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213 Cards in this Set
- Front
- Back
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Progressive regression in the mass of bone in relation to its volume.
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Osteoporosis
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The bone is is normal in shape but there is less tissue
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Osteopenia
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2 Types of Osteoporosis
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Localized and generalized
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Localized immobilization as in a fractured lower extremity that is in a cast
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Localized Osteoporosis
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Primary and Secondary Osteoporosis
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Generalized Osteoporsis
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Seen in elderly, bone resorption exceeds deposition,
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Primary Osteoporosis
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Disuse, hormonal osteoporosis, neoplasia, GI, drugs
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secondary osteoporosis
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defective mineralization of newly formed bone that occurs in children
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rickets
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defective mineralization of newly formed bone in adults
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osteomalacia
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deficiency of vitamin D, failure of vitamin D synthesis, vitamin D loss, renal disease , impaired metabolism, excess Ca2+ demands
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causes of rickets (children) and osteomalacia (adults)
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failure of calcification, overgrowth of cartilage, deposition of osteoid on persistent cartilage, ingrowth of fibroblasts and capillaries into costochondral junction, abnormal epiphysis
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Pathology of Rickets
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Affects membranous bones and cartilaginous bones, cant mineralize the newly deposited osteoid, looks similar to fracture
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Pathology of Osteomalacia
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What is due to a deficiency of vitamin C? This leads to the failure of the formation of osteoid.
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Scurvy
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What type inappropriately produces too much parathyroid hormone, like a benign tumor, and results in reabsorption of bone and deposition in the soft tissues?
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Primary Hyperparathyroidism
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What has an increase in parathyroid hormone in response to decreased levels of blood calcium? (chronis renal disease is a common cause)
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Secondary Hyperparathyroidism
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Make formations called Brown Tumors?
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Primary Hyperparathyriodism
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Characterized as local or widespread distortion of a bony architecture due to increased turnover that leads to thickening and weakness of bones
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Paget's Disease
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Associated with a chronic virus infection particularly paramyxovirus
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Paget's Disease
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Disease with thickening of the skull, polyostotic lesions to bone, pathologic fracture, and ostegenic sarcoma
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Paget's Disease- treat w/ calcitonin and diphosphonates
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Disease with the replacement of an area of bone by cellular connective tissue?
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Fibrous Dysplasia
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T/F: You can have multiple endocrinopathies due to hypofunction of an endocrine gland
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F: There is generally only one endocrinopathy associated with hypofunction of an endocrine gland.
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What is hyperfunction of an endocrine gland usually lead to? (Choose most correct)
A. Agenesis and atrophy B. Hyperplasia and agenesis C. Tumor and hyperplasia D. Atrophy and necrosis |
C. Tumor and hyperplasia
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Hypofunction of an endocrine gland may be caused by: (Choose most correct)
A. Agenesis, atrophy, infection B. Hyperplasia, necrosis, hypertrophy C. Atrophy, death, hyperplasia |
A. Agenesis, atrophy, and infection
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What are 2 diseases associated with hyposecretion of the ant. pituitary gland?
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1. Simmonds disease
2. Pituitary Dwarfism |
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What are 5 potential causes of Simmonds disease?
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1. Post-partum pituitary necrosis (Sheehans Syndrome)
2. Non-functioning pituitary tumor 3. Pituitary failure in late acromegaly 4. Hypophysectomy 5. Infiltrative diseases |
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Which of the following is a disease associated with Simmonds disease. Symptoms: Mother who just gave birth, and is experiencing 1.Failure to lactate and 2. Is not mensturating?
A. Post Partum pituitary necrosis (Sheehans Syndrome) B Non-functioning pituitary tumor C. Pituitary failure in late acromegaly D. Hypophysectomy 5. Infiltrative diseases |
A. Post-partum pituitary necrosis (Sheehan's syndrome)--> caused b/c the BP in the mother drops very low, baby if perfectly fine
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Which of the following is characterized as removal of the pituitary gland for management of an estrogen dependent carcinoma of the breast or for treatment of a pituitary adenoma?
A. Post Partum pituitary necrosis (Sheehans Syndrome) B Non-functioning pituitary tumor C. Pituitary failure in late acromegaly D. Hypophysectomy |
D. Hypophysectomy
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What are 2 examples of an infiltrative disease (associated with Simmonds disease...hyposecretion of pitu.)
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1. Histiocytosis X (Hand-Schuller-Christian)
2. Amyloid |
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What is most often due to a pituitary adenoma?
A.Hyposecretion B. Hypersecretion |
B. Hypersecretion
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What are the most common types of hyperpituitarism diseases? (in order, 3)
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1. Hyperprolactinemia
2. Excessive growth hormone 3. Corticotrophin (ACTH) aka Cushings Disease |
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Monostotic- 75%- most cases
Polyostotic-25% |
Fibrous Dysplasia
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Linked with polyostotic fibrous dysplasia, female dominance, pigmentation of skin and endocrine issues?
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Albright's Syndrome
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Coast of Maine appearance, cafe au lait spots around the buttocks??
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Albright's Syndrome
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Group of childhood diseases where one or more of the osification centers undergoes degeneration or necrosis, followed by deformity?
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Juvenile Osteochondroses
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Legg-Calve Perthes disease, freiberg's infarction, panner disease and keinbock disease
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True Juvenile Osteochondroses
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Osgood Schlatter, Blount disease, sever and Scheuermann disease
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false juvenile osteochondroses
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What is an osteonecrotic disease of the proximal femoral epiphysis, common in white males, affects thigh or hip in difficulty walking?
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Legg-Calve Pethes Disease
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Microfractures in the area of the tibia where the patellar tendon inserts into the tibial tuberosity, assoc w/ growth in athletes>
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Osgood Schlater Disease
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Seen in boys 11-15 and girls 8-13, usually resolves on ts own and Tx is to reduce tension on the tibial tuberosity?
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Osgood Schlatter disease
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Juvenile osteochondrosis, slipped femoral epiphysis, scoliosis
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pediatric bone disorders
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T/F: In females with hyperprolactinemia, it is most often macroadenoma
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F: Females with hyperprolactinemia, it is most often MICROadenoma
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In females this presents with galactorrhea, amenorrhea, and infertility.
In males this presents with decreased libido and impotense, there may be gynecomastia? (Its a problem with hypersecretion of the ant. pituitary gland) |
Hyperprolactinemia
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What is the treatment for hyperprolactinemia?
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With bromocryptine that has a dopamine like effect on ant. pituitary because DOPAMINE IS THE PROLACTIN INHIBITORY HORMONE!
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What is excessive growth hormone (somatotropin) most often cause by?
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Adenoma of the somatotropes
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What are 2 examples of excessive growth hormone (somatotropin)?
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1.Gigantism
2. Acromegaly |
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Excessive growth hormone present before the epiphyses of the bones have fused, produces an individual who is a lot taller than would be expected is characteristic of what?
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Gigantism-->BEFORE epiphyses is closed
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Excessive growth hormone after the epiphyses have fused so that bones cannot increase in length, but in width is called what?
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Acromegaly-->AFTER epiphyses is closed
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What is corticotrophin (ACTH) excess also referred to as?
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Cushings Disease
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Nelsons syndrome is associated with which disease of hypersecretion of the ant. pituitary gland?
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Corticotropin excess aka Cushings Disease
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Development of hypopituitarism years after the removal of the adrenal glands for primary bilateral adrenal hyperplasia when the problem is in the adrenal glands was in fact secondary to a pituitary adenoma producing ACTH
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Nelsons syndrome
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What are the 3 diseases of the Anterior pituitary gland?
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1. Hyposecretion
2.Hypersecretion 3. Pituitary Adenomas |
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T/F: Adenomas less then 12 mm are called microdadenomas, larger than this are macroadenomas
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F: Less the 10 mm are microadenomas and larger than this are macroadenomas
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Name this disease: Can happan @ any age (ususally 20-50) and either sex (m.c in males). Has mass effects, and tends to show excessive hormone secretion
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Pituitary Adenoma--> TX: removal of the adenoma and hormone replacement as necessary.
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What are the 2 hormones in the posterior pituitary (that we are concerned about)?
A. ADH B. ACTH C. Oxytocin D. A & B E. A&C |
E. A&C--> ADH and Oxytocin are made in the hypothalamus and stored in the post. pituitary
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What are 2 diseases of the post. pituitary?
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1. Diabetes Insipidus
2. Excessive ADH secretion |
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Causes: Head injury/Tumors/Infections
Effects: polyuria, excessive thirst, can cause severe dehydration, dilute urine TX: Nasal spray containing the hormone |
Diabetes Insipidus
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What does an insufficient production of ADH lead to?
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Diabetes Insipidus
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Causes: Ectopic production pulmonary disease (tuberculosis/malignant tumors of lung); CNS disease; Drugs
Effects: Inappropriate absorption of waterin the DCT of kidney; Weight gain and more severe= hyponaturemia which could produce coma |
Excessive ADH Secretion
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What are 6 diseases of the thyroid gland?
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1. Grave's Disease
2. Hashimoto's Thyroiditis 3. Subacute thyroiditis 4. Riedel's thyroiditis 5. Diffuse non-toxic and multi-nodular goiter 6. Thyroid neoplasms |
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Characterized as: Hyperthyroidism, difuse nodular goiter, exophthalmos (Triad)
A. Graves Disease B. Hashimoto's C. Subacute thyroiditis D. Riedel's thyroiditis E. Thyroid neoplasms |
A. Grave's disease
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What factors are common in Graves Disease?
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HLA factors e.g. HLA B8
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Autoimmune with circulating antibodies and destruction by cytotoxic T cells; the gland is infiltrated by lymphocytes.
A. Graves Disease B. Hashimoto's C. Subacute thyroiditis D. Riedel's thyroiditis E. Thyroid neoplasms |
Hashimoto's Thyroiditis
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What is also known as Lymphadenoid thyroiditis or lymphocytic thyroiditis?
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Hashimoto's Thyroiditis
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Clinical features of this thyroid gland disease include: hypothyroidism with a goiter
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Hashimoto's thyroiditis
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Clinical features of this thyroid gland disease include: lid lag
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Grave's
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Acute onset of painful enlargement of the thyroid gland with fever, malaise, and muscle aches
May have transient hyperthyroidism A. Graves Disease B. Hashimoto's C. Subacute thyroiditis D. Riedel's thyroiditis E. Thyroid neoplasms |
C. Subacute thyroiditis--> may have a viral origin (EBV or Coxsackie viruses)
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T/F: If a person recovers from subacute thyroiditis the thyroid gland could recover with no longterm effects?
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T: No sequella in this disease
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Subacute thyroidities is also known as?
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DeQuervan's Thyroiditis
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Which disease of the thyroid gland is characterized as: a rare chronic condition with dense fibrosis of the thyroid gland?
A. Graves Disease B. Hashimoto's C. Subacute thyroiditis D. Riedel's thyroiditis E. Thyroid neoplasms |
D. Riedel's thyroiditis--> destruction of thyroid follicles (parenchyma); fibrosis can compress the trachea
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Clinically: Pt notices the gradual development of a painless goiter along with the consequences of compression of the trachea, esophagus and the recurrent laryngeal nerve.
A. Graves Disease B. Hashimoto's C. Subacute thyroiditis D. Riedel's thyroiditis E. Thyroid neoplasms |
Riedel's Thyroiditis
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What is the commonest neoplasm of the thyroid gland?
A. Thyroid carcinoma B. Hashimoto's C. Follicular adenoma |
C. Follicular adenoma
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Which thyroid neoplasm presents as "cold" nodules that do not take up iodine?
A. Thyroid carcinoma B. Hashimoto's C. Follicular adenoma |
C. Follicular adenoma-->solitary, well-circumscribed nodule from 1-3 cm in diameter
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What are the 2 types of thyroid neoplasms?
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Follicular adenoma and Thyroid carcinoma
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What are the 4 types of thyroid carcinoma?
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1. Papillary carcinoma
2. Follicular carcinoma 3. Anaplastic carcinoma 4. Medullary carcinoma |
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THYROID CARCINOMAS:
Origin: follicular epithelial cell M/C of all thyroid carcinomas Slowly growing tumor that infiltrates locally and often has + lymph nodes @ time of diagnosis: A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
A. Papillary carcinoma--> m/c in females (3:1)
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THYROID CARCINOMAS:
Has a five year survival rate of 65% and the 20 year survival rate is 30% A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
B. Follicular carcinoma
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What is the tumor marker for papillary carcinomas?
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Thyroglobulin
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THYROID CARCINOMAS:
Origin is follicular epithelial cell May occur at any age but m/c in middle age. May be grossly infiltrative or encapsulated and is often angioinvasive A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
B. Follicular carcinoma-->see m/c in females
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THYROID CARCINOMAS:
Has a 5-year survival rate of 90% and a 20-year survival rate of 85%? A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
A. Papillary carcinoma
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What is the tumor marker for follicular carcinomas?
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Thyroglobulin
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THYROID CARCINOMAS:
Rapidly growing tumor that infiltrates widely locally A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
C. Anaplastic carcinoma
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THRYOID CARCINOMAS:
Has a 5 year survival rate of almost none. A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
C. Anaplastic carcinoma
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T/F: Anaplastic carcinoma's spread is through both lymphatics and the blood
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TRUE!
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THYROID CARCINOMAS:
Origin is the parafollicular or C cells of the thyroid gland Slow growing mass that is infiltrative but doesn't tend to produce metastasis A. Papillary carcinoma B. Follicular carcinoma C. Anaplastic carcinoma D. Medullary carcinoma |
D. Medullary carcinoma--> m/c seein in the age group of 30-60 yrs with an EQUAL SEX INCIDENCE
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What is the tumor marker for medullary carcinomas?
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Calcitonin
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What are the diseases of the parathyroid glands? (3)
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A. Excessive parathyroid hormone secretion
B. Hypoparathyroidism C. Pseudohypoparathyroidism |
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PARATHYROID GLAND:
Reabsorbtion of calcium from bone to the blood stream Clinical signs are fractures, renal stones, constipation, CNS depression A. Excessive parathyroid hormone secretion B. Hypoparathyroidism C. Pseudohypoparathyroidism |
A. Excessive parathyroid hormone secretion--> m/c in females ("BONES, STONES, GROANS, MOANS")
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PARATHYROID HORMONE:
Causes are adenoma or hyperplasia of the parathyroid glands Effects= MENS syndrome TX= removal of adenoma? |
Primary hyperparathyroidism
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PARATHYROID GLAND:
Iatrogenic, Idiopathic, and DiGeorges syndrome can cause this (aka Congenital Thymic Aplasia) Hypocalcemia that produces tetany and convulsions TX: Vit D therapy and calcium supplements. A. Excessive parathyroid hormone secretion B. Hypoparathyroidism C. Pseudohypoparathyroidism |
B. Hypoparathyroidism
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PARATHYROID GLAND:
Cause: Genetic disease in which there is insensitivity of the receptor to PTH Effects: High PTH and soft tissue calcification; Albrights hereditary osteodystrophy A. Excessive parathyroid hormone secretion B. Hypoparathyroidism C. Pseudohypoparathyroidism |
C. Psudohypoparathyroidism
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What are the diseases of the adrenal cortex?
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A. Hypofunction-->Addison's disease (Primary Adrenocortical deficience)
B. Hyperfunction of the cortex |
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ADRENAL CORTEX:
Idiopathic cortex is infiltrated with lymphocytes Effects are weakness, pigmentation of skin, loss of weight, anorexia, nausea and vomitting, hypotension? A. Hypofunction primary adrenocortical deficiency (Addison's disease) B. Hypofunction secondary adrenocotical deficiency C. Hyperfunction of cortex |
A. Addisons disease
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ADRENAL CORTEX:
Hypopituitarism, corticosteroid--induced hypoadrenalism Nelson's syndrome and Water-House Friedricksen syndrome are associated with this? A. Hypofunction primary adrenocortical deficiency (Addison's disease) B. Hypofunction secondary adrenocotical deficiency C. Hyperfunction of cortex |
B. Secondary Hypofunction
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What is bilateral hemorrhages into the adrenal glands with a septicemia especially meningococcus? (Syndrome with secondary hypofunction)
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Water-House Friedricksen Syndrome
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ADRENAL CORTEX:
Causes: adrenocortical adenoma, adrenal carcinoma, secondary to pituitary problems A. Hypofunction primary adrenocortical deficiency (Addison's disease) B. Hypofunction secondary adrenocotical deficiency C. Hyperfunction of cortex |
C. Hyperfunction of the cortex
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Associated with hyperfunction of the cortex
Congenital problems with the glucocorticoid metabolism Female infants= ambiguous external genitalia, accelerated growth, but epiphyses closes early Male infants= enlarged genitalia, accelerated growth and sexual maturation, "Infant Hercules"? |
Adrenal Virilism (Adrenogenital syndrome)
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What are three diseases that are caused from hyperfunction of the cortex?
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A. Adrenal Virilism (Adrenogenital syndrome)
B. Hyperaldosternosim C. Cushings syndrome (Not Cushings Disease it refers to one specific cause of the syndrom, a tumor adenoma in the pituitary gland that produces large amounts of ACTH, which in turn elevates cortisol) |
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ADRENAL CORTEX (hyperfunction):
Hyperplasia or adenoma of zona glomerulosa, rarely a carcinoma, Aldosterone producing adenoma TX: Spironoloacetone A. Adrenal Virilism (Adrenogenital syndrome) B. Hyperaldosternosim C. Cushings syndrome D. Cushings disease |
B. Hyperaldosternosim
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Symptoms: Hypertension, hypokalemia, impaired renal concentration and polyuria, low plasma renin activity
These are symptoms of what syndrome associated with hyperaldosternosim? |
Conn's Syndrome
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Primary adrenocortical disease is called?
A. Cushings Disease B. Cushings Syndrome |
Cushings syndrome
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What are the diseases of the adrenal medulla? (3)
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A.Pheochromocytoma
B. Ganglioneuroma C. Neuroblastoma |
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What are the three types of Multiple Endocrin Neoplasia Syndromes?
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A. MEN type I; Werner's Syndrome
B. MEN type IIa; Sippled Syndrome C. MEN IIb; William syndrome |
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What of the MENS has an autosomal dominant mode of inheritance?
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Werner's Syndrome (MEN type I)
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The components:
1. Parathyroid hyperplasia 2. Pancreas, insulinomas and Zollinger-Ellison 3. Pituitary tumors Are part of which MENS? A. MEN type I; Werner's Syndrome B. MEN type IIa; Sippled Syndrome C. MEN IIb; William syndrome |
A Werner's Syndrome (MEN type I)
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The components:
1. Thyroid-medullary carcinoma 2. Adrenal medulla-pheochromocytoma 3. Parathyroids-hyperplasia Are characteristic of which MENS? A. MEN type I; Werner's Syndrome B. MEN type IIa; Sippled Syndrome C. MEN IIb; William syndrome |
B. Sippled Syndrome (MEN type 2a)
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The components:
1. Thyroid 2. Adrenal 3. Ganglioneuromas of extra-endocrine sites Are characteristic of which MENS? A. MEN type I; Werner's Syndrome B. MEN type IIa; Stippled Syndrome C. MEN IIb; William syndrome |
C. William Syndrome (MEN type 2b)
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T/F: Diabetes Mellitus is characterized as having glucose in the urine?
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TRUE
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How is Diabetes Mellitus classified?
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2 groups: 1. Primary group (Type I and Type II) 2. Secondary
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Chonic pancreatitis, hormonal tumors, hemochromatosis, drugs (glucocorticoids), genetic disorders, and surgical are all examples of which kind of diabetes mellitus?
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Secondary
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What is the 7th leading cause of death?
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Diabetes Mellitus
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What results from a severe, absolute lack of insulin caused by the loss of Beta cells?
A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
Diabetes Mellitus Type I
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T/F:In primary diabetes mellitus, Type I is non-insulin dependent and Type II is insulin dependent
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F: Type I is Insulin dependent and Type II is non insulin dependent
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Usually develops in childhood. Genetic susceptibility, environmental insult, and auto-immunity are thought to be causes.
Associated with particular HLA types, esp. HLA-DR3 and HLA-DR4 A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
A. Type I
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Destruction of beta cells-->Insulin deficiency-->Hyperglycemia--> Decreased utilization of glucose--->Polydipsia and Gluconeogenesis& ketogenesis-->ketoacidosis and potential coma
A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
A. Type I
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Genetic predisposition, deranged insulin secretion, obesity, increased insulin secretion are all characteristics that lead to:
A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
B. Type II
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These are less severe and easily controlled.
Ketoacidosis is rarely seen May present with polyuria and polydipsia A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
B. Type II--> can be treated with weight loss, control of glucose levels, and insulin initially
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Complications include:
Nephrosclerosis, Retinopathy, Atherosclerosis leading to myocardial infaction, CVA and peripheral gangrene A. Type I Diabetes Mellitus B. Type II Diabetes Mellitus |
B. Type II
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What are 3 diseases of the endocrine pancreas?
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1. Diabetes Mellitus
2. Insulinoma 3. Gastrinoma |
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Produces Hypoglycemia
The tumor pours insulin out no matter what 1. Diabetes Mellitus 2. Insulinoma 3. Gastrinoma |
Insulinoma
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Tumor that produces gastrin.
Zollinger-Ellison Syndrome, so pt experiences: Hypergastrinemia, over production of gastric acid, development of intractable peptic ulcers. 1. Diabetes Mellitus 2. Insulinoma 3. Gastrinoma |
Gastrinoma
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Insulinoma and Gastrinoma are considered what type of tumor?
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Islet Cell tumors
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Name 3 soft tissue injuries
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1. Contusion
2. Hematoma 3. Laceration |
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T/F: We strain our muscles and we sprain our ligaments?
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TRUE
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Stretching or partial tear in a muscle or muscle tendon. Usually occur when a muscle that is actively contracting is suddenly stretched
A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
A. Strain
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Common sites are low back and the cervical region.
Characteristic symptoms include pain, stiffness, swelling and local tenderness. Pain increases w/stretching. A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
A. Strain
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Stretching or tearing of the ligaments around a joint. Usually caused by abnormal or excessive movement of the joint.
A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
B. Sprain
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Signs/Symptoms include pain, rapid swelling, heat, disability, discoloration and limitation of function.
A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
B Sprain
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T/F: For a STRAIN you should immobilize for several weeks at least, longer if surgical repair was needed.
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F: For a strain, you should immobilize until the pain and swelling have subsided
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T/F: For a SPRAIN you should immobilize for several weeks at least, longer if surgical repair was needed.
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TRUE!
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Loss of continuity of joint surfaces caused by displacement of separation of the bone ends from their positions in the joint
A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
C. Dislocation
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A disorder of the growth plate of the femoral head that occurs near the time of skeletal maturuty
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slipped femoral epiphysis
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Complications of this disease include avascular necrosis, leg shortening, malunion, problems with the internal fixation, and degenerative arthritis?
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slipped femoral epiphysis
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A lateral deviation of the spinal column that may or may not include rotation and deformity of the vertebrae.
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Scoliosis
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More common in girls and develops in adolescents, 75-80% are idiopathic in nature, short way: adolescent (11 yo) females with idiopathic structural being m/c
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scoliosis
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disturbances in vertebral developmentthat cause structural abnormalities that cause a severe curvature
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congential structural scoliosis
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M/C in the shoulder and AC joints
Causes include: Congenital, Traumatic, and Pathologic Symptoms include: pain, deformity and limited movement A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
C. Dislocation
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Small pieces of cartilage or bone within a joint space
May result from trauma or may occur when cartilage has worn away from articular surface causing a piece of necrotic bone free. A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
D. Loose bodies or Joint mice
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T/F: TX for dislocation should not include immobilization.
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F: TX for dislocation depends on site, MOI, and associate injuries. Immobilization is required afterwards b/c of associated soft tissue injuries
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Symptoms include painful catching and locking of the joint
May lead to osteoarthritis and restricted movement A. Strain B. Sprain C. Dislocation D. Loose bodies or Joint Mice |
D. Loose bodies or Joint Mice
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Commonly occur as a result of rotational injury from sharp/sudden pivot
Symptoms: painful & edematous knee; may have knee instability TX: Surgery A. Patellar Subluxations and Dislocations B. Chondromalacia C. Meniscus Injuries |
C. Meniscus Injuries
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Causes: Congential knee variations, Trauma
Sx: Knee giving out, swelling, crepitus, loss of ROM TX: non-surgical and surgical methods A. Patellar Subluxations and Dislocations B. Chondromalacia C. Meniscus Injuries |
A. Patellar Subluxations and Dislocations
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Softening of the articular cartilage most often under the patella
Cause: recurrent sublux of patella/overuse w/athletics SX: Ant knee pain esp when climbing stairs with knees bent. TX: Rest, Isometric exercise, ice A. Patellar Subluxations and Dislocations B. Chondromalacia C. Meniscus Injuries |
B. Chondromalacia-->Knee may also give way or lock with occasional weakness
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Traumatic in nature, Usually post. direction, Knee and hip in flexed position and knee is struck, May cause avascular necrosis
Tx: limit weight bearing A. Dislocation of the hip B. Fracture of the hip |
A. Dislocation--> shortened extremity and foot turns in
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Osteoporosis is imp contributing factor, most result from falls
TX: Early mobilization, weight bearing restricted, surgery. A. Dislocation of the hip B. Fracture of the hip |
B. Fracture of the hip
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T/F: With osteoporosis, it is likely a woman may fracture her hip before the fall
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TRUE
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develops in association with and is caused by neuropathic and myopathic diseases, ex are Duchenne's MD and cerebral palsy
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neuromusculare structural scoliosis
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A scoliometer reading greater than _____ requires a physician referrel. Early diagnosis is most important for treatment.
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10 degrees
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Deficient formation of the acetabulum that allowa the femoral head to ride up out of the joint socket in weight bearing. Unilateral= limp, bilateral= waddling gait
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Congential dislocation of the hip
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Correction for this disease involves an early diagnosis with splinting of the hips in abduction during the first few months of life.
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Congential dislocation of the hip
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Caused by abnormal intrauterine forces, abnormal fetal muscle action or defective ligament insertions.
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clubfoot
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In clubfoot what is it called when the foot goes out or lateral?
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Talipes equinovarus
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In clubfoot what is it called when the foot goes in or medial?
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calcaneovalgus
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arthritis associated with an infectious agent within the joint, usually a single large joint
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suppurative arthritis
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Common strains for this joint infection is staph aureus, strep pyogenes, N. gonorrhea, H. influenza, and salmonella which cause swelling, pain, red, hot, and an immobile joint
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suppurative arthritis
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Deer and mice are examples of (reservoir or vector)?
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reservoir
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Pen reduction and internal fixation because that allows early mobilization
A. Intertrochanteric fracture B. Proximal femur |
A. Intertrochanteric fracture
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How are fractures classified? (4)
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1. Location
2. Communication with the external environment 3. Complete/Incomplete break in the continuity of the bone 4. Configuration fo the fracture |
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What is the m/c type of fracture?
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Sudden injury
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What fracture is cause by repeat wear on a bone?
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Stress fracture
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Where do you m/c find stress fractures? (in what bones)
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M/C in the lower extremity, particularly the POST, MED TIBIAL PAIN in runners.
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What fracture occurs in a bone weakened by disease?
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Pathologic fractures
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Pain, tenderness, swelling, loss of function and defomity.
Open fracture will show bleeding Loss of nerve function (transient) A. Classification of fracture B. Treatment of fracture C. Manifestation of fracture |
C. Manifestation of a fracture
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Severe pain out of proportion to the original injury, loss of motor fcn, occurs following fracture or crushing injury, can happen if cast too tight
A. Fracture Blister B. Acute Compartment syndrome C. Chronic Compartment Syndrome |
B. Acute compartment syndrome
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Symptoms improve @ rest, usually follows exercise
A. Fracture Blister B. Acute Compartment syndrome C. Chronic Compartment Syndrome |
C. Chronic compartment syndrome
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Pain that is out of prop to injury (ANS dysfunction), Muscle wasting, thin/shiny skin, Doesn't go away.
A. Fracture Blister B. Compartment syndrome C. Complex regional pain syndrome D. Fat embolism syndrome |
C. Complex regional pain syndrome
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Is a tick and a flea a reservoir or a vector?
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vector
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Infection by a tick bite (vector) carrying Borrelia Burgdorferi, reservoir is deer and mice
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Lyme Disease
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Sympotoms are papilar skin rash at the bite and the rash last for several months and can develop Migratory Acute Arthritis
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Lyme Disease
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What are the stages of Lyme Disease?
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stage 1: weeks
Stage 2: weeks to months stage 3: late chronic form of the disease |
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Autoimmune disorder in whicg cellular inflammation and antibody complex formation destroy normal synovial tissue and articular cartilage, andusually affects the smal joints
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Rheumatoid Arthritis (RA)
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Chronic form of the disease results in a PANNUS that destroys articular cartilage
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Rheumatoid arthrits
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List the Immune complex variants of rheumatoid arthritis.
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Felty syndrome- chronic RA for splenomegaly and hypersplenism
Still's Disease- Juvenile RA, manifests as fever rash (50% show remission afer puberty) Sjogren Syndrome- triad of RA, dry mouth, dry eyes and involves the parotid gland |
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Classified by 3 conditions: arthritis, uveitis, and urethritis and occurs a week to 10 days after a GI infection or chlamydia, m/c in males
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Reiter's Syndrome
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80% of cases are associated with the HLA- B27 antigen and may present with arthritis of the large lower joints (can't see, can't pee, can't dance with me)
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Reiter's Syndrome
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disease that affects the SI joints that causes chronic inflammation, fibrosis, and calcification leading to boney fusion of joints
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ankylosing spondylitis
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Associated with HLA- B27 antigen and it produces a bamboo spine vertebral column appearance on x-ray
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ankylosing spondylitis
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Single most common form of joint disease?
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Osteoarthrosis
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Degenerative condiion or DJD or "wear and tear" arthritis, osteophyte formation.
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Osteoarthrosis
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Heberden's nodes: osteophytes on the distal interphalangeal joint, with no inflammation and the joint space narrows
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Osteaarthrosis
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group of diseases associated with the elevated levels of uric acid with urate crystal formation in joints
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Gouty Arthritis
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90% of cases, genetic disorder in which purines cant metabolize purines properly, uric acid accumulates over the years
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Primary Gout
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10% of cases, an inability to excrete uric acid (renal disease) or an abnormal amount of purine production as in leukemia
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Secondary Gout
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Terms: Urate crystal formation, gouty nephropathy, tophi
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secondary gout
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What is necessary for the manifestation of gout to occur?
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Hyperuricemia
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Crystals accumulate in small joints (yellow color), like the big toe and lead to...
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acute gouty arthritis
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Chronic, granulomatous inflammation of hands, fingers, ears, there is also increased heart attack risk and renal failure
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Chronic gout
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massively deformed joint caused by the lack of sensory nerve supply to the joint so the body doesnt know when the joint is taken past its normal range of motion
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Charcot's joint
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Muscluar atrophy, Myasthenia Gravis, Lambert-Eaton, Muscular Dystrophy, Neoplasms
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Muscle Disorders
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Neurogenic atrophy due to loss of nerve supply, injury to motor neuron of the SC and infantile spinal muscular dystrophy
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Type 1 myofiber atrophy
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Disuse atrophy and patients who are glucocorticoids, atrophy is only of fast-twitch fibers
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type 2 myofiber atrophy
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Failure of neuromuscular transmission due to blockage of and destruction of acetylcholine receptors by autoanitbody (IgG)
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Myasthenia Gravis
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Characteristics are facial muscle weakness with exercise, fatigue THAT SUBSIDES AT REST!!, ptosis, diplopia, dysphagia, slurred speech and associated with RA and Lupus
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Myasthenia Gravis
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Myasthenic Syndrome, associated with an underlying malignancy, originates in larger muscle groups and exercise MAKES THE MUSCLE STRONGER
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Lambert-Eaton
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List the inflammatory myopathies
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Idiopathic, polymyositis and dermatomyositis, parasitic (toxoplasmosis, trichinosis) disease, virus ( Influenza, coxackie, HIV), bacteria (Typhoid fever)
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List the types of muscular dystrophy:
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Duchenne's, Becker's, Fascioscapularhumeral, lim girdle, myotonic dystrophy
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Primary muscle disease, x-linked recessive, results in the absence of dystrophin (membrane protein)
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Duchenne's MD
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Symptoms are normal at birth and progress rapidly, death usually by 20 and weakness is symmetric and pseudohypertrophy of the calf muscles
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Duchenne's MD
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Similar to Duchenne's but is milder and presents symptoms later
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Becker's MD
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Common, autosomal dominance, mild and onset in the second decade of life
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Fascioscapularhumeral
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Rare, autosomal recessive, moderate degree of severity with onset of symptoms and affects pelvis and shoulders
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Limb Girdle MD
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common, autosomal dominant, onset in adulthood, affects the face, tongue and extremeties
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Myotonic Dystrophy
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Neoplasms of muscle
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Rhabdomyoma, rhabomyosarcoma, Leiomyoma
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uncommon benign tumor if striated muscle tissue
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rhabdomyoma
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malignant tumor of striated muscle that is a tumor of infancy with incidence peaking at the first decade of life, usually in the head, neck, and retroperitoneum
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rhabomyosarcoma
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Most common of all muscle neoplams of muscle
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Leiomyoma
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benign tumor of smooth muscle that is commonly found in the uterus where it is called a FIBROID
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Leiomyoma
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May be diffuse or focal
May be euthyroid, hyperthyroid, or hypothyroid Can compress the rachea causing respiratory obstruction These are all characteristic of what thyroid gland disease manifestation? |
GOITER
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Causes: Grave's Disease, Toxic nodular goiter, functional adenoma, iatrogenic
Effects:Increased metabolic rate causes sweating, weight loss, large appetite, Tachycardia, cardiac failure Anxiety, Oligomenorrhea. All characteristics of what thyroid gland disease manifestaion? |
Hyperthyroidism--> excessive secretion of thyroid hormone
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What are 2 exampes of hypothyroidism?
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1. Cretinism
2. Myxedema |
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Cause: Previously iodine deficiency and simple goiter in mom during preg. Today due to congenital enzyme deficiency
Delayed physical/mental health, Delayed eruption of teeth. Is explaining which hypothyroidism? |
Cretinism
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Causes: Iatrogenic, Hashimoto's thyroiditis, idiopathic. Describes causes of which hypothyroidism?
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Myxedema
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Hypothyroidism in childhood is called?
Hypothyroidism as an adult is called? |
1. Cretinism
2. Myxedema |
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T/F: Hyperthyroid is a non-toxic goiter and hypothyroid is a toxic goiter
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F: Hyperthyroid is a toxic goiter and a Hypothyroid is a non-toxic goiter
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