Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTRS 746 Exam 1 Combined and Randomized > Osteoporosis&Foot Neuropathy > Flashcards

Osteoporosis&Foot Neuropathy Flashcards

1
Q

Q: What T-score indicates osteoporosis?

A

< -2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Content: Life choices and bone health (5)

A
  1. Adequate Ca intake (~1200 mg/day)
  2. Optimal Vit D levels
  3. WB exercise
  4. Avoid tobacco use
  5. Avoid excessive alcohol use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Content: Foot Care Education (6)

A
  1. Check feet daily
  2. ALWAYS wear shoes
  3. No lotion/oil between toes
  4. Keep nails clipped
  5. Manage calluses
  6. Report changes immediately
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagram: Mechanism of Action of Bisphosphonates - Osteoclasts are targets

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Content: Side Effects of Bisphosphonates (6)

A
  1. Upper GI irritation
  2. Osteonecrosis of the jaw
  3. Severe musculoskeletal pain
  4. HypoCa
  5. Scleritis
  6. Atypical femur fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Content: Foot Examination (3)

A
  1. comprehensive foot exam should be completed at LEAST annually
  2. those with neuropathy should have feet visualized every medical visit
  3. those with diabetes should check their feet each day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Q: Osteoporosis is a problem of _________ peak bone _____ and _____________ bone _____.

A

decreased, mass, increased, loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Q: What does FRAX calculate?

A

10 year fracture risk, for things like hip fracture and osteoporosis fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Content: Secondary Evaluation of Osteoporosis (7)

A
  1. Comprehensive metabolic panel
  2. CBC
  3. 24 hour urine for Ca, creatinine, Na
  4. 25-Hydroxy Vit D
  5. TSH
  6. SPEP/UPEP if anemic
  7. PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Q: What calcium supplements are available?

A
  1. Calcium carbonate
  2. Calcium citrate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Content: 3 ways to define osteoporosis.

A
  1. Microarchitectural deterioration of bone tissue leading to decreased bone mass
  2. Bone fragility
  3. Susceptibility to fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Content: Four neuropathy deformities (4)

A
  1. Prominent metatarsal heads
  2. Hammer/claw toes
  3. Hallux Valgus/bunions
  4. Charcot Foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: High impact WB exercise increased BMD by 1-2% at the spine and hip.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Q: What is the recommendation for exercise to prevent osteoporosis?

A

30 min, most days of running, walking, or elliptical + muscle stregnthening and balance exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Q: What are pharmacologica treatment options for low bone mass? (4)

A
  1. Bisphosphonate
  2. Teriparatide
  3. Denosumab
  4. Selective Estrogen Receptor Modulators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Content: Teriparatide (2)

A
  1. Anabolic (bone building agent)
  2. Daily injection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Q: What 3 pulses should you check during a foot exam?

A
  1. Posterior tibilais
  2. Dorsal pedis
  3. Ankle brachial index (ABI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Q: _________ involvement in foot neuropathy is __________.

A

Early, crucial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Content: Calcium carbonate (2)

A
  1. Needs stomach acid for absorption
  2. Taken with meals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagram: Vit D formation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Content: Skin (3)

A
  1. Think, shiny, brawny and/or frail
  2. Dry
  3. Calluses/wounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diagram: Identify the Deformity

A

Upper = corn

Lower = callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Defn: Claw toe

A

Hyper extension of MTP with PIP/DIP flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Q: How do you assess fall risk?

A

TUG - Timed get up and go

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Q: What medications put you at high risk for osteoporosis? (3)

A
  1. Steroids
  2. Aromatase inhibitors
  3. Androgen deprivation therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Q: What are the mortality rates 1 and 5 years after amputation?

A

40%, 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Q: What is FRAX?

A

Fracture Risk Assessment Tool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Q: When does bone mass begin to decline?

A

Around 50 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Content: Charcot Arthropathy (4)

A
  1. Progressive bone destruction and ligament damage leading to arch colllapse and impaired skin integrity
  2. Affects abot 9% of those with diabetes
  3. Unclear if etiology is neurotraumatic, neurovascular, or both
  4. Generally treated with complete immbolizations in a total contact cast with protected WB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Q: How many million individuals in the US are affected by osteoporosis?

A

10 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Content: Exercise recommendations for foot neuropathy

A

At least 30 min most days - consider foot integrity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Content: Vitamin D supplementation (5)

A
  1. Vit D2 - ergocalciferol
  2. Vit D3 - cholecalciferol
  3. supplementation guided by 250HD value
  4. Can be taken with or without food
  5. Safe upper limite = 2,000IU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Content: Assessment - Low Risk Foot Neuropathy (4)

A
  1. Preserved sensation
  2. No defromity
  3. Intact circulation

4 Tx: Annual foot exam, education, good footwear

28
Q

T/F: For every standard deviation below the norm, the risk of fractures triples.

A

False: doubles

29
Q

Content: Goals of the foot exam (4)

A
  1. Est. history/diagnostic factors
  2. Identify risks
  3. Intervention
  4. Education
30
Q

Content: Assessment - High Risk Foot Neuropathy (6)

A
  1. Sensory loss
  2. Deformity
  3. Vascular disease
  4. Callus formation
  5. Hx of ulcer or amputation
  6. Tx: comprehensive assessment, education, diabetic shoe
30
Q

Content: Education (4)

A
  1. General diabetes self care
  2. Foot/skin care
  3. Daily skin checks
  4. Proper footwear (breathable, adjustable, wide toe box, good support)
31
Q

Diagram: Identify the Deformity

32
Q

Q: What habit can increase your risk of neuropathy?

A

smoking (current or past)

33
Q

Content: Risk factors for Osteoporosis (10 - general idea)

A
  1. Genetics
  2. Low Ca intake
  3. Low vitamin D stores
  4. Tobacco and alcohol us
  5. Prior history of fracture
  6. Medications
  7. Malabsorpation
  8. Excessive urinary calcium
  9. Overactive thyroid gland
  10. Other medical conditions
34
Q

Content: Sensation assessment (2)

A
  1. Semmes Weinstein Monofilament (10 locations)
  2. Vibratory sensation (128 Hz tuning fork, latency > 10 sec = sensory loss)
35
Q

Diagram: Identify the Deformity

A

Hammer toe

37
Q

Content: Types of Bisphosphonates (4)

A
  1. Alendronate -wkly
  2. Risedronate - wkly/moly
  3. Ibandronate - moly/IV every 3 mo
  4. Zolendronic Acid - IV annually
38
Q

T/F: Neuropathy is implicated in 25% of non-traumatic amputations.

A

False, 50-75%

39
Q

Content: Toenails (3)

A
  1. Thickened
  2. Deformed
  3. Ingrown
41
Q

Content: Primary Osteoporosis (2)

A
  1. unrelated to chronic illness
  2. Related to aging and decreased gonadal function
41
Q

Q: What is HbA1c?

A

Average blood sugar over a peroid of 3 months

42
Q

Defn: Hammer toe

A

Hyperextension of MTP and DIP

43
Q

Content: glycemic control recommendations for foot neuropathy

A

HbA1c goal of < 6.5-7

44
Q

Q: When does bone mass peak?

A

Between 20-25 yo

45
Q

Q: What type of training increased spine BMD?

A

Resistance

46
Q

Content: Causes of neuropathy (6)

A
  1. Diabetes
  2. Tumor, trauma
  3. Autoimmune disease
  4. Vitamin B, E, niacin deficiency
  5. Exposure to toxins
  6. Infection
47
Q

Content: OE for foot neuropathy (5)

A
  1. Condition of skin, hair, toenails
  2. Deformities
  3. Pulses
  4. Sensation
  5. Shoe wear
48
Q

Diagram: Identify the Deformity

A

Hallux Valgus

49
Q

Content: Nutrition recommendations for foot neuropathy (4)

A
  1. Montior BMI - stable or weight loss
  2. Fresh fruits/veggies
  3. Pre meal glucose 90-130 mg/dl
  4. Post meal glucose 180 mg/dl
51
Q

Q: What imaging is often used to identify osteoporosis?

51
Q

Q: For bone health how often should bone density be evaluated?

A

On treatment = every 1-2 years

Not on treatment = every 2 years

53
Q

Defn: Z-score

A

number of standard deviations from age matched mean density

55
Q

Content: TUG (5)

A
  1. Stand from a seated position
  2. Walk ~10 ft
  3. Turn around
  4. Return to seated position in chair
  5. Normal time < 10 seconds
56
Q

Content: Offloading (5)

A
  1. Total contact casts (change ever 1-2 wks)
  2. Orthotics/walking boots
  3. Surgical shoes
  4. Dressings
  5. Cutouts
57
Q

Q: How should you elevate a pts. heels?

A

With pillow under calves

59
Q

Content: SE for foot neuropathy (7)

A
  1. Contributing diagnosis
  2. PMH/social factors
  3. Medications
  4. Complications
  5. Hx of LE surgery, ulcer, amputation
  6. Current or past smoker
  7. HbA1c (diabetes)
60
Q

Content: Ulcer intervention (4)

A
  1. Debulk callus
  2. Control moisture
  3. Decrease infection risk
  4. Edema management
62
Q

T/F: WB activities decrease BMD.

64
Q

Q: What T-score indicated osteopenia?

A

-1 to -2.5

65
Q

Q: What is BMD?

A

Body mass density - comes from a DEXA test

66
Q

Q: How much Ca is in 8 oz of milk?

67
Q

Cotent: ABI Scale (6 parts)

A

> 1.2 = vessels are incompressible, consider toe brachial indexes

  1. 0-1.2 = normal
  2. 9-0.99 = acceptable

< 0.9 = arterial disease

0.5-0.8 = intermittent claudication

< 0.5 = severe arterial disease

68
Q

Defn: T-score

A

number of standard deviations from the young adult mean density

69
Q

Content: Hair

A

May be present or absent

70
Q

T/F: FRAX is the treatment decision making tool in previously treated pts.

A

False, untreated

71
Q

T/F: Menstraul cycle effects gains in BMD.

72
Q

Q: When does the z-score apply for osteoporosis?

A

pre-menopausal females and males < 50

73
Q

Content: Calcium citrate

A

Can be taken with or without food

74
Q

Content: Calcium supplements (2)

A
  1. Limit to ~500 mg in a dose
  2. May cause constipation
75
Q

Q: Who will be referred to PT for osteoporosis type treatment?

A

Those at increased risk or fall, unstable gait, weakness

76
Q

Q: What % of those with diabetes will develop neuropathy?

77
Q

Q: What type of training increased hip BMD?

A

high impact

78
Q

Content: Secondary osteoporosis (2)

A
  1. Secondary to chronic illnesses/meds that cause accelerated bone loss
  2. Ex. glucocorticoid use, hyperthyroidism
80
Q

Content: 4 types of neuropathy

A
  1. Peripheral - UE/LE
  2. Autonomic - CVS, temp reg, bowel/bladder
  3. Proximal - thigh, hip, core mm
  4. Focal - sudden loss in one n. or group of n.
81
Q

Q: Who could you refer pts. with foot neuropathy to? (4)

A
  1. Podiatry
  2. Wound care
  3. Nurse educator
  4. Dietician
82
Q

Content: Denosumab (3)

A
  1. Inhibits osteoclast function
  2. Decreases bone resorption
  3. Consider in pts. with kidney dysfunction

PTRS 746 Exam 1 Combined and Randomized (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions