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Sem 2 LEAPS > Week 3 - Arthritis and Musculoskeletal conditions > Flashcards

Week 3 - Arthritis and Musculoskeletal conditions Flashcards

1
Q

What effect does estrogen have on osteoporosis?

A

It has a protective effect –> women after menopause are more likely to get it

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2
Q

What are some risk factors for Osteoporosis?

A
  • Coeliac disease - impairs calcium absorption
  • Alcohol
  • Glucocorticoid therapy for longer than 3 months - affects osteoclasts/blasts
  • Thinness
  • Smoking
  • Genetics
  • Fracture history
  • Calcium/Vit D intake
  • More than 3 cm height loss
  • Lifestyle factors
  • Inflammatory arthritis
  • Premature menopause
  • Hyperthyroidism
  • Age - over 70
  • No exercise
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3
Q

What proportion of Australian’s have OP?

A

1 in 10 over 50

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4
Q

What is the difference in male and female rates of OP?

A

5x more women over 50 than men (15.1% women, 3.3% men)

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5
Q

Where do RCTs sit in the Hierarchy of evidence?

A

Third from the top, beneath systematic reviews/meta-analysis and evidence based synopses
Above Cohort studies/non-randomised trials

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6
Q

WHy is OP called the Silent Epidemic?

A

Symptomless development

Lack of Public Awareness

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7
Q

How many times more likely are women over 50 to be hospitalised for minimal trauma hip fractures?

A

2x

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8
Q

What are the 8 recommended elements of clinical assessment after a fragility fracture?

A
  1. Prior fragility fractures
  2. Parental hip fractures
  3. Glucocorticoid use
  4. Current smoking
  5. High alcohol intake (>3 units P/D)
  6. RA
  7. Falls in previous 12 months
  8. Gait/balance
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9
Q

What are some risk factors for falls?

A
  • Reduced lower limb strength/impairments in gait/balance
  • Cognitive impairment
  • Incontinence
  • Feet/footwear problems
  • Syncope/dizziness
  • Medications like antidepressants, antipsychotics
  • Poor vision
  • Environment
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10
Q

How do you fail the single leg stance test?

A

If you cannot complete all three trials of 10 seconds -> indicates significant sensory and strength impairment

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11
Q

How do you fail the Time Up and Go (TUG) test?

A

If a patient takes more than 15 seconds to stand up from a chair, walk 3m, turn and return to sit on the chair

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12
Q

What does a failed TUG test indicate?

A

Those with a high risk of falling

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13
Q

What % of community living people over 65 fall every year?

A

33%

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14
Q

What % of residential facilities/nursing home residents fall every year?

A

50%

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15
Q

WHat % of emergency admissions are accounted for falls in 65 year olds?

A

17%

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16
Q

What % of falls are responsible for hip fractures?

A

90%

17
Q

What are some fall prevention strategies in the community dwelling elderly?

A
  • Exercise - more than 2 hours per week
  • High level balance based exercise i.e. Tai Chi
  • High Dose Vit D if low
  • Occupational therapy home visits
  • Restriction of multifocal glasses in those who take part in outdoor activity
  • Multifac assessments in high risk populations with targeted interventions
  • Psychoactive medication withdrawal
  • Expedited cataract surgery
  • Podiatry intervention
18
Q

What are evidence based fall strategies for elderly living in residential care?

A
  • High dose Vit D
  • Medication review
  • Hip protectors - this is only a good practise point
19
Q

WHat is associated with low bone mineral density in men over 50 and postmenopausal women?

A

BW 10% of 25 year old weight

20
Q

WHat is the importance of height loss?

A

Increased risk of vertebral fracture

21
Q

WHat is the significance of rib/pelvis distance?

A

Less than 2 finger breadths apart is associated with vertebral fractures

22
Q

WHat percentage of 80 year olds have a vertebral body fracture?

A

50%

23
Q

How many low-trauma vertebral fractures present?

A

No recognizable symptoms

  • Self-limiting episode of back pain
  • Thoracic kyphosis - excessive curvature of the spine
24
Q

What is a fragility fracture?

A

Spontaneous fracture after minimal trauma falling from standing height or less
-Excludes craniofacial, hand, ankle and foot

25
Q

What is the fracture cascade?

A

Minimal trauma fractures increase 2-4 times in likelihood after a fracture at any site
- approx half subsequent fractures occurred within 2 years of initial fracture

26
Q

Define osteopororis

A

A disease characterised by low bone mass and microarchitectural deterioration of one tissue, leading to enhanced bone fragility and a consequent increase in fracture risk

27
Q

How do you diagnose OP?

A

BMD T-score of -2.5 or lower in lumbar spine or hip
OR
Occurrance of one or more minimal trauma fractures in a patient over 50 years

28
Q

WHat % of australians over 50 have OP or osteopenia?

A

66%

29
Q

What % of fractures relating to osteoporosis and osteopenia are accounted for by men?

A

30%

30
Q

What are the annual predicted costs of osteoporosis, osteopenia and fractures between 2013-2022

A

$33.6 billion

31
Q

What is FRAX?

A

Fracture risk assessment tool

32
Q

What does FRAX measure?

A

10-year probability of fracture

33
Q

What do you need to use FRAX?

A 
Country
BMD from Fem-neck T-score
Age
Gender
Clinical risk factors i.e. low BMI, previous frag fract, smoking, alcohol intake etc
34
Q

How does RDI of calcium change as you get older?

A

Moves from 1000mg/day to 1300mg/day for women over 50 and men over 70

35
Q

WHat kind of exercise is effective for OP?

A
  • Weight-bearing i.e. walking, running, dancing, tennis
  • Resistance training
  • Balance/mobility
36
Q

What kind of impact does a femoral neck fracture have?

A

Loss of confidence/fear of falling

Sem 2 LEAPS (2 decks)

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