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41 Cards in this Set
- Front
- Back
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What % of patients with a prior vertebral fracture experience more fractures within 3 years?
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50%
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Define osteoporosis:
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A skeletal disorder characterised by compromised bone strength predisposing to increased risk of fracture
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How much bone mass can a woman lose in the first 5-7 years post-menopause?
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20%
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Risk factors for osteoporosis:
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Female
Over 65 years Caucasian or Asian Low body weight Family history Glucocorticoids Thyroid replacement Previous fracture Early estrogen deficiency Testosterone/estrogen depletion Low calcium intake Vitamin D deficiency Sedentary 3+ drinks/day Smoker |
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Most common form of secondary osteoporosis:
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Glucocorticoid-induced
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What kind of glucocorticoid use can lead to secondary osteoporosis?
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Long-term use of oral (> 3 mo)
High-dose inhaled (> 5mg prednisone) |
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Where should bone mineral density be evaluated?
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Hip, spine
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General guidelines for prevention/treatment of osteoporosis:
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Calcium
Weight bearing exercise Avoid soft drinks |
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Pharmacologic treatment of osteoporosis:
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Biphosphonates
Selective estrogen receptor modulators Calcitonin |
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High-calcium foods:
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Yogurt
Sardines Cheese Milk Tofu Fruit juice Salmon Turnip greens Cereal (fortified) |
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Vitamin D needs for 50+ y/o:
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800-1000 IU/day
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Vitamin D needs for under-50 yo:
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400-800 IU/day
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Foods providing Vitamin D:
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Fortified milk, cereal, OJ
Fatty fish and eggs |
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Most easily absorbed calcium supplement:
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Calcium citrate
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How do bisphosphonates work?
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Inhibit osteoclast activity
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Administration guidelines for bisphosphonates:
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Take before breakfast with a full glass of water
Nothing by mouth for 30 minutes Stay upright for 30 minutes |
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Side effects of bisphosphonates:
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Hypocalcemia
Abdominal pain Bone, joint, muscle pain Uveitis Atrial fibrillation Osteonecrosis of the jaw Femoral fractures |
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Side effects of ORAL bisphosphonates:
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Difficult/painful swallowing
Nausea Heartburn Esophagitis |
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Bone mineral density peaks between the ages of:
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25-30 years
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How do we prevent dislocation of new hip replacement?
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Abduction pillow
Don't cross legs Don't bend operated leg at more than 90 degrees |
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Major sites of osteoarthritis:
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Spine
Knee Hip Hand Foot |
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Index used to assess hip and knee osteoarthritis:
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WOMAC index
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Scoring of the WOMAC index:
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0-100
> 39 is severe arthritis |
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Recommended calcium intake for adults 19-49:
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1,000 mg/day
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Recommended calcium intake for adults 50+ years:
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1,200 mg/day
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Elements of a bone-healthy diet:
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Low soda consumption
Potassium Low sodium Iron and folate (childbearing women) B12 (people over 50) Vitamin D |
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Define osteomalacia:
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Loss of bone related to vitamin D deficiency
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Osteomalacia vs. osteoporosis:
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Osteomalacia: demineralized (softened) bone from lack of vit D
Osteoporosis: decreased bone mass from lack of calcium |
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Causes of osteomalacia:
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Vitamin D deficiency
Kidney disease IBD Liver disease Drugs |
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What causes phantom limb pain?
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Mixed nerve signals in the spinal cord/brain, damaged nerve endings, scar tissue, physical memory of pre-amputation pain
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When does phantom limb pain begin?
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Early post-op
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What are the sx of phantom limb pain?
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Shooting, stabbing, boring, squeezing, throbbing, or burning pain
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Is phantom limb pain psychological or physiological?
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Physiological
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Define osteomyelitis:
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Bone infection
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Treatment of osteomyelitis:
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Long term antibiotics
Wound irrigation, dressing changes Pain medication Hyperbaric O2 therapy Surgical debridement |
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Define compartment syndrome:
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Increased pressure within 1 or more compartments causing impaired circulation and ischemia (from edema)
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Body parts most commonly affected by compartment syndrome:
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Lower leg and forearm
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Sx of compartment syndrome:
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Early: localized, throbbing pain unrelieved by opioids; area is firm and hard
Late: parasthesia, pulselessness, paralysis |
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Joints affected by rheumatoid arthritis:
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Basically everything besides the spine
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Two types of nodes seen in RA:
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Bouchard's
Heberden's |
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Physical therapy/exercise in RA:
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Acutely inflamed joints should be rested
Non-inflamed joints can benefit from stretching |
