nx, N0, N1-3
M = mets (distant ones) - Mx,M0, M1
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7
Q

Cancer stages?

A

0 - 4

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8
Q

Stage __ cancer = in situ

A

0

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9
Q

Stage __ - __ cancer = cancer has extended beyond organs in which it first developed

A

1-3

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10
Q

Stage __ cancer = cancer has spread to different organs

A

4

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11
Q

5 possible Rx for cancer ?

A
  1. Sx
  2. chemo
  3. radiation
  4. hormone replacement therapy
  5. biological or genetic Rx to destroy ca cells
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12
Q

Name 5 side effects of chemo

A

any of…

1) alopecia
2) mucositis
3) pulmonary fibrosis
4) cardiotoxicity
5) renal failure
6) sterility
7) myalgia
8) neuropathy

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13
Q

Name 5 side effects of radiation

A

any of…

1) FATIGUE
2) skin irritation
3) scar tissue
4) hair loss
5) temporary change in skin colour
6) swallowing discomfort

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14
Q

4 PT Rx for cancer

A
  1. fatigue management
  2. function and mobility management
  3. physical symptom management
  4. psychological symptom management
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15
Q

Exercise precautions for ca pts? (5)

A
  1. swollen ankle
  2. fatigue
  3. vomiting / diarrhea
  4. unexplained weight loss or gain
  5. SOB w/ low level of exertion
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16
Q

Exercise CI’s for ca pts? (9)

A
  1. racing pulse
  2. fever
  3. pain in back or neck, or bone, calf pain and chest pain
  4. nauseated while exercising
  5. confused or disoriented
  6. dizzy or faint
  7. blurred vision
  8. sudden SOB
  9. very weak or tired
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17
Q

For metastatic disease, you need ____ ______ orders from MD!

A

weight bearing (cannot just have AAT!)

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18
Q

Metastatic disease pts: ask about any new _______ symptoms

A

neurological (B/B, unrelenting pain)

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19
Q

Normal Hb levels males = __ - __ g/dl

A

14-18

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20
Q

Normal Hb levels females = __ - __ g/dl

A

12-16

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21
Q

Anemia: exercise will need to be scaled back if below __ g/Dl

A

8

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22
Q

_________ = decreased WBC

A

neutropenia

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23
Q

WBC count should be > ____ mcl

A

1000

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24
Q

Risk of infection if absolute neutrophils falls below ____ MCL

A

500

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25
Q

Neutropenia: avoid exercise if pt has fever > ___

A

37.5

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26
Q

_________ = low platelet count

A

thrombocytopenia

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27
Q

Normal platelet count = __ - ______ /mcl

A

150-400,000

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28
Q

Thrombocytopenia: if < _____ MCL = avoid any activities w/ contact or risk of falling

A

50,000

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29
Q

Thrombocytopenia: Rx b/w __ - ____ MCL = low weights, stationary bike LOW resistance, walking or ALDs

A

40-60000

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30
Q

Thrombocytopenia: Rx b/w __ - _____ mcl = low intensity exercise, low weights, stationary bike NO resistance or minimal, walking and ADLs

A

20-40000

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31
Q

Thrombocytopenia: if < _______ = risk of spontaneous bleed unrelated to trauma

A

20000

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32
Q

Thrombocytopenia: Rx b/w __ - ______ mcl = doctor approval, active ROM exercises, walking, ADLs

A

10-20000

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33
Q

Thrombocytopenia: if below ________ = spontaneous CNS, GI or resp bleed; no exercise, only essential ADLs, prevent falls and injury

A

10,000

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34
Q

_______ lymphedema = rare, inherited condition where developmental problems occur in lymph vessels

A

primary

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35
Q

______ lymphedema = D/T damage or obstruction to normally functional lymph vessels and nodes

A

secondary

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36
Q

6 risk factors for lymphedema ?

A
  1. radiation
  2. axillary node dissection
  3. arm infection / virus
  4. weight gain since operation
  5. obesity (BMI > 25)
  6. older age
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37
Q

4 things to do to prevent lymphedema?

A
  1. skin care
  2. activity / lifestyle
  3. avoid limb constriction
  4. avoid extreme temp
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38
Q

Measuring lymphedema: > __ cm difference between size indicates lymphedema

A

2

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39
Q

3 ways to measure lymphedema?

A
  1. circumferential
  2. water displacement
  3. perometer and bioelectrical impedance
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40
Q

HIV can be transmitted through urine, sweat and vomit (T/F)

A

FALSE

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41
Q

Result of AIDS = loss of immune system function, decrease in ____ helper T cells

A

CD4+

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42
Q

3 ways to Dx AIDS?

A
  1. clinical findings
  2. systemic evidence
  3. lab evidence
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43
Q

Lab evidence HIV: HIV-1 ______ test, CD4 cell count __ - ___ / ml

A

antibody; 200-500

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44
Q

Normal CD4 cell count?

A

b/w 800-1200

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45
Q

HIV: want to keep viral ____ as low as possible

A

load

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46
Q

Med Rx for HIV?

A
  1. multidrug antiviral therapy

2. symptomatic treatment

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47
Q

_______ = antibody mediated demyelination of schwann cells in PNS from spinal nerves –> terminating fibers

A

GBS

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48
Q

GBS: __/3 people had recent illness in last 30 days

A

2

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49
Q

4 S/S of GBS?

A
  1. onset to peak 4 weeks
  2. rapid ascending motor weakness and distal sensory loss
  3. stocking and glove pattern of loss
  4. absent DTR!
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50
Q

5 PT rx for GBS?

A
  1. positioning
  2. joint protection
  3. chest Rx, mobilization
  4. strength
  5. ROM
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51
Q

GBS trajectory is usually opposite to what other disorder?

A

ALS!

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52
Q

______ ______ = can involve skin and other multi system (organs, arthritis, etc)

A

lupus erythematous

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53
Q

8 S/S of lupus erythematous?

A
  1. skin (butterfly rash)
  2. localized erythema
  3. localized edema
  4. alopecia
  5. photosensitivity
  6. mucusal ulcers
  7. Raynauds
  8. joint effusion
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54
Q

Lupus erythematous = may see _____ (malar) rash

A

butterfly

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55
Q

Dx of lupus erythematous?

A

+ve serum antinuclear antibodies (ANA), symmetric arthritis

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56
Q

_______ = chronic disease primarily affecting skin, characterized by sclerosis

A

scleroderma

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57
Q

Scleroderma provokes massive ______ tissue response

A

fibrotic

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58
Q

Name 6 side multi system side effects caused by scleroderma

A
  1. joint contractures
  2. pulmonary fibrosis
  3. HTN
  4. renal side effects
  5. GI dysmotility
  6. Raynauds
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59
Q

Dermatomyositis / polymyositis = inflammatory CT disorder characterized by _______ limb girdle weakness

A

proximal

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60
Q

Dermatomyositis affects skin, and polymyositis affects muscles (T/F)

A

FALSE; dermatomyositis affects both skin and muscles!

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61
Q

_______ = hereditary bleeding disorder; body unable to control blood clotting / coagulation

A

haemophilia

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62
Q

Type __ haemophilia = most common of hereditary clotting factor deficiencies

A

A

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63
Q

Type A haemophilia = __ linked recessive ; males have condition, females carry gene

A

X

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64
Q

If father has haemophilia, mother doesn’t carry gene: male child (can/cannot) carry gene; female child = ______ carrier

A

CANNOT; obligate

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65
Q

Most common problem w/ haemophilia ?

A

bleeding into joints !

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66
Q

Haemophilia: joint bleeding symptoms ?

A
  1. joint tightness + no pain
  2. tightness + pain
  3. swollen, hot to touch, hard to move
  4. all ROM lost + severe pain
  5. bleeding slows in few days b/c joint is full of blood
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67
Q

If haemophilia / joint bleeds are not treated will cause disabling ______

A

arthritis

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68
Q

2 Rx for haemophilia ?

A
  1. recombinant factor VIII infusion

2. dismopressin (mild hemophila)

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69
Q

Red flags in rheumatic diseases? (6)

A
  1. #
  2. septic arthritis
  3. malignancy
  4. central cord S/S
  5. focal/diffuse muscle weakness
  6. burning / numbness paresthesia
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70
Q

4 questions to ask in rheumatic diseases?

A
  1. red flags
  2. inflammation in joint or around joint
  3. focal or widespread
  4. acute or chronic
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71
Q

If inflammation is (in/around) joint, it will effect multiple ROM, no focal TOP, swelling common

A

IN

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72
Q

Focal arthritis = < __ joints, widespread = > __ joints

A

3;3

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73
Q

Acute arthritis = < __ weeks, chronic = > ___ weeks

A

6

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74
Q

Inflammatory condition = when is pain worst? Non inflammatory ?

A

AM; after use

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75
Q

Swelling in inflammatory conditions ?

A

moderate to severe

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76
Q

Swelling in non-inflammatory conditions ?

A

mild

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77
Q

Is there warmth in inflammatory conditions? Non inflammatory ?

A

sometimes; no

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78
Q

Inflammatory conditions = morning stiffness > __ hour; non inflammatory conditions = morning stiffness < __ minutes

A

1; 30

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79
Q

Inflammatory conditions = often increased in _____

A

ESR

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80
Q

______ features are often present in inflammatory conditions, absent in non inflammatory conditions

A

SYSTEMIC

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81
Q

Example inflammatory condition? Non inflammatory condition ?

A

RA; OA

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82
Q

Main feature of RA = _______

A

synovitis

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83
Q

RA = ______ pattern

A

symmetrical

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84
Q

RA: dense cellular membrane (_______) spreads over articular cartilage

A

pannus

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85
Q

RA: _____ erodes underlying cartilage and bone

A

pannus

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86
Q

RA: w/ time, pannus may extend to the opposite articular surface creating what 3 things?

A
  1. fibrous scar tissue
  2. adhesions
  3. bony ankylosing
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87
Q

8 RA criteria?

A
  1. morning stiffness > 1 hour (6 weeks)
  2. arthritis of >/= 3 joints (6 weeks)
  3. arthritis of hands
  4. symmetric arthritis (6 weeks)
  5. rheumatoid nodules
  6. serum rheumatoid factor
  7. radiographic changes
  8. abnormal antibody (80% in those w/ RA)
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88
Q

What is the abnormal antibody found in pts with RA?

A

HLA-DR4

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89
Q

5 other conditions besides RA HLA - DR4 is found in ?

A
  1. ILD
  2. chronic hepatitis
  3. IPF
  4. normal aging adults
  5. SLE
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90
Q

3 things that increase risk of RA?

A
  1. giving birth
  2. cigarette smoke
  3. pollution
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91
Q

7 S/S of RA?

A
  1. pain
  2. fatigue
  3. stiffness
  4. swelling
  5. joint deformity
  6. mm atrophy
  7. extra-articular features
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92
Q

Meds for RA (3 groups)?

A
  1. DMARDS / biologics
  2. methotrexate
  3. NSAIDS, tylenol, cortisone
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93
Q

______/ _____ stope the RA disease process

A

DMARDs / biologics

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94
Q

________ prevents permanent joint damage / premature death from RA

A

methotrexate

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95
Q

RA: With ______ , it is important to educate your pt on effects on liver and reproductive organs

A

methotrexate

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96
Q

NSAIDS, tylenol and cortisone do not stop RA disease process but improve inflammation and pain, but not ROM (T/F)

A

FASLE - DO improve RIM

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97
Q

RA rehab in ______ phase = energy conservation, ice, splints, gentle ROM

A

acute

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98
Q

RA rehab acute phase: NO _______ !

A

stretching

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99
Q

Name 5 rehab goals for RA chronic phase.

A

Any of…

  1. relieve pain
  2. splints, exercise (gentle ROM)
  3. relaxation / rest
  4. dec stiffness (gentle ROM)
  5. aquatic exercise
  6. functional exercises
  7. prevent deformity
  8. fall prevention
  9. moderate intensity PA
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100
Q

4 R’s of surgical management of RA?

A
  1. remove (MTP resection
  2. re-align (tendon rupture)
  3. rest (arthrodesis)
  4. replace (arthroplasty)
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101
Q

Name the 3 steps in a joint count assessment.

A

STOP!

  1. joint effusion (2 or 4 finger technique)
  2. joint line tenderness
  3. stress pain
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102
Q

Name 7 commonly affected joints in RA

A
  1. AA joint
  2. TMJJ
  3. GHJ
  4. AC joint
  5. elbow
  6. hip
  7. knee
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103
Q

Elbow in RA: superior ______ joint commonly involved, leading to erosion of ______ head

A

radioulnar; radial

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104
Q

RA: ______ ligament may be affected at AA joint

A

transverse

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105
Q

RA: humeral head may move _______ at GHJ

A

superiorly

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106
Q

_____ _____ = 1st MTP synovitis, big toe is lateral, ligament laxity and erosion

A

hallux valgus

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107
Q

Hallux valgus: subluxation –> dislocation, proximal phalanx drifts _______, causing _______ of mid foot

A

laterally; pronation

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108
Q

______ ________ = synovitis, displacement of the flexors, unopposed extensors pull the proximal phalanx into hyperextension

A

MTP subluxation

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109
Q

MTP subluxation: MT heads prolapse and get dislocation and _______ drift of toes

A

lateral

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110
Q

Sign of MTP subluxation?

A

callouses

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111
Q

______ _____ = MTP synovitis. MTP ext, PIP + DIP flexion

A

claw toe

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112
Q

Claw toe: often in all toes except?

A

big toe

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113
Q

_____ ______ = MTP and PIP synovitis, usually involves __ toe, flex of PIP and hyperextension of DIP

A

hammer toe ; 2nd

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114
Q

Hammer toe is similar to what finger deformity ?

A

boutonniere

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115
Q

_____ _____ = flexion of DIP, affects longest toe

A

mallet toe

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116
Q

____ _____ = contracture of instrinic muscles w/ dorsal subluxation of lateral extensor tendons

A

swan neck

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117
Q

Swan neck = ____ of MCP, hyperextension of _____ and flexion of ____

A

flexion; PIP; DIP

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118
Q

Test for swan neck deformity ?

A

Bunnel Littlers

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119
Q

_________ = rupture of central tendinous slip of extensor hood

A

boutonniere

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120
Q

Boutonnières = zig - zag deformity; ______ of MCP, _____ of PIP and _______ of DIP

A

extension; flexion; hyperextension

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121
Q

Test for boutonnières?

A

central slip tendinitis

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122
Q

_______ ______ = most common hand deformity in RA;

A

ulnar drift

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123
Q

ulnar drift = involves synovitis of ____ + structural differences; causes _____ subluxation / laxity of MCP in radial collateral ligaments

A

MCP; volar

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124
Q

Tests for ulnar drift deformity ?

A

radial collateral ligament test; extensor tendon subluxation test

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125
Q

Rx for ulnar drift?

A
  1. lateral finger walking

2. joint protection

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126
Q

Test for thumb deformities?

A

grind and crank

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127
Q

2 Rx for thumb deformities?

A
  1. web space massage / stretch

2. opposition and abduction exercises

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128
Q

DRUJ instability: _______ at joint, stretches ulnar carpal ligaments, ulnar head will sublux ______

A

synovitis; dorsally

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129
Q

DRUJ instantly: _____ is displaced and becomes a FLEXOR tendon

A

ECU

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130
Q

Test for DRUJ instability ?

A

ballottement test

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131
Q

________ contracture = contract of the palmar fascia

A

Dupuytrens

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132
Q

Dupuytrens = affects MCP’s and PIPs of ___ and ___ digits

A

4th, 5th

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133
Q

____ _____ = thenar muscle wasting w/ first digit moving dorsally until in line w/ second

A

ape hand

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134
Q

Ape hand results from ____ nerve dysfunction

A

median

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135
Q

_____ ______ = rupture of avulsion of extensor tendon at its insertion into distal phalanx

A

mallet finger

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136
Q

Mallet finger causes _______ at DIP

A

flexion

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137
Q

Gamekeeper’s thumb = sprain / rupture of _____ of MCP at first digit leading to ______ instability

A

UCL; MEDIAL

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138
Q

______ = genetic disorder of purine metabolism

A

gout

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139
Q

Gout leads to increased serum _____ acid

A

uric (hyperuricemia)

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140
Q

Gout = acid forms ______ and deposits into joints; most affected joints in gout?

A

crystals; knee and great toe!

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141
Q

Rx for gout? (4 meds)

A
  1. NSAIDs
  2. Cox2 inhibitors
  3. corticosteroids
  4. ACTH
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142
Q

3 PT goals for pt w/ gout?

A
  1. injury prevention
  2. education
  3. fast intervention
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143
Q

_______ = release of enzymes + abnormal biomechanical forces leading to fibrillation and articular cartilage damage

A

OA!

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144
Q

2 results of fibrillation and articular cartilage damage?

A
  1. cartilage loss

2. increased bone turnover (osteophytes)

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145
Q

6 risk factors for OA?

A
  1. age
  2. F>M
  3. obesity
  4. physical inactivity
  5. injury
  6. joint stress
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146
Q

Name 5 most common OA sites

A
  1. spine
  2. hand
  3. knee
  4. hip
  5. foot
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147
Q

Osteophytes in facet joints of L spine = _______

A

stenosis

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148
Q

OA at PIP = ______ node; OA at DIP = _____

A

Bouchard; Heberden

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149
Q

_____ = most common affected joint in OA

A

Knee

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150
Q

3 common findings in pt w/ knee OA ?

A
  1. varus
  2. flexion contracture
  3. crepitus
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151
Q

4 S/S of hip OA?

A
  1. walks w/ trendelenberg
  2. groin pain
  3. osteophytes
  4. flexion deformities
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152
Q

Most common area affected by OA in foot ?

A

1st MT joint

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153
Q

OA in foot: osteophytes cause ____ _____ + rigidus, bunions

A

hallux valgus

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154
Q

4 main X ray findings of OA?

A
  1. joint space narrowing
  2. osteophytosis
  3. subchondral cysts
  4. subchondral sclerosis
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155
Q

4 questions to ask pts suspected of having OA?

A
  1. pain most days over the last month ?
  2. pain over the last year?
  3. worse with activity ?
  4. received with res?
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156
Q

3 tests indicative of knee OA?

A
  1. flexion contracture
  2. abnormal gait
  3. swipe tests / patellar tap test +ve
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157
Q

5 categories of Rx for OA?

A
  1. weight loss
  2. exercise
  3. protective aids
  4. medications
  5. electromodalities
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158
Q

1 lb weight loss = __ lb decrease in knee joint stress per step; aim is to decrease __% of body weight

A

4; 10

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159
Q

Exercise for pt w/ OA: __ min moderate aerobic training, __ minute bouts

A

30;10

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160
Q

Most common med for pts with OA?

A

acetominophen

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161
Q

______ type FAI = decreased / absent waist of the junction of femoral neck and head

A

CAM

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162
Q

CAM type FAI is common in what population ?

A

young men

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163
Q

____ type FAI = abnormal acetabulum provides excessive cover of femoral head

A

pincer

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164
Q

______ or deep acetabulum seen in pincer type FAI

A

retroverted

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165
Q

Pincer type FAI is common in what population ?

A

women 30-40 years old

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166
Q

Does spondyloarthritis have a rheumatoid factor ?

A

NO

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167
Q

5 characteristics of spondyloarthritis ?

A
  1. spine inflammation
  2. synovitis
  3. eye inflammation
  4. NO RF (seronegative)
  5. can be hereditary
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168
Q

Gene commonly found in pts with spondyloarthritis?

A

HLA-B27

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169
Q

Is psoriatic arthritis more common in males or females?

A

equally common!

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170
Q

4 characteristics of psoriatic arthritis ?

A
  1. chronic
  2. erosive
  3. inflammation
  4. affects digit joints + axial skeleton
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171
Q

2 types of psoriatic arthritis?

A
  1. dactylitis

2. enthesitis

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172
Q

Common sites of enthesitis in psoriatic arthritis ?

A

heels and back

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173
Q

5 meds for psoriatic arthritis ?

A
  1. acetaminophen
  2. NSAIDS
  3. DMARDs
  4. corticosteroids
  5. biological response modifiers
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174
Q

3 PT goals for pt w/ psoriatic arthritis ?

A
  1. joint protection strategies
  2. maintain joint mechanics
  3. endurance
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175
Q

_______ spondylitis = related to inflammatory conditions of the bowel

A

enteropathic

176
Q

2 conditions related to enteropathic spondylitis?

A
  1. ulcerative colitis

2. chrons disease

177
Q

Is ulcerative colitis or Chrons disease more severe?

A

Chrons! (affects whole bowel, whereas ulcerative colitis just affects lower half of bowels)

178
Q

Enteropathic spondylitis can also affect the spine, SI joint and limb joints (T/F)

A

TRUE

179
Q

______ arthritis is triggered by infection in bowel or GI tract

A

reactive

180
Q

3 S/S of reactive arthritis ?

A
  1. affects LE
  2. hot and swollen joints
  3. SYMMETRICAL!
181
Q

AS = onset before ___, males > females

A

40

182
Q

Low back pain and ______ = hallmark sign of AS

A

sacroiliitis!

183
Q

AS: increased kyphosis T spine, _____ lumbar lordosis

A

DECREASED!

184
Q

Dx of AS?

A

HLA-B27 marker

185
Q

4 meds for AS?

A
  1. NSAIDs
  2. corticosteroids
  3. cytotoxic
  4. tumour necrosis factor (biologics!)
186
Q

3 PT goals for pt w/ AS?

A
  1. trunk flexibility
    2 endurance
  2. improve resp function
187
Q

AS = stiffness / fusion of spine due to ________, usually bilateral but may initially start as unilateral and migrate

A

inflammation

188
Q

_______ = inflammation where tendon, legs and joint capsule attach to bone

A

enthesitis

189
Q

Result of enthesitis = bony _____ and overgrowth

A

erosion

190
Q

Are pts with AS at increased or decreased # risk?

A

increased! have OP + fusion / rigidity

191
Q

Enthesitis will affect rib cage = decreased ______ _______

A

chest expansion

192
Q

_________ = bony spurs on 2 sides of a joint, cause bony fusion and rigidity

A

syndesphmophytes

193
Q

Synovitis usually affects peripheral joints: name 4

A
  1. shoulders
  2. hips
  3. knees
  4. ankles
194
Q

AS: may cause _______ ______ in lungs, avoid smoking

A

apical fibrosis

195
Q

AS: can cause ______ / ______ of conduction system, and aortic _______

A

inflammation; scarring; inflammation

196
Q

AS can also affect eyes and bowel (T/F)

A

TRUE

197
Q

7 clinical criteria for AS?

A
  1. LBP and stiffness for > 3 months
  2. AM stiffness
  3. altered posture / muscle imbalances
  4. decreased strength / reconditioned
  5. decreased L spine ROM in sagittal and frontal planes
  6. altered breathing mechanics
  7. fatigue
198
Q

AS: LBP is worse with ____, better w/ _____

A

rest; exercise

199
Q

6 deformities seen in AS?

A
  1. HFP
  2. thoracic kyphosis
  3. flattening of anterior chest way
  4. protrusion of abdomens
  5. flattening of lumbar lordosis
  6. slight hip flexion
200
Q

AS: will have _______ breathing pattern and ______ vital capacity

A

diaphragmatic; decreased

201
Q

7 measures to take for AS ROM?

A
  1. posture (tragus to wall)
  2. lateral trunk flexion
  3. trunk flexion (modified schooners)
  4. trunk extension (smythe test)
  5. chest expansion
  6. trunk rotation
  7. cervical mobility
202
Q

4 meds for pts with AS?

A
  1. DMARDs
  2. NSAIDs
  3. corticosteroids
  4. biologics
203
Q

5 categories for physical management of AS?

A
  1. control / decrease inflammation
  2. P management
  3. decrease stiffness / increase ROM
  4. posture correction
  5. increase mm strength and endurance
204
Q

2 outcome measures to use for pt w/ AS?

A
  1. BASFI (disease impact on function)

2. BADAI (how disease is managed)

205
Q

JIA = life time disease (T/F)

A

TRUE

206
Q

Ax for JIA?

A
  1. pain
  2. ROM
  3. joint count
  4. muscle strength / length
  5. fatigue
  6. orthotics
  7. gait aids
207
Q

Dx of JIA: S/S must be present for __ weeks; subtype determined by presentation in 1st ___ months

A

6;6

208
Q

Does JIA affects the eyes?

A

YES (uveitis)

209
Q

JIA can affect the synovium, tendon sheath synovium and entheses (T/F)

A

TRUE

210
Q

JIA: Complete remission of disease in __% of kids if occurs before age __

A

75;16

211
Q

RA most typically affects what 2 joints?

A
  1. MCP

2. PIP

212
Q

CI’s / red flags for exercise in RA and OA? (6)

A
  1. increase in pain, fatigue, or AM stiffness
  2. sudden pain at joint or joint deformity
  3. joint becomes red, swollen and hot after doing exercise (within 24 hours)
  4. decrease in muscle strength and function (local myositis)
  5. neurological SSx
  6. SOB on mild exertion
213
Q

Precautions for exercise in RA/OA?

A
  1. watch our for inappropriate exercise that can harm joints
  2. swollen joints at risk for capsular stretch and rupture
  3. OP bone at risk for #
  4. use machine and resistance bands rather than free weights
214
Q

_____ ______ questionnaire = measures difficulty performing ADLs on past week; good measure of disease activityl most widely used functional measure in rheumatology

A

health assessment (HAQ)

215
Q

Do you want a lower or higher score in the HAQ?

A

Lower!

216
Q

________ - __ = measures QOL profile, looks at self care, ADL, pain / discomfort, anxiety and depression, used in general population along w/ RA and OA

A

EuroQol - 5D

217
Q

_________ = assess disability in RA patients (specific pt picked activities that are affected by RA); 5 activities, questionnaire administered by PT

A

MACTAR

218
Q

MACTAR = better for ____ term follow up rather than _____ term

A

short; long

219
Q

MACTAR: is a lower or higher score better?

A

higher; ranges from -1 –> +1, +1 is better

220
Q

______ _____ _____ test = lower body strength in older adults as an indicator of functional status; some predictive validity for falls

A

timed chair chair test

221
Q

Timed chair stand test = time for 1, 5, or 10 reps; or reps in a ___ s period

A

30

222
Q

_____ or _____ = short and long term pt relevant outcome measure of knee or hip injury that can result from traumatic OA; 5 dimensions (pain, other symptoms, ADLs, sport and recreation fxn, knee or hip related QOL)

A

knee / hip injury and OA outcome measures (KOOS or HOOS)

223
Q

____ or _____ = for people w/ ACL injury, meniscus injury, post traumatic OA, hip or knee pathologies post surgical, etc

A

KOOS; HOOS

224
Q

Type __ DM = beta cell destruction usually leading to absolute insulin deficiency

A

1

225
Q

Type __ DM = variation from insulin resistance and increased insulin levels to a dominant defect in insulin secretion w/ insulin resistance

A

2

226
Q

There are > 40 well defined types of diabetes (T/F)

A

TRUE

227
Q

______ regulates glucose levels, promotes glucose uptake into the cells for storage

A

insulin

228
Q

How is glucose stores in the liver, muscle and adipose tissue ?

A

as glycogen

229
Q

Type 1 DM = _____ onset, requires insulin, immune mediated attach of _____ cell in pancreases

A

juvenile; islet

230
Q

There is a ____ in circulating insulin in type I DM

A

DECREASE

231
Q

Presentation of type __ DM = weight loss, increased urination and dehydration

A

1

232
Q

Type 2 DM = ___ onset, dont need insulin bc they don’t respond to it, causes insulin resistance in _____ tissues

A

adult; peripheral

233
Q

Presentation of type ___ DM = obese, acanthosis nigricans (hyperpigmented skin in axilla, groin, back of neck) and HTN

A

2

234
Q

_______ = dizzy, weak, nauseous, sweating profusely; fatigue; irritably, confusion, fainting

A

hypoglycaemia

235
Q

What S/S of hypoglycaemia rules out orthostatic hypertension?

A

sweating profusely!

236
Q

_______ = blurred vision, fatigue, thirst, frequent urination, weakness, abnormal breathing; acetone breath

A

hyperglycaemia

237
Q

3 long term effects of hyperglycaemia?

A
  1. damage to small blood vessels (retinopathy and diabetic nephropathy)
  2. damage to large blood vessels
  3. damage to peripheral nerves (diabetic neuropathy)
238
Q

Normal glucose levels fasting? Diabetic fasting levels

?

A

5.6 mmol/L; > 7 mmol/L

239
Q

Impaired fasting plasma glucose < ___ mmol/L to > __ mmol/L

A

5.6;7

240
Q

5 long term consequences of diabetes?

A
  1. peripheral (diabetic neuropathy, ulcers, amputation)
  2. kidney failure
  3. diabetic retinopathy
  4. heart disease
  5. infection
241
Q

6 things to keep in mind when exercising w/ pts with DM?

A
  1. regular exercise = very important
  2. talk to MD re insulin levels for exercise
  3. have snack before
  4. monitor blood sugar levels pre, during and post exercise
  5. avoid exercise at night!!!
  6. PT to ALWAYS monitor pt for s/s of hyper or hypoglycaemia
242
Q

SCI: ____ of pts w/ SCI develop chronic pain

A

2/3

243
Q

Pain is transmitted via what 2 types of fibers ?

A
  1. A delta

2. C fingers

244
Q

___ _____ fibers = high threshold, sharp prickling, localizing, fast adapting

A

A delta

245
Q

____ fibers = low threshold, dull, aching, diffuse, slow adapting and persistent

A

C

246
Q

Do meds work well for A delta or C fibres ?

A

A delta!! Do not work well for C!

247
Q

Conduction of pain = at SC goes up ____ _____ tract to thalamus and to the cortex

A

lateral spinothalamic

248
Q

_______ ______ = released endorphins and inhibits substrate P and glutamate release, therefore decreasing pain

A

periacqueductal grey

249
Q

Chronic pain = actual chemical changes occur in tissue and brain, receptors become hypersensitive leading to ______ or _____

A

allodynia; hyperalgesia

250
Q

3 Rx for chronic pain ?

A
  1. desensitize area
  2. educate them that it is not in their head
  3. restore normal function to area
251
Q

______ ______ _______ = by exclusion, persistent of relapsing fatigue for at least 6 months NOT reduced w/ bed rest, reduces daily activity by at least 50%

A

chronic fatigue syndrome

252
Q

PT role in chronic fatigue syndrome?

A

checking exercise tolerance

253
Q

________ = chronic pain syndrome affecting mm and soft tissue

A

fibromyalgia

254
Q

7 S/S of fibromyalgia ?

A
  1. headaches
  2. sensitivity to stimuli
  3. fatigue
  4. myalgia
  5. sleep disturbances
  6. generalized aching
  7. anxiety / depression
255
Q

Fibromyalgia = will have + at ___/ 18 points ; name these points.

A

11;

  1. occiput
  2. lower cervical (C5-7)
  3. traps (mid point of upper border)
  4. supraspinatus (origin)
  5. second rib
  6. lateral epicondyle
  7. gluteal
  8. greater trochanter
  9. knee
256
Q

2 PT Rx for fibromyalgia ?

A
  1. energy conservation

2. aquatic therapy

257
Q

______ = presence of whole body inflammatory state (SIRS) + presence of unknown infection

A

sepsis

258
Q

Septic shock = severe sepsis but _______ abnormalities in spite of adequate fluid resuscitation

A

hypo perfusion

259
Q

Septic shock = ______ system spirals out of control, normal response to infection is local but then causes widespread _______ and vascular _______

A

immune; vasodilation; permeability

260
Q

_______ = poor distribution of blood at the microcirculation level

A

shock

261
Q

shock = decreased tissue ______, does not meet cellular needs leading to cell death

A

perfusion

262
Q

4 types of shock ?

A
  1. hypovolemic
  2. cardiogenic
  3. distributive
  4. obstructive
263
Q

_______ shock = blood loss

A

hypovolemic

264
Q

______ shock = due to heart damage

A

cardiogenic

265
Q

_______ shock = hypotension and general tissue hypoxia

A

distributive

266
Q

_______ shock = great vessels of heart, usually goes with cardiogenic shock

A

obstructive

267
Q

________ = whole body inflammatory state, dx w/ body temp, HR, RR and WBC count

A

SIRS

268
Q

SIRS = dx along w/ 2 or more of the following signs: HR > ___, temp > ___ or < ___, RR > ___ OR PaCO2 < __, WBC count > _____ and < _____

A

90; 38; 36; 20; 32; 12000; 4000

269
Q

BMI equation?

A

weight (kg) / height (m) ^2

270
Q

Overweight BMI = b/w ___ - ___

A

25-29.9

271
Q

Obesity= BMI > or = ___

A

30

272
Q

Morbidly obese = > or = __

A

40

273
Q

Skin caliper test: fat greater than __ inch is in excess

A

1

274
Q

______ obesity is an independent predictor of morbidity and mortality

A

abdominal

275
Q

FITT parameters for pts w/ obesity ?

A

F: 5-7 days a week
I: mod intensity (40-60% progress to 50-70% HRR)
T: 45 - 60 mins
T: circuits or aquatics

276
Q

Pts w/ obesity: be mindful of response to heat, excess fat leads to heat _____ and can lead to _______

A

insulation; overheating

277
Q

Normal weight gain in pregnancy = __ - __ lbs

A

20-30

278
Q

Preterm = < ___ weeks

A

37

279
Q

5 postural changes w/ pregnancy ?

A
  1. inc thoracic kyphosis
  2. forward lean in C spine
  3. inc lumbar lordosis
  4. inc breast size
  5. shoulder protraction
280
Q

Pregnancy = decrease in ____ and ____ closure, and pelvic floor is on stretch

A

form; force

281
Q

Pregnancy: incontinence in __% of vaginal deliveries

A

67

282
Q

4 PT antepartum concerns ?

A
  1. antepartum bleed
  2. preterm labor (irritable uterus w/ mini contractions)
  3. ruptured membrane (slow trick of fluid, not water breaking)
  4. incompetence cervix / changes
283
Q

_______ ______ ______ = lateral separation / split of rectus abdominus; separation from midline > ___ cm significant, may be deterred in 2nd trimester

A

diastasis recti abdominus; 2.5

284
Q

3 effects of diastasis rectus abdominis?

A
  1. weak abdominal wall
  2. dec support for back and viscera
  3. related to lumbo pelvic pain
285
Q

5 Rx for diastasis rectus abdominis?

A
  1. education
  2. posture and body mechanics
  3. movement patterns and recruitment strategies
  4. exercises
  5. abdominal binders
286
Q

Recovery for diastasis rectus abdominis = usually __ - __ months

A

2-6

287
Q

CTS / De quervains = usually seen in ___ trimester, d/t increase in ____ and pressure, ______ changes, poor lifting/carrying technique of cobbler or newborn

A

2nd; pressure; hormone

288
Q

4 Rx for CTS/ de quervains due to pregnancy ?

A
  1. education
  2. ice
  3. electrotherapy
  4. stretching
289
Q

______ _______ = S/S include heaviness, dull pain /ache in legs w/ standing and walking, may be incapacitating pain

A

varicose veins

290
Q

5 Rx for varicose veins ?

A
  1. posture
  2. positioning elevation
  3. limit cross legged time
  4. pressure graded stockings / tights / underwear
  5. circulatory exercises
291
Q

3 types of incontinence ?

A
  1. stress
  2. urge
  3. mixed
292
Q

Incontinence: ______ abdominal recruitment w/ ____ intra-abdominal pressure, or strong need to urinate when on way to toilet

A

decreased; increased

293
Q

6 causes of incontinence?

A
  1. injury to connective tissue
  2. damage to pelvic nerves and muscles
  3. direct injury to urinary tract
  4. changes in pelvic floor anatomy
  5. urethral weakness
  6. vaginal relaxation
294
Q

5 Rx for incontinence ?

A
  1. PF exercises
  2. co contraction of TA and PF
  3. posture and body mechanics
  4. urgency techniques
  5. diet changes
295
Q

PF exercise: ___ s holds, __ contractions, __ - __ x a week

A

10;10; 2-3

296
Q

______ diabetes = abnormal blood sugar reading 1st seen during pregnancy; undetected or mismanaged can lead to very high risk to baby and mom!

A

gestational

297
Q

Rx for gestational diabetes may include?

A
  1. team
  2. insulin
  3. diet
  4. exercise *(20 minute walk post meal)
298
Q

Overall Rx for pregnancy: what are 6 things to avoid?

A
  1. valsalva, exercise techniques that stress PF and abdominals
  2. rapid uncontrolled movements
  3. positions of inversion
  4. deep heat modalities or EStim
  5. manual therapy
  6. positioning (prone not well tolerated, supine ok for short periods)
299
Q

3 red flags for reproductive problems ?

A
  1. change in B/B and sexual function
  2. non mechanical LBP
  3. suprapubic of groin pain
300
Q

3 pelvic floor disorders?

A
  1. cystocele
  2. rectocele
  3. uterine prolapse
301
Q

6 S/S of pelvic floor disorders ?

A
  1. increase in symptoms w/ activity / at end of day
  2. pelvic pain
  3. urinary incontinence
  4. pain w/ sexual intercourse
  5. heaviness in saddle region
  6. incomplete B/B emptying
302
Q

Rx for pelvic floor disorders if not resolved after ___ weeks may include what 4 things ?

A

6;

  1. pelvic floor mm exercise
  2. postural re education
  3. pessary
  4. Sx
303
Q

_______ = pregnancy induced acute HTN after 24 weeks gestation

A

pre eclampsia

304
Q

5 S/S of pre eclampsia?

A
  1. HTN
  2. edema
  3. headache
  4. visual disturbance
  5. hyperreflexia
305
Q

Is it safe to use TENS around incision for C section?

A

YES

306
Q

___ degree burn =superficial, erythema appearance

A

1st

307
Q

__ degree burn = partial thickness, blistering appearance

A

2nd

308
Q

__ degree burn = full thickness, necrosis

A

3rd

309
Q

Rule of __ = to determine body surface area involvement. Name the 5 body parts and their SA

A

9’s

  1. head = 9
  2. torso = 36
  3. each arm = 9
  4. each leg = 18
  5. pubic area = 1
310
Q

2 differences for rule of 9’s in kids?

A
  1. head = 18

2. each leg = 14

311
Q

Scarring = only occurs if there is significant damage to the ______

A

dermis

312
Q

3 phases of wound healing ?

A
  1. inflammatory
  2. proliferative
  3. remodelling
313
Q

______ phase = vascular and cellular effects to eliminate the necrotic tissue and deliver materials for healing

A

inflammatory

314
Q

_______ phase = rebuild the dermis and epidermis, fibroplasias and neovascularization that produce granulation tissue (early angiogenesis)

A

proliferative

315
Q

______ phase = wound contract and increases strength, scar

A

remodelling

316
Q

3 classifications for wound healing?

A
  1. acute vs chronic
  2. partial vs full thickness
  3. primary vs secondary
317
Q

3 different zones in a wound ?

A
  1. zone of coagulation
  2. zone of stasis
  3. zone of hyperemia
318
Q

Zone of _______ = point of maximum damage, irreversible tissue loss

A

coagulation

319
Q

Zone of _____ = decreased tissue perfusion, potentially salvageable

A

stasis

320
Q

Zone of _______ = increased perfusion, will recover unless sepsis occurs

A

hyperaemia

321
Q

5 effects of burns on the CV system?

A
  1. inc capillary permeability (interstitial edema)
  2. peripheral vasoconstriction
  3. hypovolemia
  4. myocardial depression (hypotension and decreased organ perfusion)
  5. decreased cardiac output
322
Q

Metabolism can increase up to 3x due to a burn (T/F)

A

TRUE

323
Q

Immune system is compromised due to a burn (T/F)

A

TRUE

324
Q

Burns can lead to bronchoconstriction, ARDS and if there is carbon monoxide exposure it can increase O2 carrying capacity of blood (T/F)

A

FALSE ; CO DECREASES O2 carrying capacity of blood

325
Q

Effects of burns on renal system: due to loss of fluids, = vasoconstriction, ___ in GFR. ____ in myoglobin, gets processed in kidneys and can block tubules

A

decrease; increase

326
Q

6 signs of an inhalation injury?

A
  1. singed eyebrows / nasal hairs / burnt face
  2. black oral / nasal discharge
  3. swollen lips
  4. hoarse voice
  5. abnormal oxygenation
  6. history of being enclosed in a room
327
Q

Inhalation injury process: w/in ___ hours upper airway obstruction / pulmonary edema

A

24

328
Q

Management of inhalation injury may include what 3 things?

A
  1. early mobilization
  2. breathing exercises
  3. postural drainage
329
Q

PT Rx for burn wounds: first 2-3 weeks may include what 4 things?

A
  1. AROM and PROM to maintain range
  2. positioning
  3. edema management
  4. encourage ambulation
330
Q

Scar management is a huge part of PT Rx for burns bc pt can get a scar tissue contracture within __ - ___ days

A

1-4!

331
Q

4 CI’s to exercise w/ burn pts?

A
  1. exposed joint
  2. fresh skin graft
  3. DVT
  4. compartment syndrome
332
Q

____ thickness skin graft uses skin graft, stitched, glued or sutured in place

A

split

333
Q

____ thickness skin graft = skin transplant

A

full

334
Q

Split thickness skin graft = immobilize for __ days

A

5

335
Q

4 Rx for skin grafts?

A
  1. scar massage
  2. sun protection
  3. ROM
  4. pressure garments
336
Q

Post skin graft strengthening can begin in __ - __ weeks

A

3-4

337
Q

Scar from burns: __ - __ weeks = fibroblastic / proliferative

A

0-4

338
Q

Scar from burns: __- __ weeks = early remodelling

A

4-12

339
Q

Scar from burns: __ - __ = late remodelling / maturation

A

12-40

340
Q

4 factors that can influence a scar?

A
  1. age
  2. smoking
  3. type of tissue
  4. nutrition
341
Q

5 modifiable risk factors for wounds / ulcers?

A

Any of …

  1. autonomic dysreflexia
  2. incontinence
  3. smoking
  4. obesity
  5. poor nutrition
  6. comorbidities
  7. depression
342
Q

5 non modifiable risk factors for wounds / ulcers?

A

Any of …

  1. dec sensation
  2. activity and mobility
  3. mm atrophy
  4. completeness of injury
  5. age
  6. hx of previous wounds
  7. inc tissue temp, moisture
  8. spasticity
343
Q

Name 4 areas at risk for wounds in lying

A
  1. occiput
  2. elbow
  3. sacrum/coccyx
  4. heels
344
Q

Name 5 areas at risk for wounds in sitting

A
  1. shoulder blade
  2. sacrum / coccyx
  3. ischial tub
  4. post knee
  5. foot
345
Q

4 causes of ulcers?

A
  1. pressure
  2. shearing
  3. friction
  4. deep tissue damage from banging or bumping
346
Q

Ulcers caused by _____: blisters can be a sign, and spasticity is a common cause

A

friction

347
Q

Stage __ wound: reddened (non blanch able)

A

1

348
Q

Stage __ wound = skin is broke, small crater

A

2

349
Q

Stage __ wound = deep crater might be infected, may be back, dead tissue

A

3

350
Q

Stage __ wound: deep through muscle to the bone or joint

A

4

351
Q

7 ways to describe a wound?

A
  1. location
  2. size
  3. wound base
  4. wound edges
  5. surrounding skin
  6. stage
  7. photos
352
Q

Wounds: red area should disappear after __ - __ minutes

A

20-30

353
Q

2 points to touch on for client education re wound prevention?

A
  1. look at skin 2x a day, check all bony prominences, use a mirror and attendants
  2. look for change in colour, temp, texture, persistent erythema, discolouration
354
Q

Use the _____ scale for Ax of risk of wound

A

Braden

355
Q

Very high evidence for use of _____ for wound healing

A

HVPC!!!

356
Q

_________ = autoimmune disease that affects the skin; faulty signs that speed uptake growth cycle of skin cells

A

psoriasis

357
Q

______ leads to profound cutaneous inflammation and epidermal hyper proliferation

A

psoriasis

358
Q

5 cardinal signs of psoriasis?

A
  1. plaque
  2. well circumscribed margins
  3. bright salmon red colour
  4. silvery micaceous scale
  5. symmetrical distribution
359
Q

1 way to differentiate psoriasis from eczema ?

A

psoriasis is more likely to be found on the OUTER side of the joint

360
Q

Severe psoriasis is associated with risk of CV disease and death (T/F)

A

TRUE

361
Q

5 Rx for psoriasis?

A
  1. topical creams containing glucocorticoids
  2. tars
  3. vit D or A
  4. phototherapy w/ UV light
  5. systemic therapy w/ immunosuppressive drugs
362
Q

______ = form of dermatitis or inflammation of the epidermis; itchy, red, scaly disorder

A

eczema

363
Q

2 types of eczema ?

A
  1. atopic dermatitis

2. contact dermatitis

364
Q

________ dermatitis = intensely itchy skin disorder associated w/ atopy, predisposition towards developing allergic hypersensitivity reactions (asthma, hay fever, and allergic conjunctivitis)

A

atopic

365
Q

Atopic dermatitis is also known as _______ eczema

A

endogenous

366
Q

Presentation of atopic dermatitis (4 points):

A
  1. itchiness***
  2. lichenification (thickening of skin lines)
  3. excoriations (scratching or picking at skin)
  4. crusting
367
Q

3 phases of atopic dermatitis and main points?

A
  1. infantile (facial and extensor distribution)
  2. childhood (dry skin, flexural distribution esp popliteal and cuboid fossa)
  3. adult (generally improves w/ age, primarily affects the hands)
368
Q

5 Rx for atopic dermatitis?

A
  1. avoid irritating factors
  2. moisturizers
  3. topical glucocorticoids
  4. oral antihistamines
  5. UV therapy
369
Q

Contact dermatitis = also known as _______ eczema

A

exogenous

370
Q

______ contact dermatitis = immune hypersensitivity to an allergen in contact w/ the skin

A

allergic

371
Q

______ contact dermatitis = contact of skin w/ something that primarily causes direct local irritation

A

irrtant

372
Q

Rx for contact dermatitis?

A

usually topical steroids, clears up in 7 - 10 days

373
Q

Seborrheic dermatitis = occurs in areas of high _______ gland activity, probably due to an excessive immune response to a _____

A

sebaceous; yeast

374
Q

3 associated disorders w/ seborrheic dermatitis ?

A
  1. PD
  2. neurological Dx
  3. HIV pts
    … aka things that dec mobility
375
Q

Rx for seborrheic dermatitis?

A

antifungals

376
Q

3 main function of the livers?

A
  1. producing ALBUMIN
  2. producing CLOTTING factors
  3. ammonia metabolism
377
Q

Albumin has a large role in ______ transmission

A

fluid

378
Q

5 S/S of hepatitis ?

A
  1. yellow
  2. itching
  3. big belly (ascites)
  4. bleeding
  5. esophageal varices
379
Q

Hep ___ = virus transmitted by fecal oral route, usually self limited bout; risk facts = international travel and daycare

A

A

380
Q

7 S/S of Hep A ?

A
  1. jaundice
  2. fatigue
  3. weakness
  4. anorexia
  5. nausea
  6. vomiting
  7. abdominal pain
381
Q

Children w/ Hep A are often symptomatic (T/F)

A

FASLE ; usually asymptomatic

382
Q

Hep __ = infection of liver, can persist and become chronic, long standing can lead to cirrhosis and hepatocellular carcinoma

A

B

383
Q

Example of high risk spread of Hep B?

A

mother to child

384
Q

Example of low risk spread of Hep B?

A

sexual transmutation and injection drug use

385
Q

Is there a cure for Hep B?

A

NO

386
Q

3 ways to transmit Hep C?

A
  1. percutaneous (needle stick)
  2. non percutaneous (sexual)
  3. hemodialysis
387
Q

Hep C has a ______ risk of turning chronic from acute compared to Hep B , can take decades for chronic complications to occur

A

HIGHER

388
Q

2 Rx fo Hep C?

A
  1. interferon

2. antiviral agents

389
Q

_____ disease = hyperthyroidism, autoantibodies stimulate the thyroid (TSH receptor)

A

Graves

390
Q

T3 and T4 _____ the secretion of TSH

A

inhibit!

391
Q

Will T3 and T4 be high or low in Grave’s disease?

A

HIGH

392
Q

7 S/S of Graves disease?

A
  1. fever
  2. weight loss
  3. exercise intolerance
  4. goiter
  5. bulging eyes
  6. tachycardia
  7. decreased fertility
393
Q

Bulging eyes seen in Graves disease = _______

A

exophthalmos

394
Q

4 Rx for Graves disease?

A
  1. beta blockers for HR
  2. anti-thyroid drug therapy
  3. radioactive iodine
  4. surgical removal of thyroid
395
Q

_________ thyroiditis = hypothryrodism; autoimmune destruction of the thyroid gland

A

hashimoto

396
Q

In Hashimotos, T3 and T4 are ___ and TSH is ___

A

LOW; HIGH

397
Q

6 S/S of hashimotos

A
  1. weight gain
  2. cold intolerance
  3. round puffy face
  4. bradycardia
  5. constipation
  6. depression
398
Q

Rx for hashimotos?

A

thyroid hormon replacement

399
Q

_________ disease = autoimmune process against the adrenal cortex, FATAL if not treated, great prognosis if treated

A

Addison’s

400
Q

6 S/S of Addison’s disease?

A
  1. weakness
  2. fatigue
  3. anorexia
  4. hyponatremia
  5. hypoglycaemia
  6. hyperpigmentation
401
Q

Rx for Addisons disease = replace missing adrenal hormone with _____ and _____

A

aldosterone; cortisol

402
Q

______ disease = chronic glucocorticoid (cortisol) excess; can get from cancer of the adrenal gland

A

Cushing’s

403
Q

3 S/S of Cushing’s disease ?

A
  1. moon face
  2. central obesity
  3. abdominal striations
404
Q

_______ disease: affects the entire GI tract from mouth to anus, small and large intestines

A

Chrons

405
Q

Chron’s disease: can have skipped lesions (normal segments) T/F

A

TRUE

406
Q

Chron’s disease: ulcers, fissue and fistulas, get alterations in digestion and absorption = ________

A

malnutrition

407
Q

4 Rx for Chron’s disease?

A
  1. anti-inflammatory drugs for bowl
  2. prednisone
  3. anti-biotics
  4. biologic therapies
408
Q

_____ ______ = same as Chron’s but no skipped lesions

A

Ulcerative colitis

409
Q

Ulcerative colitis only affects the _____

A

Colon

410
Q

Ulcerative colitis: can have significant ______ and ______

A

bleeding; anemia

411
Q

______ tumor = carcinoma

A

epithelial

412
Q

_______ tumor = sacroma

A

mesenchymal

413
Q

_______ tumor = glioma

A

glial

414
Q

_______ tumour = lymphoma

A

lymphoid

415
Q

_______ tumor = leukemia

A

hematopoietic

416
Q

________ tumor = melanoma

A

melanocytic

417
Q

TMN staging for tumors?

A
  1. tumour (extent / spread)
  2. nodes
  3. met (distant / local)
418
Q

6 aspects of the clinical presentation of cancer survivors?

A
  1. fatigue
  2. myalgia
  3. arthralgia
  4. bone health
  5. peripheral neuropathy
  6. deconditioned
419
Q

____ ____ lung cancer = 20-25% develop into bronchial cell mucosa, spread rapid and met early

A

small cell

420
Q

_____ lung cancer (non small cell) = slow speed, arises in central portion near hilum, mets late

A

squamous

421
Q

_________ lung cancer (non small cell) = 30-40% slow to mod spread, early mets through lungs. brains and other organs

A

adenocarcinoma

422
Q

____ ____ lung cancer = rapid spread, wide spread mets, kidney, liver adrenals and other organs so poor prognosis

A

large cell

423
Q

Brain tumor = __ cause of death in brain, __ % survival rate

A

2nd; 50

424
Q

_______ _______ brain tumor = from lung, breast, prostate, compensate by decreasing brain tissue, CSF and blood flow volume

A

Intracerebral metastatic

425
Q

_____ ______ brain tumor = nerve root pain, worst at night, cough , radicular pain, Rx = surgery or radiation

A

intra spinal

426
Q

_____ _____ ________ brain tumor = benign, good survival if treated early

A

low grade astrocytoma

427
Q

________ brain tumor = frequent mets to other areas of brain / spine

A

medulloblastoma

428
Q

________ brain tumor = schwannoma; CN 8; headaches, seizure, nausea, vomiting, cognition and behaviour changes

A

neuromas

429
Q

_________ tumor = end of long bones, produces pain, Xray will show moth eaten appearance, usually secondary primary is rare (may occur in youth), treatment = Sx

A

osteosarcoma

430
Q

______ ______ tumor = usually in larger joints, = swelling and instability, treatment = surgery +/- radiation and chemo

A

synovial sarcoma

431
Q

_______ ______ tumor = benign tumor, exercise related bone pain and tenderness, abolition of symptoms w/ ASPIRIN, Tx = ablation, ethanol or laser

A

osteoid osteoma

432
Q

________ cancer = in men > 50, treatment = Sx, external beam radiation, brachytherapy, androgen deprivation therapy

A

prostate

433
Q

____ ______ carcinoma = most common form of skin cancer, low risk of spreading, translucent and red in colour

A

basal cell

434
Q

_____ _____ carcinoma = solid skin tumour, often volcano shaped, HIGH risk for mets

A

squamous cell

435
Q

_________ ______ = most dangerous, HIGH potential for mets

A

malignant melanoma

436
Q

ABCD rule for melanoma?

A 
A = asymmetry 
B = border
C = colour
D = diameter

Written Prep (9 decks)

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