Ssc Ams Test 4 - Bones & Connective Tissue

Front 1

An excellent early predictor of RA. This lasts a few minutes to an hour or more each morning. Must last at least 6 months duration in order to be diagnostic:

Back 1

Early a.m. joint stiffness

Front 2

This is a warning sign that someone with SLE may be about to get an exacerbation:

Back 2

Temperature elevation; fever

Front 3

Where does the fat of a fat embolism come from after a patient has a total knee or total hip replacement?

Back 3

Bone marrow

Front 4

Why does a patient post-myelography get the worst headache of their life? What is best to help with this?

Back 4

Because the hole where the LP was done leaks CSF and decreases the circulating amount. Keeping well-hydrated is best to treat.

Front 5

This, in the morning, can help RA sufferers move more and get out of bed with more motivation:

Back 5

A hot shower

Front 6

A chronic connective tissue disorder characterized by inflammation, fibrosis, and sclerosis of the skin & vital organs:

Back 6

Scleroderma

Front 7

A complication of total knee and hip replacements and hip fractures; can be life threatening:

Back 7

DVT, fat embolism

Front 8

These two surgical treatments for osteoarthritis are commonly performed when OA begins to affect ability to perform ADLs and walking:

Back 8

Total knee and hip replacements

Front 9

How should NSAIDs be taken to avoid GI upset?

Back 9

With food

Front 10

"Bamboo" spine is seen in this connective tissue problem:

Back 10

Ankylosing spondylitis

Front 11

Initially post-op from a knee replacement, how should the patient's leg be positioned?

Back 11

Elevated

Front 12

Symmetrical joint swelling is diagnostic of RA if these many joints are involved for this length of time:

Back 12

3 more more joints, for at least 6 months

Front 13

How would a physician be able to determine whether or not a bone tumor originated in the bone or if it spread from another organ to bone?

Back 13

By looking at the cells

Front 14

Primary (bone-originating) bone tumors that are malignant most likely develop before this age? Is the prognosis good or poor?

Back 14

Before age 30; poor prognosis

Front 15

How would a patient recovering from spinal surgery be turned? Why?

Back 15

By log-rolling; keeps the spine straight

Front 16

Where would you watch for bleeding postoperatively in a patient who has had a total knee replacement?

Back 16

Under the knee

Front 17

These types of bone tumors can often be asymptomatic and are often found by accident:

Back 17

Benign

Front 18

These potent antiinflammatory drugs are given to RA patients when they have exacerbations:

Back 18

Steroids

Front 19

What is the distinguishing characteristic of scleroderma?

Back 19

Sausage fingers

Front 20

A definitive way to tell if a bone tumor is benign or malignant:

Back 20

Biopsy

Front 21

Test done to check for tumors, metastasis, and osteomyelitis; an isotope is injected which shows "hot spots" where there is increased bone turnover:

Back 21

Bone scan

Front 22

These types of objects are prohibited in MRI areas:

Back 22

Metal

Front 23

When do symptoms of a fat embolism appear after a total hip or knee replacement?

Back 23

1-7 days post-op

Front 24

True of false: Post-op hip replacement patients should allow little to no flexion of their hips.

Back 24

True

Front 25

Rest would actually be encouraged for a patient with this joint disorder:

Back 25

Osteoarthritis

Front 26

Tumor that arises from cartilage tissue; not too common but yields a fair prognosis. S/S include a dull pain and swelling for a long period of time:

Back 26

Chondrosarcoma

Front 27

True or false: There is no cure for scleroderma.

Back 27

True

Front 28

Which isoenzyme is elevated with skeletal muscle problems?

Back 28

CK-MM

Front 29

What are the three signs and symptoms most associated with fat embolism?

Back 29

Fever, petechiae, and change in level of consciousness

Front 30

A chronic inflammatory disorder that starts in the sacroiliac joint and moves upward until there is fusion of the entire spine:

Back 30

Ankylosing spondylitis

Front 31

SIADH is a complication following what kind of surgery?

Back 31

Spinal

Front 32

The most common of the malignant bone tumors; most often involves the distal femur. Signs are swelling and pain in the affected area. Lung metastasis is common with death within 2 years:

Back 32

Osteosarcoma

Front 33

A chronic progressive inflammatory disorder that causes organ failure; has periods of exacerbations and remissions:

Back 33

SLE

Front 34

What organ(s) are mostly affected by SLE and are a major cause death?

Back 34

Kidneys

Front 35

What is the primary cause of osteoarthritis? The secondary?

Back 35

Age; trauma to the cartilage

Front 36

A slow-acting antiinflammatory also used to treat malaria as well as RA; takes between 6 & 12 months to work; causes GI upset and retinal edema:

Back 36

Plaquenil

Front 37

How would you know if a person had a dislocated hip?

Back 37

Unrelieved pain, one leg longer than the other, a "popping" sound

Front 38

These diagnostic tests will identify fractures and the presence of other diseases; no patient prep is needed:

Back 38

X-rays

Front 39

In a patient receiving Plaquenil for RA, what may they need to have as a baseline and every six months after first taking the drug due to risk of retinal edema?

Back 39

Eye exam

Front 40

How long does Plaquenil, taken for RA, take to begin to work?

Back 40

6-12 months

Front 41

Another name for secondary bone tumors; more common than primary cancers. Cells spread from elsewhere to the bones:

Back 41

Metastatic bone disease

Front 42

These malignant bone tumors originate in the bone:

Back 42

Primary

Front 43

What is the treatment of choice for primary bone tumors, with or without chemo and radiation?

Back 43

Surgery

Front 44

An increase of serum calcium is seen in this because the calcium is leaking out of the bones and is going into the bloodstream:

Back 44

Bone demineralization

Front 45

Bone cancer common in kids less than 20 y/o; highly malignant. Usually involves pelvis and lower extremities. Pain, swelling, low grade fever, anemia, and leukocytosis are s/s. Usually goes to the lungs, causing death:

Back 45

Ewing's Sarcoma

Front 46

What is the main treatment goal for degenerative bone and joint disorders?

Back 46

Slow disease progression and allow patient to be as independent as they can for as long as possible

Front 47

Up to 3,000 mL of fluid a day is recommended after a myelography using dye for this reason:

Back 47

To help the body flush out contrast dye

Front 48

An increased level of serum calcium results in a decreased level of this:

Back 48

Serum phosphorus

Front 49

How should a patient with ankylosing spondylitis sleep in bed?

Back 49

Flat with no pillows

Front 50

People taking new and expensive RA drugs, like Humira and Enbrel, are more at risk for infections and shouldn't take them if they've ever had TB:

Back 50

Biological response modifiers

Front 51

Found in 90% of all people with RA; little bumps up underneath the joint skin. Collections of debris that have settled there:

Back 51

RA nodules

Front 52

What is the most distinguishing characteristic of SLE?

Back 52

Butterfly rash on the face

Front 53

How often should neurovascular checks be done post-myelography?

Back 53

Every hour

Front 54

This machine decreases post-op swelling of the joint, decreases pain, prevents adhesions, helps with early ambulation, prevents contractures, and facilitates healing:

Back 54

CPM

Front 55

Assumption of the Risk

Back 55

If the plaintiff expressly or impliedly consents to relieve the defendant of an obligation of conduct toward the plaintiff and to take his chances of harm from a particular risk, he is held to have assumed that risk and he is barred from recovering. (Murphy v. Steeplechase Amusements - the "flopper" ride. 'One who takes part in such a sport accepts the dangers that inhere in it so far as they are obvious and necessary.")

Front 56

Problem in which the walls of arteries become inflamed and causes ischemia to the tissues involved; treated with steroids:

Back 56

Systemic necrotizing vasculitis

Front 57

A radiologic exam of the spinal canal; radiopaque dye is injected into the arachnoid space. Used to detect herniated discs and tumors:

Back 57

Myelography

Front 58

What is the most important thing to remember in taking care of a post-op hip replacement patient?

Back 58

Never cross the hips over the body's midline - NO ADDUCTION!

Front 59

A chronic, systemic, progressive inflammatory disease that causes symmetrical joint involvement with remissions and exacerbations; exact cause is unknown:

Back 59

RA

Front 60

Malignant bone tumor that has started someplace else (like the breast, liver, or colon) and has spread to the bone:

Back 60

Secondary tumor

Front 61

Disease that occurs as part of the aging process; the spinal disc space narrows and loses resiliency; back pain, decrease ROM, numbness, paralysis, and tingling occur:

Back 61

Degenerative spinal disease

Front 62

True or false: Unilateral joint stiffness and swelling are indicative of RA.

Back 62

False - Symmetrical joints are affected.

Front 63

What should be between the legs of a patient who has just had a hip replacement and needs turned?

Back 63

A pillow or abduction pillow

Front 64

True or false: one of the goals for RA treatment is for the patient to NOT become immobile.

Back 64

True

Front 65

Measures electrical activity of the muscles; can be used to distinguish between nerve problems and muscle problems. Needles are stuck into the muscle and electricity is applied:

Back 65

EMG (electromyelogram)

Front 66

An inherited disorder in which the patient has skeletal, ocular, cardiopulmonary, and CNS problems; excessively tall with long hands and feet, scoliosis, decreased vision and glaucoma, and a funnel-shaped chest:

Back 66

Marfan's Syndrome

Front 67

What information is most important to obtain before a patient has a procedure involving radiopaque contrast dye?

Back 67

Allergies

Front 68

Taking amphetamines, phenothiazides, or tricyclic antidepressants 12 hours before a myelography may increase the risk of these:

Back 68

Seizures

Front 69

This acid, present in the urine, may be elevated in bone demineralization:

Back 69

Uric acid

Front 70

This type of exercise program is excellent for RA patients to take pressure off of the joints while working out:

Back 70

Water exercise

Front 71

Bone demineralization is commonly seen in patients who don't have any orthopedic problems if they are:

Back 71

Immobile or bedridden

Front 72

What usually causes the death of Marfan's Syndrome patients?

Back 72

Cardiac problems

Front 73

Test done to measure bone density to help in the diagnosis of osteoporosis, predict risk of fractures, and to monitor treatments:

Back 73

Bone densitometry

Front 74

Degenerative hypertrophic joint changes manifested by pain, swelling, decreased ROM, crepitus & grating, and stiffness worse in the morning:

Back 74

Osteoarthritis

Front 75

True or false: Patients who have RA have problems in their joints ONLY, nowhere else.

Back 75

False - it can affect any body part

Front 76

These are now the first line treatments for RA; patients are started off on them:

Back 76

NSAIDs