Urinary + MSK

Question 1

consequences of nocturia

Answer 1

interrupted sleep
risk for falls

Question 2

normal urinary changes

Answer 2

decreased bladder capacity
involuntary bladder contractions
increased urine production at night
urgency + frequency

Question 3

urge incontinence

Answer 3

involuntary urine loss after sudden urge to void
most common

Question 4

stress incontinence

Answer 4

leaking urine w physical exertion
in older women
r/t increase in intrabdominal pressure
caused by lack of estrogen, obesity, vaginal deliveries, surgery

Question 5

overflow incontinence

Answer 5

chronically full bladder
mostly men
c/o dribbling
caused by urethral blockage, nerve injury, weakened bladder muscles, drugs

Question 6

functional incontinence

Answer 6

barriers interfering w ability to make it to toilet
should be a diagnosis of exclusion

Question 7

mixed incontinence most common in community dwelling pts

Answer 7

urge and stress

Question 8

mixed incontinence most common in residential pts

Answer 8

urge and functional

Question 9

upper UTI manifestations

Answer 9

fever, chills, flank pain, mental status changes

Question 10

lower UTI manifestations

Answer 10

dysuria, hematuria, urgency, frequency

Question 11

ligaments

Answer 11

bone to bone
prevents movement out of normal ROM

Question 12

ligaments

Answer 12

bone to bone
prevents movement out of normal ROM

Question 13

tendons

Answer 13

bone to muscle
facilitate movement

Question 14

interventions post hip surgery

Answer 14

maintain hip abduction
HOB 45 degrees
do not bend hip more than 90 degrees
do not cross legs
high toilet seats

Question 15

arthritis

Answer 15

inflammation of joint
leading cause of disability

Question 16

osteoarthritis

Answer 16

patho: degenerative, localized. wear + tear on synovial joints
cause: age, genetics, obesity, repetitive use
signs: joint instability, inflammation, Heberdon’s nodes

Question 17

rheumatoid arthritis

Answer 17

patho: chronic, systemic autoimmune
signs: symmetrical, polyarticular pain and swelling, stiffness in AM 30+min, often w fever and fatigue

Question 18

gouty arthritis

Answer 18

patho: accumulation of uric acid and crystals in joints from hyperuricemia
cause: decreased renal clearance and increased uric acid synthesis, obesity, diuretics, renal issues, diet high in purines and fructose
signs: severe and sudden pain in big toe or knee
treat: hydration, avoid high purine foods and organ meat, avoid alcohol

Question 19

hip fractures

Answer 19

treat: immobilization, ORIF, arthroplasty
signs: severe pain, paralysis, edema, audible pop, affected extremity appears shorter and is externally rotated

Question 20

reduction

Answer 20

to put back into alignment

Question 21

interventions for cognitively impaired UI pts

Answer 21

scheduled toileting
habit training
prompted voiding

Question 22

interventions for cognitively intact UI pts

Answer 22

pelvic floor exercises
bladder retraining

Question 23

benign prostatic hypertrophy

Answer 23

patho: large prostate r/t constriction of urethra and obstruction of urine flow
etiology: age related, 80% of ppl 80+ yrs
signs: hesitancy, decreased urine stream, dribbling, sensation of full bladder, urinary retention

Question 24

how is prostate cancer diagnosed

Answer 24

digital exam
PSA blood test

Question 25

algor mortis

Answer 25

cold body
decreased elasticity
lack of circulation

Question 26

postmortem decomposition

Answer 26

bruising and skin softening
body turns gray
mottling and RBC breakdown

Question 27

rigor mortis

Answer 27

w/in 4hrs of death
contraction of muscles and immbolization of joints

Question 28

kennedy terminal ulcers

Answer 28

3:30 syndrome
rapid progression
starts stage 2, blister, black dots

Question 29

osteoblasts

Answer 29

increase calcium in bones
by decreasing calcitonin in blood

Question 30

osteoclasts

Answer 30

decreased calcium in bones by increasing calcium in blood (PTH)

Question 31

osteoporosis

Answer 31

patho: creation of new bone unable to keep up w old bone removal
diagnosis: DXA w T score below 2.5
complication: falls
signs: kyphosis of cervical spine
meds: antiresorptive(slows breakdown) or anabolic(encourages building)

Question 32

primary osteoporosis

Answer 32

age related, most common
type 1- post menopausal
type 2- aging r/t (70+)

Question 33

secondary osteoporosis

Answer 33

r/t other disease or meds
think steroids

Question 34

foods high in purines

Answer 34

bacon, grouse, liver, anchovies, salmon, turkey, veal, scallops, haddock, yeast, sardines, herring, mussels

Question 35

preventing osteoporosis

Answer 35

weight bearing exercise
avoid smoking + alcohol
consume 1000mg Ca per day