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Ortho Lec > ORS 3 Midterms > Flashcards

ORS 3 Midterms Flashcards

1
Q

primary cause of osteoporosis

A

menopause

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2
Q

secondary cause of osteoporosis

A

glucocorticoid use

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3
Q

modifiable risk factors of osteoporosis

A

sedentary lifestyle
smoking
drinking
low vit. D intake
low calcium intake

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4
Q

non-modifiable risk factors of osteoporosis

A

race (caucasian)
previous family hx
premature menopause

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5
Q

treatments for osteoporosis

A

alendronic acid
bisphosphonates
hormonal replacement

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6
Q

normal T score

A

within 1.0

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7
Q

T score of people with osteopenia

A

between 1-2.5

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8
Q

T score of people with osteoporosis

A

> 2.5

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9
Q

T score of people with severe or established osteoporosis

A

> 2.5 with fracture

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10
Q

medication risk factors for osteoporosis

A

Phenytoin therapy
Omeprazole
Glucocorticoids
Vitamin A

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11
Q

indications of increased serum calcium

A

primary hyperparathyroidism or other causes of hypercalcemia

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12
Q

indications of decreased serum calcium

A

secondary hyperparathyroidism
malabsorption

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13
Q

indications of decreased serum phosphate

A

secondary hyperparathyroidism
malabsorption

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14
Q

indications of increased serum alkaline phosphate

A

osteomalacia

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15
Q

indications of increased serum creatinine

A

renal osteopathy

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16
Q

adverse effects of bisphosphonates

A

mild upper GI symptoms

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17
Q

> -2.5 BMD score in men

A

osteoporosis

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18
Q

-1.5 to -2.5 BMD score in men

A

reduced bone density

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19
Q

there is a defect in bone mineralization

A

osteomalacia

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20
Q

minerals that are low in osteomalacia

A

vit. D
calcium
phosphorus

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21
Q

S/Sx of osteomalacia

A

periarticular tenderness
easily fatigue
Looser’s zone (thru X-ray - pseudofractures)

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22
Q

treatment for osteomalacia

A

Vit. D replacement
calcium supplements
sunlight exposure

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23
Q

causes of osteomalacia

A

low vit. D
hypophosphatemia

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24
Q

tumor-induced osteomalacia

A

hypophosphatemia

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25
Q

prevalence of primary hyperparathyroidism

A

F>M (3:1)

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26
Q

hyperparathyroidism results in

A

loss of bone mass in sites rich in cortical bone

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27
Q

how is primary hyperparathyroidism diagnosed?

A

increased levels of serum calcium

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28
Q

causes of secondary hyperparathyroidism

A

vit. D deficiency
low dietary Ca+
loop diuretic theray
renal insuficiency

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29
Q

treatment for secondary hyperparathyroidism

A

Ca+ supplements
vit. D replacements

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30
Q

brittle bone disease

A

Osteogenesis Imperfecta

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31
Q

what is impaired in OI?

A

inability to quantitatively or qualitatively form collagen

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32
Q

what type of collagen is affected in OI?

A

type I collagen

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33
Q

S/Sx of OI

A

childhood fractures
deafness in adulthood
blue sclera

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34
Q

mild manifestations of OI

A

easily sweating
easy bruising
generalized laxity

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35
Q

basal angle landmarks

A

nasion with the center of the pituitary fossa
anterior border of the foramen magnum with the center of the pituitary fossa

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36
Q

normal basal angle

A

125-143 degrees

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37
Q

platybasia angle

A

> 143 degrees

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38
Q

basilar kyphosis angle

A

<125 degrees

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39
Q

treatment for OI

A

bisphosphonates
teriparatide
gonadal hormones

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40
Q

inheritance of type 1 OI

A

X-linked

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41
Q

characteristics of type 1 OI

A

mild and most common
bones break from mild to mod trauma
most broken bones occur before puberty
normal collagen structure but less than normal is produced

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42
Q

characteristics of type 2 OI

A

most severe
causes death shortly after birth
improperly formed collagen

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43
Q

characteristics of type 3 OI

A

most severe type for those who survive the neonatal period
presents with severe physical disabilities

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44
Q

characteristics of type 4 OI

A

bones break easily
first bone break occurs before puberty
mild to moderate bone deformity

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45
Q

presence of numerous bone breaks at birth

A

OI congenita

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46
Q

presence of bone fractures soon after birth

A

OI tarda

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47
Q

type of OI congenita that is compatible with life

A

Congenita B

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48
Q

type of OI congenita that is incompatible with life

A

Congenita A

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49
Q

type of OI tarda wherein fractures occur before walking

A

Tarda A

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50
Q

type of OI tarda wherein fractures occur after walking

A

Tarda B

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51
Q

cause of blue sclera

A

thinness and transparency of the collagen fibers of the sclera

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52
Q

blue sclera is commonly associated with

A

OI
iron deficiency anemia

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53
Q

cause of hyperthyroidism

A

iatrogenic - overuse of thyroid supplements

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54
Q

proptosis or bulging eyes

A

exophthalmos

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55
Q

causes of exophthalmos

A

extension of inflammation into the orbit
invasion of the orbit by new growth
foreign matter being forced into the orbit

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56
Q

cause of exophthalmos in children

A

orbital cellulitis

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57
Q

cause of exophthalmos in adults

A

thyroid-associated diseases (graves disease ophthalmopathy)

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58
Q

glucocorticoid treatment of inflammatory bowel disease results in

A

calcium and vit. D malabsorption

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59
Q

1st biliary cirrhosis manifests in bone as

A

osteomalacia
osteoporosis

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60
Q

Post-gastrectomy manifests in the bone as

A

osteoporosis

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61
Q

Avascular necrosis

A

Osteonecrosis

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62
Q

osteonecrosis primarily affects

A

weight-bearing joints

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63
Q

S/Sx of osteonecrosis

A

joint-motion induced pain

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64
Q

prevalence of osteonecrosis

A

M>F

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65
Q

A degeneration followed by reossification of non-fused epiphyses

A

osteochondrosis

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66
Q

traumatic causes of osteochondrosis

A

post-ORIF femoral neck fracture

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67
Q

atraumatic causes of osteochondrosis

A

steroids
SLE
sickle cell dse
pregnancy
hyperlipidemia

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68
Q

how is osteonecrosis diagnosed through x-ray?

A

donut lesion

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69
Q

a destructive joint disorder initiated by trauma to a neuropathic extremity

A

Charcot neuropathic osteoarthropathy

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70
Q

most common etiology of charcot neuropathic osteoarthropathy

A

diabetic neuropathy

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71
Q

two types of charcot

A

neuro-traumatic
neurovascular

72
Q

neuropathy and repeated microtrauma produce joint destruction.

A

neuro-traumatic theory

73
Q

Increased peripheral blood flow results in osteolysis and demineralization.

A

neurovascular theory

74
Q

clinical manifestation of CNO

A

erythematous foot with edema and calor

75
Q

treatment for acute CNO

A

immobilize the foot and restrict WB

76
Q

Pre-charcot/Prodromal stage

A

CNO stage 0

77
Q

CM of CNO stage 0

A

red, hot swollen foot

78
Q

Development/destruction stage

A

CNO stage 1

79
Q

CM of CNO stage 1

A

erythema
foot edema
elevated temperature
no pain
bony debris at joints

80
Q

coalescence stage

A

CNO stage 2

81
Q

CM of CNO stage 2

A

decreased inflammation
new bone formation
coalescence of large fragments
increased stability

82
Q

consolidation stage 3

A

CNO stage 3

83
Q

CM of CNO stage 3

A

resolution of inflammation
changes in foot architecture

84
Q

most common site of CNO

A

tarsometatarsal joints (40%)

85
Q

least common site of CNO

A

calcaneus (5%)

86
Q

DM results in

A

increased bone resorption

87
Q

characterized by a combination of clinical findings of severe disabling arthralgia and arthritis, digital clubbing, and periostitis of tubular bones, with or without synovial effusion.

A

Hypertrophic Osteoarthropathy

88
Q

primary HOA is caused by

A

Pachydermoperiostosis

89
Q

secondary HOA is caused by

A

hypertrophic pulmonary ostearthropathy

90
Q

what causes sickle-shaped RBC?

A

Hemoglobin S

91
Q

Avascular necrosis of the Lunate

A

Kienbock’s

92
Q

Avascular necrosis of the Navicular

A

Kohler’s

93
Q

Avascular necrosis of the vertebral

A

Kummel’s

94
Q

Hyperkyphosis involving the discs and its anterior wedging of equal or more than 5 degrees in 3 or more adjacent vertebral bodies

A

Scheurman’s

95
Q

Avascular necrosis of the femoral head epiphysis

A

Legg-Calve-Perthes dse

96
Q

Avascular necrosis of the metatarsal head

A

Freiberg’s

97
Q

Most commonly affected in Freiberg’s

A

2nd MTT

98
Q

Spontaneous osteonecrosis of the knee

A

SONK or Ahlback dse

99
Q

Avascular necrosis of the humeral head

A

Hass’ dse

100
Q

Avascular necrosis of the talus

A

Dias dse

101
Q

Avascular necrosis of the medial epicondyle

A

Adams dse

102
Q

Avascular necrosis of the radial epiphysis

A

Madelung dse

103
Q

Avascular necrosis of the calcaneus

A

Sever

104
Q

Avascular necrosis of the distal pole of the patella

A

Sinding-Larsen-Johansson dse

105
Q

Avascular necrosis of the phalangeal epiphysis

A

Theeman dse

106
Q

Avascular necrosis of the scaphoid

A

Preiser dse

107
Q

Avascular necrosis of the vertebral end plates

A

Scheurmann’s dse

108
Q

Idiopathic avascular necrosis of the femoral head in adult

A

Chandler dse

109
Q

Avascular necrosis of the medial malleolus

A

Breck dse

110
Q

a destructive joint disorder initiated by trauma to a neuropathic extremity

A

Charcot neuropathic Osteoarthropathy

111
Q

Clinical findings in a pt with Hypertrophic Osteoarthropathy

A

Severe disabling arthralgia
Arthritis
Digital clubbing
Periostosis of tubular bones

112
Q

Sickle cell disease is characterized by

A

Osteonecrosis
Osteomyelitis
Arthritis

113
Q

most common form of joint infection in sickle cell disease.

A

Osteomyelitis

114
Q

An acute vaso-occlusive complication characterized by pain and edema in both hands and feet, frequently with increased local temperature and erythema.

A

Dactylitis

115
Q

Another name for Dactylitis

A

Hand-foot syndrome

116
Q

Most common site of joint bleeding

A

Knees
Elbows
Ankles

117
Q

What does recurrent joint bleeding cause?

A

Proliferation and inflammation (Hemophilic Synovitis)

118
Q

Protrusion of one or both eyes anteriorly out of the orbit

A

Exopthalmos

119
Q

Cause of expothalmus

A

Increase in orbital contents

120
Q

Sclera composition

A

Collagen (types I-VIII)
Elastin
Proteoglycans
Glycoproteins

121
Q

Factor I

A

Fibrinogen

122
Q

Factor II

A

Prothrombin

123
Q

Factor III

A

Thromboplastin

124
Q

Factor IV

A

Calcium

125
Q

Factor V

A

Labile

126
Q

Factor VII

A

Stable

127
Q

Factor VIII

A

Anti-hemolitic factor A

128
Q

Factor IX

A

Anti-hemolitic factor B/Christmas

129
Q

Factor X

A

Stuart

130
Q

Factor XI

A

Factor C

131
Q

Factor XII

A

Hageman/Factor D

132
Q

Factor XIII

A

Fallen

133
Q

A glycoprotein crucial to primary hemostasis

A

Von Willebrand Factor

134
Q

Diseases associated with Von Willebrand Factor

A

Von Willebrand dse
Thrombotic Thromobocytopenic purpura
Bernard-Soulier syndrome

135
Q

Functions of connective tissue

A

Connect, support, and help bind other tissues

136
Q

Two primary types of connective tissue are

A

Connective tissue proper
Specialized connective tissue

137
Q

Sub types of connective tisue proper

A

Dense
Loose

138
Q

Examples of specialized connective tissue

A

Adipose
Cartilage
Bone
Blood
Reticular tissues

139
Q

Pathogenesis of Hemochromatosis

A

Substitution of tyrosine for cysteine resulting in increased intestinal absorption leading to iron overload

140
Q

Joints most commonly affected in Hemochromatosis

A

MCP
RC jt
Ankles
Hips
Elbows
Knees
Shoulders

141
Q

Common s/sx in hemochromatosis

A

Fatigue
Arthralgias

142
Q

Bronze diabetes

A

Hemochromatosis

143
Q

High index of suspicion for hemochromatosis

A

Long-standing unexplained jt pain or OA in pts younger than 55 y/o

144
Q

Dx for Hemochromatosis

A

Serum Iron
Serum Ferritin

145
Q

Another name for Wilson’s dse

A

Hepatolenticular degeneration

146
Q

Cause of Wilson’s

A

Mutation in copper-transporting ATPase

147
Q

Neurologic manifesations of Wilson’s

A

Dysarthria
Dystonia
Tremors

148
Q

S/Sx of Wilson’s

A

Joint pain and stiffness in knees, wrists or other large joints

149
Q

Distinguishing clinical feature of Wilson’s

A

Kayser-fleischer rings

150
Q

a rare autosomal recessive disorder of homogentisic acid metabolism caused by a deficiency of homogentisic acid oxidase

A

Alkaptonuria

151
Q

Cause of Alkpatonuria

A

Deficiency in homogentistic acid oxidase

152
Q

1st s/sx in childhood of Alkpatonuria

A

Darkened or black urine

153
Q

Clinical manifestations of Alkaptonuria in aging people

A

Back pain
Valve stenosis
Coronary a. calcificiation
Nephrolithiasis

154
Q

Where can degeneration be found in pts w Alkaptonuria

A

Lumbar spine
IVD

155
Q

Tx for Alkaptonuria

A

Vit C
Portein restriction
Jt replacement

156
Q

A heterogenous group of diseases characterized by deposition of plasma proteins in an abnormal, insoluble, fibrillar form

A

Amyloidosis

157
Q

Most common presentation of Amyloidosis

A

Congo red stain

158
Q

A type of amyloidosis that affects organs and tissues

A

AL amyloidosis

159
Q

Secondary amyloidosis

A

AA amyloidosis

160
Q

Most common organ affected by AA amyloidosis

A

Kidneys

161
Q

Poorly understood disease of non caseating granuloma development, typically in the lungs and lymph nodes

A

Sarcoidosis

162
Q

Msk S/Sx of Sarcoidosis

A

Inflammatory Arthritis
Tenosynovitis
Dactylitis
Myopathy

163
Q

A type of Sarcoidosis that presents with bilat hilar adenopathy with acute erythema nodusm

A

Lofgren’s syndrome

164
Q

Tx for Sarcoidosis

A

NSAIDS
Steroids
Colchicine
Immunosuppressants

165
Q

An autoimmune diseases that predominantly affects female pts aging 20-30

A

Systemic Lupus Erythematosus

166
Q

Cause of SLE

A

Lupus antibodies

167
Q

Organ manifesations of SLE

A

Nephritis
Hematologic
Serositis
Neurologic
Cutaneous

168
Q

ACR classification criteria

A

Malar rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Serositis
Renal d/o
Neurologic d/o
Hematologic d/o

169
Q

How many symptoms in the ACR classification must there be to diagnose SLE

A

4/11

170
Q

An exaggerated vasospastic response to cold temperature or emotional stress

A

Raynaud’s phenomenon

171
Q

Pathogenesis of Raynaud’s phenomenon

A

Vasoconstriction leads to reactive hyperemia

172
Q

an autoimmune disorder that affects the skin and internal organs.

A

Systemic sclerosis

173
Q

Prevalence of Systemic Sclerosis

A

Among people aged 30-50 y/o

174
Q

Pathogenesis of Systemic Sclerosis

A

Excessive deposition of collagen
Non-inflammatory Vasculopathy
Alterations in cellular and humoral immunity

175
Q

Cause of primary vasculitis

A

Idiopathic

176
Q

Cause of secondary vasculitis

A

Infection
Drug
Toxin
Inflammatory d/o
Cancer

177
Q
A

Ortho Lec (2 decks)

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