Gero Test 1 Part 3

Front 1

changes in appearance from shrinkage noted after

Back 1

fifth decade

Front 2

loss of water in intervetrebal discs

Back 2

lose 1 cm q 10 years after age 40

Front 3

hyphosis

Back 3

hunchack

Front 4

sarcopenia

Back 4

natural loss of muscle tissue from aging

Front 5

lower extremity atrophy

Back 5

earlier than upper, issues with falls

Front 6

what lines joints

Back 6

hyaline cartilage

Front 7

main joint of hyaline wear and tear

Back 7

knee

Front 8

amount of collagen does not change but becomes

Back 8

stiffer

Front 9

metabolic bone disease

Back 9

osteoporosis

Front 10

joint disease

Back 10

osteoarthritis, rheaumatoid arthritis, gout

Front 11

OA is

Back 11

noninflammatory

Front 12

RA and gout are

Back 12

inflammatory

Front 13

noninflammatory distinguished by 3 sns

Back 13

lack of synovial inflammation, absensce of systemic manifestations, normal synovial fuid

Front 14

inflammatory distinguished by 3 sns

Back 14

synovial inflammation, systemic manifestations, abn synovial fluid

Front 15

most common metabolic disease

Back 15

osteoporsis

Front 16

osteoporiss in women

Back 16

50%

Front 17

long term coritco does what to bones

Back 17

weakens

Front 18

osteoporosis more common in

Back 18

whites, asians

Front 19

2 drugs that increase risk of osteoporosis

Back 19

anticonvulsant, thyroidhormoone

Front 20

4 modifiable risk factors for osteoporosis

Back 20

low Ca intake, prolonged immobility, excessive caffeine/alcohol, smoking

Front 21

osteoporosis primary type 1

Back 21

bone destroyed more rapidly than made

Front 22

osteoporosis primary type 1 increased incidence of

Back 22

vertebral fractures

Front 23

osteoporosis primary type 1 occurs when

Back 23

postmenopausal, related to estrogen levels

Front 24

osteoporosis primary type 2

Back 24

senescent bone loss

Front 25

osteoporosis primary type 2 causes decrease in

Back 25

actual amount of bone formed during remodeling

Front 26

osteoporosis primary type 2 increased risk of

Back 26

hip fractures

Front 27

osteoporosis secondary commonly from (2)

Back 27

steroids, vit d defecient

Front 28

osteoporosis sns

Back 28

usually absent

Front 29

osteoporosis referred to as

Back 29

silent killer

Front 30

first sign of osteoporosis is usually

Back 30

fractures

Front 31

loss of height is called

Back 31

dowager's hump

Front 32

BMD

Back 32

bone mineral density

Front 33

gold standard for measuring bmd

Back 33

DEXA

Front 34

DEXA

Back 34

dual energy xray absorptiometry

Front 35

DEXA is very

Back 35

$$$

Front 36

Calcium slows

Back 36

the rate that bone is lost

Front 37

what Ca is better

Back 37

citrate is better than carbonate

Front 38

tums is Ca

Back 38

carbonate

Front 39

to prevent osteoporosis avoid beverages containing

Back 39

phosphorous because is inversely r/t Ca

Front 40

2 things bad for osteoporosis

Back 40

tobacco smoking, alcohol

Front 41

high Ca foods (10)

Back 41

dairy, dried figs, fish c bones, fortified OJ, beans, spinach, turnips greens, chocolate, nuts, liver

Front 42

3 foods enhancing Ca excretion

Back 42

caffeine, excess fiber, meat phosphorous

Front 43

antiresorptive drugs do what

Back 43

preserve or inc BD and dec rate of bone resorption

Front 44

3 antiresorptive drugs

Back 44

bisphophonates, estrogen, calcitonin

Front 45

estrogen use

Back 45

is controversial

Front 46

bisphosphonate main drug

Back 46

fosamax

Front 47

bisphosphonate actonel

Back 47

daily or weekly

Front 48

bisphosphonate fosamax

Back 48

daily or weekly

Front 49

bisphosphonate boniva

Back 49

monthly

Front 50

most serious side effects of bisphosphonates

Back 50

esophagitis

Front 51

bisphosphonates can also cause

Back 51

osteonecrosis of jaw

Front 52

esophagitis

Back 52

prolonged drug exposure

Front 53

bisphosphonates - difficulty swallowing

Back 53

causes heartburn

Front 54

most important thing about bisphosphonate (bis) therapy

Back 54

TEACH TEACH TEACH

Front 55

bis TEACH - to prevent

Back 55

esophageal irritation

Front 56

bis TEACH - take atleast 1 hr before

Back 56

any meds or food

Front 57

bis TEACH - take with what fluid

Back 57

water and nothing else

Front 58

bis TEACH - do what for 30-60 min post drug admin

Back 58

sit upright

Front 59

bis TEACH - do not do what for 30 min post admin

Back 59

drink anything

Front 60

bis TEACH - do not take what med at same time

Back 60

Ca

Front 61

bis TEACH - Ca may interfere with

Back 61

bis drug absorption

Front 62

estrogen supp ie

Back 62

evista

Front 63

FDA and estrogen supps

Back 63

no longer approved

Front 64

estrogen supps for

Back 64

osteoporosis

Front 65

estrogen supps inc risk for (5)

Back 65

breast ca, blood clots, MI, CVA, endometrial ca

Front 66

estrogen supps now for

Back 66

short term use for menopause sns

Front 67

estrogen supps research

Back 67

still in progress

Front 68

calcitonin tx for osteoporosis

Back 68

safe but less effective

Front 69

>95% of oa hip fractures caused

Back 69

by falls

Front 70

leading cause of accidental death in age 65+

Back 70

falls

Front 71

intracapsular fx located

Back 71

within joint

Front 72

intracapsular fx causes

Back 72

impaired blood to femoral head

Front 73

extracapsular fx located

Back 73

trochanter, below trochanter

Front 74

extracapsular fx causes

Back 74

acute blood loss from vascular cancellous bone surfaces

Front 75

extracapsular fx rarely cause

Back 75

avascular necrosis

Front 76

what can cause hip fx

Back 76

neoplasms

Front 77

hip fx can cause (3)

Back 77

sepsis, bleeding, death

Front 78

death from hip fx - #s

Back 78

1/5 die within 1 year

Front 79

leg of hip fx

Back 79

shortened and externally rotated

Front 80

most hip fx occur

Back 80

in women who fall sideways on hip

Front 81

hip fx Sx

Back 81

is tx of choice

Front 82

important post-op care for hip sx

Back 82

keep extremity aligned

Front 83

hip fx post-op ambulation

Back 83

asap

Front 84

pre and post op pt edu

Back 84

prevent dislocation, encourage physical therapy, use assistive devices

Front 85

prevent dislocation how

Back 85

dont cross legs, use raised toilet, pillow b/t legs

Front 86

most common form of arthritis in US

Back 86

osteo

Front 87

osteoarthritis is leading cause

Back 87

of disability in ppl over 65

Front 88

OA joints

Back 88

hands, knee, hip, central joints of cervical and lumbar

Front 89

OA characterized by

Back 89

progressive erosion of articular cartilage with formation of bone in joint space

Front 90

does OA have exacerbations and remissions

Back 90

no

Front 91

OA is asymmectric or symmectric

Back 91

asymmetric

Front 92

most signif cause of eldelry pain and disability

Back 92

OA of hips and knees

Front 93

OA not caused by

Back 93

aging alone

Front 94

OA called the (2)

Back 94

wear and tear, or a mileage phenomenon

Front 95

OA predisposing factors (2)

Back 95

repetitive joint use (running), cold climate

Front 96

OA predisposing factors (5)

Back 96

inc age, obestiy, trauma, lifestyle, genetics

Front 97

2 clinical manifestations of OA in hands

Back 97

heberden's nodes, bouchard's nodes

Front 98

OA pain

Back 98

morning stiffness, usually resolves in 30 min, ? confirm that

Front 99

OA will have what c movement

Back 99

crepitus

Front 100

OA physcial assess look for

Back 100

erythema

Front 101

OA heat to joints

Back 101

dec pain

Front 102

OA cold to joints

Back 102

dec swelling

Front 103

4 major complications of hip/knee replacement

Back 103

thromboembolsim, infection, blood loss, joint dislocation

Front 104

CPM device

Back 104

continuous passive motion device

Front 105

CPM device for

Back 105

post knee replacemnet

Front 106

OA topical analgesics most effective for

Back 106

hands and knees

Front 107

OA topical analgesics may cause

Back 107

heat or burning

Front 108

OA topical analgesics agent

Back 108

capsaicin found in keyan pepper

Front 109

OA systemic analgesics agent

Back 109

acetaminophen

Front 110

how much acetaminophen

Back 110

4g/day

Front 111

acetaminophen has what effect

Back 111

ceiling effect

Front 112

acetaminophen - tylenol

Back 112

one of safest drugs

Front 113

most common OA pain tx

Back 113

NSAIDS

Front 114

NSAIDS given post

Back 114

tylenol

Front 115

NSAIDS long term (4)

Back 115

ulcers, bleeding, inc MI risk, inc CVA risk

Front 116

3 NSAIDSie

Back 116

aspirin, ibuprofen, naproxen

Front 117

cox 2 inhibitors ie

Back 117

celebrex

Front 118

celebrex is anti

Back 118

inflammatory

Front 119

celebrex requires

Back 119

rx

Front 120

celebrex considered safe for

Back 120

GI tract

Front 121

celebrex inc risk for

Back 121

CV SE

Front 122

celebrex SE

Back 122

renal impairment

Front 123

intra articular agents are

Back 123

analgesics, cortico

Front 124

intra articular agents for what disease

Back 124

OA

Front 125

what is removed before intra articular agent injection

Back 125

synovial effusion

Front 126

max # of intra articular injections

Back 126

4 per year in singular joint

Front 127

OA - hyaluronic acid is normal component of

Back 127

joint lubrication and nutrition

Front 128

hyaluronic acid admin

Back 128

3-5 injections

Front 129

hyaluronic acid dec

Back 129

pain for longer than other intra articular therapies

Front 130

OA OTC

Back 130

glucosamine, chondroitin sulfate

Front 131

OA OTC do what and not what

Back 131

dec pain, do not grow new cartilage

Front 132

OA OTC doc reccommends

Back 132

3 month trial period

Front 133

RA affects more than just

Back 133

joints

Front 134

RA more common in

Back 134

women, 3:1

Front 135

RA is ___ disorder

Back 135

autoimmune

Front 136

RA inflamed synovium does what

Back 136

invades and destroys bone and cartilage

Front 137

RA characterized by

Back 137

exacerbations and remissions

Front 138

RA disabling morning joint stiffness

Back 138

may last an hour or more

Front 139

RA affects what first

Back 139

fingers, hands, wrists

Front 140

RA affects second

Back 140

hips, knees

Front 141

RA hand terms

Back 141

boutonniere thumb, ulnar deviation, swan-neck fingers

Front 142

rheumatoid factor

Back 142

- early, + late

Front 143

what determines if inflammatory process is present

Back 143

ESR, CRP (erythrocyte sedimentation rate and c reactive protein)

Front 144

RA cortico

Back 144

prednisone 2.5-7.5mg daily

Front 145

long term steroid use can cause

Back 145

osteoporosis, cataracts, HTN, inc risk for infection

Front 146

RA NSAID

Back 146

cox 2 inhibitor (celebrex)

Front 147

RA DMARDs

Back 147

disease modifying antirheumatic drugs

Front 148

begin DMARDs within

Back 148

3 months of RA dx

Front 149

DMARD ie

Back 149

methotrexate

Front 150

DMARD dec ___, reduce/prevent ___, preserve ___

Back 150

decrease pain and inflammation, reduce/prevent joint damage, preserve structure and function of joints