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pt management 3 > RA and other things > Flashcards

RA and other things Flashcards

1
Q

when is the age of onset for OA

A

normally after 40 yo

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2
Q

what is the progression of OA like

A

occurs slowly over many years in response to mechanical stress

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3
Q

how does OA manifest

A

cart degradation, altered joint artecture, osteophyte formation

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4
Q

joint involvement for OA

A

DIP, PIP, 1st CMC, 1st MCP

cervical and lumbar spine

hips, knees

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5
Q

systematic signs for OA

A

none

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6
Q

RA age of onset

A

15 -50

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7
Q

RA progression

A

suddenly within weeks or months

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8
Q

manifestations of RA

A

inflammatory synovistis and tenosynovistis

ersion of the cart, bones and ligaments

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9
Q

joint involvement of RA

A

many joint normally symmetric

MCP, PIP, MTP

wrist, elbow, shoulder

C-spine

talonavicular and ankle

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10
Q

signs and symptoms of RA

A

redness
warmth
swelling
prolonged morning stiffness
increased pain with activity

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11
Q

signs and symptoms of OA

A

morning stiffness < 30 mins

pain with weight bearing

crepitus

loss of range of motion

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12
Q

systematic signs of RA

A

weight loss

fever

fatigue

rheumatoid nodules

ocular

hematological

respiratory and cardiac features

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13
Q

systematic effects of rheumatoid disease

A

fatigue

cardiac and respirtory symptoms

neuropathy

anemia

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14
Q

what are some examples of rheumatoid diseases

A

RA

Lupus

scleoderma

ankylospondylistis

fibromyalgia

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15
Q

unstable joints and resistance exercises

A

unstable joint may not tolerate resistance exercises

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16
Q

what is a nodule at the elbow

A

bump at the elbow

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17
Q

when a joint is unstable what plane of motion should they be moved

A

in a single plane of motion

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18
Q

how can we accomplish joint specific rest

A

with the use of of AD or splints

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19
Q

knee OA - what part of the knee joint

A

the entire thing

art cart, synovium, bone , soft tissue

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20
Q

capsular pattern for the knee

A

flex > ext

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21
Q

what are some risk factors for OA

A

genetics

age

BMI

bone shape

AFAB

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22
Q

are there different approaches for knee replacements

A

traditional - 8-10 inch incision

minimally invasive approach - 4-6 inch incision, quad sparing

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23
Q

what kind of patient is the min invasive approach good for

A

lower BMI

younger

limited co-morbities

motivated for the rehab process

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24
Q

prognostic factors for TKA

A

BMI

depression

pre-op ROM

physical function and stregnth

age

DM

comorbities

sex

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25
Q

pre -op exercises

A

focused on strengthing and flexibility

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26
Q

CPMs and post op

A

do not use them

27
Q

cyrotherapy and post op TKA

A

good use for pain managment

28
Q

NMES and post-op TKA

A

pt should use NMES to improves quads muscle strengths and other things

29
Q

KOOs score

A

0-100

0 - problems

100 - no problems

30
Q

STS scores

A

the teens are the cut off score for most adults

31
Q

TUG cut off score

A

> 13.5*for community dwelling adults

32
Q

joint involvmenet OA

A

asymmetrical

33
Q

medical management for OA

A

low impact exercise - biking and swimming

stretching to increase ROM of the effected joint

avoid activities that do not allow for a change in position

heat for pain relief

34
Q

medical management for RA

A

avoid high load activities - jumping and running

orthoese or splint for joint protections

mod activities to require less energy

heat for pain relief , caution when the pt is experiencing a flare up

35
Q

is there are single test to diagnose RA or OA

A

no

diagnosis is mainly based on the symptom presentation, labs, imagaing

36
Q

what is scleroderma

A

a systemic disease due to progressive fibrosis of the skin, vasculature, and internal organs

37
Q

is scleroderma progressive

A

yes

38
Q

what population does scleroderma occur in

A

women

30-50

39
Q

what are the symptoms of scleroderma

A

thickened tight skin

tiff hypomobile joints

muscle shortening and weakness

educed sweating

40
Q

what is diffuse cutaneous scleroderma

A

rapid progression that extends proximally

early pulmonary fibrosis

high risk of cardiac and renal involvement

41
Q

what is limited cutaneous scleroderma

A

CREST

C - calcinosis
R- raynauds
E - esophageal dysfunctions
S - sclerodactyly
T - telengiectasis

42
Q

what is Calcinosis cutis

A

condition in which calcium salts are deposited in the skin and subcutaneous tissue

43
Q

what is sclerodactyly

A

a hardening of the skin of the hand that causes the fingers to curl inward and take on a claw-like shape.

44
Q

what is telengiectasis

A

small, widened blood vessels on the skin.

45
Q

what is raynauds

A

small art constrict in response to the cold - limiting the blood supply to affected skin areas

46
Q

what can you do to prevent raynaud’s

A

self care - dress warmer

anti-HTN drug

CA blocker used to promote vasodilation

47
Q

how do we medically diagnosis scleroderma

A

CBC

anti-body levels

creatine levels

history

pulmonary function tests

CT

skin biopsy

48
Q

is therapy considered safe in those with scleroderma

A

yes it is safe

49
Q

what is lupus

A

chronic autoimmune disease that effects the entire body
- skin, joints, heart, lungs, kidneys, etc.

50
Q

how does lupus present

A

periods of illness and periods of wellness

51
Q

women and lupus

A

women are 9x more likely to have this

more common in black people

52
Q

sym of lupus

A

butterfly rash

fever

fatigue

raynuads

swelling

53
Q

what is the fatigue severity scale

A

scale that can be used to measure fatigue

54
Q

what is fibromyalgia

A

chronic disorder that causes msk pain and tenderness throughout the body

accompanied by fatigue, sleep, memory, and mmod issues

55
Q

medical managment of fibromyalgia

A

medicaltions

therapy - pt, ot, consueling

self care - stress management, sleep stratgies, regular exercise

56
Q

location of most fibro pain

A

superior chest

back

calves

ant and post knee

57
Q

what is one of the leading causes of hip dislocation

A

cog impairment

58
Q

risk factors for hip joint dislocation

A

pt age and when they had surgery

small dia of femoral head

history of instability

number of previous revisions

59
Q

what are poetential complications of chronic hip dislocation

A

nerve damage

osteonecrosis

arthritis

stretched out ligament and capsule

60
Q

PL approach for hip replacement

A

most common approach

the abd muscle is not cut

61
Q

PL approach precautions

A

no past mid line

IR

flex > 90-deg

do not roll on unprotected side for 6-weeks - sleep on back for the first 6 weeks

62
Q

lateral approach

A

split glute med and vastus lateralis

less chance of nerve damage and dislocation

63
Q

anterior approach

A

incision is made near the front of the hip

discharged sooner

less precautions

64
Q

min invasive hip replacement done in what population

A

more active

younger

motivated to particpate in rehab

pt management 3 (10 decks)

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