PBLs + readings Flashcards

1
Q

what are the risk factors assciated with skin tears?

A
  • hx. skin tears
  • age, gender
  • dry/fragile skin
  • med e.g. steroids
  • echmoses (bruising/discolouration of skin caused by leaky BVs as a result of trauma to BVs)
  • impaired mobility or vision
  • poor nutrition and hydration
  • cognitive or sensory impairement
  • comorbidities that compromise vascularity and skin status
  • ability to self care
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2
Q

function of the skin?

A
  • thermo-reg
  • homeostasis
    -vit. D
    protection
  • sensation
  • sweat
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3
Q

outline the classification of skin tears

A

1: skin tear without loss of tissue. epidermal flap covers it mostly. A= white B= dark
2: skin tears with partial tissue loss: edges cant be realigned to normal position. a= white B= darkened
3: skin tear where skin flap is completely absent

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4
Q

outline the key principles for management of the wound

A
  • assess and document the wound
  • classify
  • manage using an appropriate dressing
  • prevent further trauma
  • control bleed
  • clean wound
  • approximate skin flap
  • apply dressing
  • review and reassess
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5
Q

what are some things we should consider RE: skin tears

A
  • oedema: if its over an area of oedema there will be more exudate
  • pain
  • infection
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6
Q

when do we refer a skin tear?

A

when the skin tear is full thickness skin injury or infected

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7
Q

outline the stages of wound healing?

A

hemostasis, inflammation, proliferation, remodelling

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8
Q

what is angiogenesis?

A

formation of new BVs (capillaries)

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9
Q

what can lead to impaired wound healing?

A
  • -oxygenation
  • infection
  • foreign body
  • venous insufficiency
  • age/gender
  • hormones
  • stress
  • obesity
  • other comorbidities e.g. diabetes, healing disorders
  • meds : glucocorticoid steroids, NSAIDs, chemo
  • alcohol/smoking
  • immunocompromised conditions: cancer/radiation therapy, AIDS
  • nutrition
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10
Q

what is recommended therapeutic range of INR with warfarin? (approx.)

A

2-3

or 2.5-3.5 depending on condition

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11
Q

risk factors for DVT:

A
  • immob: hospo/surg/long haul travel
  • recently ocmmenced oestrogen therapy
  • intravascular device (e.g. venous catheter)
  • chemo, leg paralysis, oestrogen therapy,
  • hx.
  • inherited conditions e.g. natural anticoagulant deficiency
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12
Q

signs of DVT:

A
  • pitting oedema (greater in asx. leg)

- T-score

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13
Q

what is pathogenesis of osteoporosis?

A

rate of bone resorption exceeds rate of bone formation

  • decrease in bone mass esp. trabeculae
  • lack of oestrogen causes the level of cytokines to rise and therefore increases bone resorption through increase activity of osteoclasts
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14
Q

when you have osteoporosis and you get a fracture (irrespective of fracture site) how much more at risk are you of having another one?

A

2-4 fold

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15
Q

what does a T-score of below -1.5 mean in osteoporosis?

A

pharm intervention is indicated

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16
Q

tell your pt. how can you reduce your risk of osteoporosis/further dev. of osteoporosis/ further complications

A
  • WB exercise
  • easy on the smokes and the drinking
  • nutrition
17
Q

what systemic conditions increase your risk of osteoporosis? ( so much so that it is considered clinical risk factor for medicare payment for dx. testing)

A

RA, hyperparathyroidism, hyperthyroidism, chronic kidney disease, chronic liver disease, premature menopause of at least 6 months in women age <45 yrs, hypogonadism in men and/or proven malabsorption

18
Q

they say that we should assume a pt has OP if they get a # after “minimal trauma” /// what is considered minimal trauma

A

falling from standing height or less

19
Q

what is the gold standard for dx. of osteoporosis (OP)

A

DXA: dual energy x-ray absorptiometry

20
Q

ddx. of CMT?

A
  • other hereditary neuropathies, acquired neuropathies
  • motor neuron diseass
  • hereditary ataxia
  • mitochondrial disorders
  • hereditary spastic paraplegias,
  • leucodystrophies
  • cellulitis
21
Q

what is hereditary ataxia (ddx. of CMT)

A
  • hereditary (yas we know what that means)
  • ataxia= uncontrolled loss of co-ordination of mms etc.

–> gait abnormalities

22
Q

rx. of CMT

A

intervention aimed at improving posture and balance

AFOs can help with foot drop

23
Q

what is paget’s disease?

A
  • increased bone remodely, bone hypertrophy, abnormal bone structure –> pain nd bone deformity.
    complications: #, degen, OA
24
Q

what is rx. of pagets disease (of bone)

A
  • calcitonin, bisphophonates
  • offloading
  • footwear: padding, space/accomodative
  • orthotics if LLD or anything else like that
  • wound management
  • mobility aids if indicated
  • emollient use if neuropathy
    -
25
Q

how do you dx. pagets disease?

A

x-ray

alkaline test

26
Q

what is prognosis of pagets disease?

A

no cure but can be managed

27
Q

what is a side effect of bisphosphonates?

A

cold/flu like sx.

28
Q

how does paget’s disease affect the foot specifically?

A
  • # risk
  • HD/Hk due to bony abnormalities
  • bow legs
  • scoliosis –> potential LLD?
  • PAIN
  • neuropathies possible if spine affected –> tingling etc. and no sweating
  • can cause damage to soft tissue
29
Q

what is ddx. of pagets disease?

A

arthritis, gout (esp. 1st MPJ)