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► Med Misc 49 > Unit VII part 2 COPY > Flashcards

Unit VII part 2 COPY Flashcards

1
Q

Initial infection or an infection lasting less than one month

A

Acute infection

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2
Q

What classification of infection has a high incidence with children less than 12 years old

A

Acute infection

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3
Q

Infection lasting longer than one month or that has failed the initial course of antibiotic therapy for acute osteomyelitis

A

Chronic infection

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4
Q

What classification of infection is seen mostly in adults

A

Chronic infection

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5
Q

What is the most common single pathogen

A

Staphylococcus aureus

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6
Q

What kind of invasion by an organism is caused by open fx, surgery, trauma, GSW?

A

Direct or exogenous invasion

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7
Q

What kind of invasion by an organism is caused by hematogenous, infection from a distal site, usually sen in long bones

A

Indirect or endogenous invasion

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8
Q

What kind of invasion by an organism is caused by soft tissue, decubitus or diabetic ulcers
(surrounding areas)

A

Extension or contiguous invasion

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9
Q

What type of invasion most frequently affects growing bones in young boys (

A

Indirect

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10
Q

What are the most common sites of indirect injury in children

A

Distal femur
Proximal tibia
Humerus
Radius

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11
Q

What are the most common sites of infection because they are vascular

A

Pelvis & vertebrae

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12
Q

Direct entry can occur at any age when there is?

A

An open wound

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13
Q

Metaphysis

A

Growth plate

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14
Q

Where do the microorganisms lodge themselves in the bone

A

Metaphysics

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15
Q

Area of devitalized bone seperates from living bone and forms

A

Sequestra

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16
Q

Part of the periosteum that continues to have blood supply forms new bone

A

Involucrum

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17
Q

Sequestrum

A

Dead bone

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18
Q

Pathophysiology of osteomyelitis

A 
Bacteria enters bone
Inflammation occurs 
Purulent material collects within bone
Increased pressure ->pain
Ischemia & vascular 
compromise->decrease O2
Bone dies & Sequestrum form
Involucrum grows around Sequestrum
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19
Q

Why is Sequestra a haven for bacteria

A

Unreadable by antibiotics or leukocytes due to pus enclosure

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20
Q

Complications of osteomyelitis

A 
Fractures
Chronic infection 
Sepsis
Deformities 
Brodie's abscess 
Amputation
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21
Q

What can develop at the epipysis of the bone

A

Brodie’s abscess

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22
Q

Where is the most common place for a Brodie’s abscess

A

Tibia

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23
Q

S/S acute osteomyelitis

A 
Fever
Chills
Malaise nausea
Restlessness 
Bone pain that's unrelieved with rest
Swelling, tenderness & warmth at infection site 
Restricted movement of affected part
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24
Q

S/S of chronic osteomyelitis

A

Constant bone pain & swelling
Drainage sinus tract
Local signs more common

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25
Q

What are some diagnostic tests done for osteomyelitis

A 
Wound and blood cultures 
H & P
Increase WBC (infection) 
Increase ESR (inflammation)
Bone scan
X-ray 
MRI 
CT
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26
Q

What is the best tool to use for early diagnosis of osteomyelitis

A

Bone scan

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27
Q

What is the best treatment for osteomyelitis

A

Vigorous & prolonged IV antibiotic therapy

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28
Q

Decompression surgery

A

Saucerization

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29
Q

Use of one drain coming in one going out for continuous or intermittent irritations

A

Closed wound

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30
Q

What kind of wound would you use dressing changes for Debridement
Used for invasion of anerobic organisms

A

Open wound

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31
Q

Are amputations more common in males or females

A

Males

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32
Q

Most puts toons occur where

A

Lower extremity

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33
Q

Lower extremity amputations are caused by ?

A

PVD (diabetes, atherosclerosis)

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34
Q

Upper extremity amputations are caused by?

A

Trauma
Accidents
Burns
Frostbite

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35
Q

Goal of prosthesis

A

To preserve the most distal level that will heal, try to preserve elbow & knee joints

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36
Q

To preserve the most distal level that will heal, try to preserve elbow & knee joints

A

Goal of prosthesis

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37
Q

The level of amputation is determined by

A

Amount of circulation and presence of infection

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38
Q

Are all pt’s candidates for prosthesis ?

A

No

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39
Q

Who expends more energy for ambulation amputees or non amputees

A

Amputees

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40
Q

The longer the residual limb, the _______ the energy costs for the amputee

A

Lower

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41
Q

Amputation through a joint

A

Disarticulation

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42
Q

Occurs through ankle @ level of foot, take both malleoli

A

Syme’s amputation

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43
Q

BKA

A

Below knee amputation

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44
Q

AKA

A

Above knee amputation

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45
Q

Lower extremity amputation including half of pelvis is removed

A

Hemipelvectomy

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46
Q

Entire shoulder & arm amputated

A

Forequarter amputation

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47
Q

Type of amputation that has actual or potential infection, stump left open for drainage

A

Open or guillotine

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48
Q

Type of amputation that allows weight bearing, no infection present, may or may not have drains

A

Closed or myoplastic or flap

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49
Q

When is a total contact rigid dressing placed on pt

A

During surgery

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50
Q

Aluminum rod that is attached to the ankle piece which is attached to a rigid dressing

A

Pylon

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51
Q

What is a disadvantage of immediate post op prosthesis

A

Unable to visualize operative site

infection risk

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52
Q

Delayed prosthesis that decreases edema & begins stump molding for prosthesis

A

Compression dressing

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53
Q

Aching, tingling, or itch in a amputated limb

A

Phantom sensation

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54
Q

Phantom sensation is more frequent in

A

AKA

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55
Q

4 stages of adjustment to loss of body part

A

Impact
Retreat
Acknowledgement
Reconstruction

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56
Q

In what stage does the pt show despair, discouragement, passive acceptance

A

Impact

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57
Q

In what stage of loss does the reality of the amputation become apparent & acute grief is seen

A

Retreat

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58
Q

In what stage does the pt show a willingness to participate in care & rehab

A

Acknowledgement

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59
Q

In what stage does the pt try to reach maximum rehab potential

A

Reconstruction

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60
Q

Most frequent complication of amputations is

A

Contracture for above the joint amputations

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61
Q

What would you do to help prevent deformities

A

Place the pt prone 3-4 times a day for 30 minutes

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62
Q

How long does it take to shrink the stump for a permanent prosthesis

A

2-3 months

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63
Q

What do you want to avoid with amputations to avoid contractures

A

Dangling

Elevating limb after first 24 hours

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64
Q

What are complications of amputations

A

Injury
Skin breakdown
Pneumonia
Thrombophlebitis

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65
Q

More Bone cancer cases each year are found in?

A

Men

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66
Q

More deaths per year from bone cancer occur in

A

Men

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67
Q

Bone cancer effects who more often?

A

More children then adults

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68
Q

Arise in a particular tissue

Originates in the bone

A

Primary tumor

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69
Q

Cancer that spreads to another tissue from the original site

A

Secondary tumor

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70
Q

Is primary or secondary tumor the most common bone cancer?

A

Secondary tumor

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71
Q

What is the most common malignant primary bone tumor seen in adults

A

Osteosarcoma

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72
Q

Osteosarcoma is usually seen in what bones

A

Distal femur, proximal tibia & proximal humerus (long bones)

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73
Q

S/S of osteosarcoma

A

Pain
Local tenderness
Enlargement of part affected
Limited joint movement

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74
Q

Diagnostic studies for osteosarcoma

A

MRI shows sunburst
Bone scan
Biopsy
Increased calcium & alkaline phosphatase

75
Q

Treatment of osteosarcoma

A

Radiation
Chemotherapy
Possible amputation

76
Q

Osteosarcoma can metastasis to?

77
Q

Tumor of cartilage

A

Chondrosarcoma

78
Q

Common age group for those diagnosed with chondrosarcoma

A

30-60 years

79
Q

Chondrosarcoma is usually found where

A

Pelvis
Proximal femur
Proximal humerus

80
Q

Diagnostic tests for chondrosarcoma

A

X ray or CT will show thinned bone cortex, bone destruction

81
Q

S/S of chondrosarcoma

A

Dull pain
Edema
Deformity

82
Q

Treatment for chondrosarcoma

A

Surgery

Occasional radiation

83
Q

What is the most malignant bone tumor

A

Ewings sarcoma

84
Q

Rapid growth within the medullary cavity of long bones

A

Ewings sarcoma

85
Q

Malignant giant cell tumor

Bone destruction & expansion of bone ends

A

Osteoclastoma

86
Q

Tumor bearing bone is resected & replaced with a cadaver allograft or a custom made prosthesis

A

Limb salvage

87
Q

Treatment for primary tumors

A

Chemotherapy

88
Q

Plasma cell myeloma
White blood cell cancer
Produces osteolytic lesions throughout the skeletal system

A

Multiple myeloma

89
Q

What is common in metastatic cancer to bone
Excessive calcium release as tumor destroys bone
Can lead to heart dysrythmias

A

Hypercalcemia

90
Q

What is the treatment for hypercalcemia

A

Diuresis

Flush extra Ca+ out of the body

91
Q

Study of rheumatology

A

Study of rheumatic disease

92
Q

Any disease or condition involving the muscular skeletal system

A

Rheumatic disease

93
Q

Inflammation of joint

94
Q

3 types of arthritis

A

Inflammatory
Degenerative
Metabolic

95
Q

Osteoarthritis

A 
Degenerative disease
Wear & tear disease
Ages 50-70
Disease of articulate cartilage
Cartilage becomes thinner
Joint pain/stiffness 30 min/asymmetrical
96
Q

Osteophyte formation on DIP joints

A

Heberden’s nodes

97
Q

Red, swollen tender nodes on the PIP joints

A

Bouchard’s nodes

98
Q

Remove bits of broken cartilage or bone

A

Arthroscopy

99
Q

Realignment

100
Q

Fusion

A

Arthrodesis

101
Q

Joint replacement

A

Arthroplasty

102
Q

Rheumatoid arthritis

A

Inflammatory
Symmetrically
Stiffness 60 minutes

103
Q

Inflammation of the tendon and it’s sheath

A

Tenosynovitis

104
Q

A chronic systematic disease characterized by inflammation of connective tissue in the diarthrodial joints

105
Q

Deformity of hand towards ulnar side

A

Ulnar drift

106
Q

Flexing of fingers

A

Boutonnière deformity

107
Q

Deformity of great toe

A

Hallux vagus

Bunion

108
Q

Hyper extension of joint in fingers

A

Swan neck deformity

109
Q

Diminished lacrimal and salivary gland secretion

A

Sjögren syndrome

110
Q

Inflammatory eye disorders, splenomegaly, lymphadenopathy, pulmonary disease, blood dyscrasias

A

Felty syndrome

111
Q

Tissue biopsy

A

Arthroscopy

112
Q

Anti inflammatory analgesic

A

Corticosteroid

113
Q

Why can you not stop corticosteroids suddenly

A

Cause adrenal crisis

114
Q

Anti inflammatory drug

Inhibits synethesid of prostaglandin

115
Q

Cytoxic agents

Suppression of bone marrow to decrease immune response

A

Immunosuppressants

116
Q

Decrease inflammatory response

Prevents progression of RA

A

Disease modifying anti rheumatic drugs (DMARDs)

117
Q

Used for prestant RA
Slows progression of RA
4-6 months to work

A

Antimalarials

118
Q

Deposit in the pigment layer of retina cause irreversible rental degeneration

A

Retinopathy

119
Q

Anti inflammatory

IM injection given 5 months

A

Gold salts

120
Q

Chronic progressive metabolic bone disease characterized by porous bone, low bone mass, structural deterioration of bone tissue

A

Osteoporosis

121
Q

Why is osteoporosis more common in women than men

A 
Lower calcium intake 
Loss body mass
Bone reabsorption begins earlier & increase with menopause
Pregnancy/breast feeding
Women live longer than men
122
Q

Patho of osteoporosis

A

Bone reabsorption exceeds bone deposition

123
Q

What’s the most common osteoporosis diagnostic study

A

Duel energy X-ray absorptiometry

DEXA

124
Q

T score

A

1.0- to -1.0 normal bone density
-1.0 to -2.5 low bone density
Osteopenia
-2.5 to -4.0 osteoporosis

125
Q

Measures trabecular & cortical bones at hip & lumbar spine

A

DEXA

DUAL ENERGY X-RAY ABSORPTIOMETRY

126
Q

Low dose radiation scanner

A

Single photon absorptiometry

127
Q

How much Ca is needed for Pre menopausal women

A

1000mg/day

128
Q

How much Ca is needed for post menopausal women

A

1500mg/day

129
Q

If too much Ca is taken what can happen

A

Kidney stones

130
Q

Inhibit osteoclasts activity

Mediated bone reabsorption

A

Biophosphonates

131
Q

Good for pt’s with fx helps decrease pain

A

Calcitonin

132
Q

Treatment for vertebral compression fx

A 
Bed rest 
Position of comfort
Muscle relaxant 
Local heat
Log roll
OOB ASAP to decrease Ca loss
133
Q

Inadequate mineralization of bone
Vit D deficiency
Bone become abnormally soft

A

Osteomalacia

134
Q

Ribbons of decalcification in bone

Classic sign of osteomalacia

A

Loosers transformation zones

135
Q

Chronic bone disease excessive bone reabsorption followed by excessive & abnormal bone replacement
Increase vascularity with bone

A

Paget’s disease

136
Q

When you have an Increase of Alkaline phosphatase it is because of

A

Excessive bone building

137
Q

Chronic progressive inflammatory disease of the spine & sacroiliac joint
Found in men more

A

Ankylosing spondylitis

138
Q

Inflammation of spine

A

Spondylitis

139
Q

Fuse

140
Q

Kyphosis

A

Round back

141
Q

A genetic marker found in AS

A

HLA B27

Human leukocyte antigen

142
Q

Treatment goal of Ankylosing spondylitis

A

Maintain maximal skeletal mobility

143
Q

Self limiting disease associated with arthritis, urethritis & conjunctivitis

A

Reiters syndrome

144
Q

Invasion of synovial membranes with micro organisms

Septic arthritis

A

Bacterial arthritis

145
Q

Joint aspiration

A

Arthrocentesis

146
Q

Result of prolonged hyperuricemia

Increase uric acid

147
Q

Inflammation of great toe

148
Q

Multiple joint involvement with deposites of sodium irate crystals

A

Chronic gout

149
Q

Irate crystals

150
Q

Prevent future gout attacks

A

Avoid etoh, high purine food

Chicken, sardines, organ meats

151
Q

Disorder of the connective tissue characterized by fibrotic degenerative & inflammatory changes in skin, blood vessels, synovium skeletal muscle & internal organs

A

Scleroderma

152
Q

Skin thickening on the trunk face and proximal & distal extremities

A

Diffuse scleroderma

153
Q

Thick skin limited to sites distal to the elbow & knees but also involves face & neck

A

Limited scleroderma

154
Q

CREST

A 
Calcinosis (Ca deposits)
Raynauds phenomenon red white blue
Esophageal desmotility
Sclerodactyly scleroderma of digits
Telangiectasis benign tumor of blood vessels
155
Q

Chronic progressive inflammatory multi system disease of connective tissue

156
Q

Classic sign of lupus

A

Butterfly rash

157
Q

Inflammatory disease involving voluntary muscles also a

Degeneration of muscle fibers

A

Polymyositis

Proximal muscles are affected first

158
Q

Dusky red rash on face neck shoulders anterior chest upper back & arms

A

Dermatomyositis

159
Q

Autoimmune response
Inflammation & dysfunction of the exocrine glands
Salivary & lacrimal glands

A

Sjögren syndrome

160
Q

What allows for NWB ambulation

161
Q

What provides solid support helps with balance problems

162
Q

What hand do you hold the cane in

A

Opposite the involved extremity

163
Q

Cane should be where?

A

Top of the greater trochanter

164
Q

Crutches up/down the steps

A

Up with good

Down with bad

165
Q

Joint movement

166
Q

Muscle setting exercise

167
Q

Goals of surgery

A

Relieve pain
Improve joint motion
Remove debris
Correct deformity

168
Q

Insertion of endoscope into a joint for direct visualization of joint

A

Arthroscopy

169
Q

Removal of synovial membrane

A

Synovectomy

170
Q

Cutting a bone to change its alignment

171
Q

Removal of degenerative debris

A

Debridement

172
Q

Surgical fusion of joint

A

Arthrodesis

173
Q

Joint exploration

A

Arthrotomy

174
Q

Cutting tendon

175
Q

Movement of a tendon insertion to improvement function

A

Tendon transfer

176
Q

Reconstruction or replacement of joint

A

Arthroplasty

177
Q

Replacement of part of a joint

A

Hemiarthroplasty

178
Q

Peak time for fat embolus

A

4th post op day 72 hours

179
Q

Closed wound drainage system

180
Q

What is the most complex joint in the body

A

Ball & socket

181
Q

A body part that has been totally severed from the body by trauma, surgery or a congenital abnormality

A

Amputation

182
Q

What can help with arthritic joints

A 
Exercise
Balanced nutrition
Weight loss
Drug therapy
Hot/cold therapy 
Rest
Joint protection
183
Q

Sublaxation

A

Partial dislocation

184
Q

Infection of bone and/or bone marrow

Direct or indirect invasion by an organism

A

Osteomyelitis

► Med Misc 49 (29 decks)

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