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150 Cards in this Set
- Front
- Back
changes in appearance from shrinkage noted after |
fifth decade |
|
loss of water in intervetrebal discs |
lose 1 cm q 10 years after age 40 |
|
hyphosis |
hunchack |
|
sarcopenia |
natural loss of muscle tissue from aging |
|
lower extremity atrophy |
earlier than upper, issues with falls |
|
what lines joints |
hyaline cartilage |
|
main joint of hyaline wear and tear |
knee |
|
amount of collagen does not change but becomes |
stiffer |
|
metabolic bone disease |
osteoporosis |
|
joint disease |
osteoarthritis, rheaumatoid arthritis, gout |
|
OA is |
noninflammatory |
|
RA and gout are |
inflammatory |
|
noninflammatory distinguished by 3 sns |
lack of synovial inflammation, absensce of systemic manifestations, normal synovial fuid |
|
inflammatory distinguished by 3 sns |
synovial inflammation, systemic manifestations, abn synovial fluid |
|
most common metabolic disease |
osteoporsis |
|
osteoporiss in women |
50% |
|
long term coritco does what to bones |
weakens |
|
osteoporosis more common in |
whites, asians |
|
2 drugs that increase risk of osteoporosis |
anticonvulsant, thyroidhormoone |
|
4 modifiable risk factors for osteoporosis |
low Ca intake, prolonged immobility, excessive caffeine/alcohol, smoking |
|
osteoporosis primary type 1 |
bone destroyed more rapidly than made |
|
osteoporosis primary type 1 increased incidence of |
vertebral fractures |
|
osteoporosis primary type 1 occurs when |
postmenopausal, related to estrogen levels |
|
osteoporosis primary type 2 |
senescent bone loss |
|
osteoporosis primary type 2 causes decrease in |
actual amount of bone formed during remodeling |
|
osteoporosis primary type 2 increased risk of |
hip fractures |
|
osteoporosis secondary commonly from (2) |
steroids, vit d defecient |
|
osteoporosis sns |
usually absent |
|
osteoporosis referred to as |
silent killer |
|
first sign of osteoporosis is usually |
fractures |
|
loss of height is called |
dowager's hump |
|
BMD |
bone mineral density |
|
gold standard for measuring bmd |
DEXA |
|
DEXA |
dual energy xray absorptiometry |
|
DEXA is very |
$$$ |
|
Calcium slows |
the rate that bone is lost |
|
what Ca is better |
citrate is better than carbonate |
|
tums is Ca |
carbonate |
|
to prevent osteoporosis avoid beverages containing |
phosphorous because is inversely r/t Ca |
|
2 things bad for osteoporosis |
tobacco smoking, alcohol |
|
high Ca foods (10) |
dairy, dried figs, fish c bones, fortified OJ, beans, spinach, turnips greens, chocolate, nuts, liver |
|
3 foods enhancing Ca excretion |
caffeine, excess fiber, meat phosphorous |
|
antiresorptive drugs do what |
preserve or inc BD and dec rate of bone resorption |
|
3 antiresorptive drugs |
bisphophonates, estrogen, calcitonin |
|
estrogen use |
is controversial |
|
bisphosphonate main drug |
fosamax |
|
bisphosphonate actonel |
daily or weekly |
|
bisphosphonate fosamax |
daily or weekly |
|
bisphosphonate boniva |
monthly |
|
most serious side effects of bisphosphonates |
esophagitis |
|
bisphosphonates can also cause |
osteonecrosis of jaw |
|
esophagitis |
prolonged drug exposure |
|
bisphosphonates - difficulty swallowing |
causes heartburn
|
|
most important thing about bisphosphonate (bis) therapy |
TEACH TEACH TEACH |
|
bis TEACH - to prevent |
esophageal irritation |
|
bis TEACH - take atleast 1 hr before |
any meds or food |
|
bis TEACH - take with what fluid |
water and nothing else |
|
bis TEACH - do what for 30-60 min post drug admin |
sit upright |
|
bis TEACH - do not do what for 30 min post admin |
drink anything |
|
bis TEACH - do not take what med at same time |
Ca |
|
bis TEACH - Ca may interfere with |
bis drug absorption |
|
estrogen supp ie |
evista |
|
FDA and estrogen supps |
no longer approved |
|
estrogen supps for |
osteoporosis |
|
estrogen supps inc risk for (5) |
breast ca, blood clots, MI, CVA, endometrial ca |
|
estrogen supps now for |
short term use for menopause sns |
|
estrogen supps research |
still in progress |
|
calcitonin tx for osteoporosis |
safe but less effective |
|
>95% of oa hip fractures caused |
by falls |
|
leading cause of accidental death in age 65+ |
falls |
|
intracapsular fx located |
within joint |
|
intracapsular fx causes |
impaired blood to femoral head |
|
extracapsular fx located |
trochanter, below trochanter |
|
extracapsular fx causes |
acute blood loss from vascular cancellous bone surfaces |
|
extracapsular fx rarely cause |
avascular necrosis |
|
what can cause hip fx |
neoplasms |
|
hip fx can cause (3) |
sepsis, bleeding, death |
|
death from hip fx - #s |
1/5 die within 1 year |
|
leg of hip fx |
shortened and externally rotated |
|
most hip fx occur |
in women who fall sideways on hip |
|
hip fx Sx |
is tx of choice |
|
important post-op care for hip sx |
keep extremity aligned |
|
hip fx post-op ambulation |
asap |
|
pre and post op pt edu |
prevent dislocation, encourage physical therapy, use assistive devices |
|
prevent dislocation how |
dont cross legs, use raised toilet, pillow b/t legs |
|
most common form of arthritis in US |
osteo |
|
osteoarthritis is leading cause |
of disability in ppl over 65 |
|
OA joints |
hands, knee, hip, central joints of cervical and lumbar |
|
OA characterized by |
progressive erosion of articular cartilage with formation of bone in joint space |
|
does OA have exacerbations and remissions |
no |
|
OA is asymmectric or symmectric |
asymmetric |
|
most signif cause of eldelry pain and disability |
OA of hips and knees |
|
OA not caused by |
aging alone |
|
OA called the (2) |
wear and tear, or a mileage phenomenon |
|
OA predisposing factors (2) |
repetitive joint use (running), cold climate |
|
OA predisposing factors (5) |
inc age, obestiy, trauma, lifestyle, genetics |
|
2 clinical manifestations of OA in hands |
heberden's nodes, bouchard's nodes |
|
OA pain |
morning stiffness, usually resolves in 30 min, ? confirm that |
|
OA will have what c movement |
crepitus |
|
OA physcial assess look for |
erythema |
|
OA heat to joints |
dec pain |
|
OA cold to joints |
dec swelling |
|
4 major complications of hip/knee replacement |
thromboembolsim, infection, blood loss, joint dislocation |
|
CPM device |
continuous passive motion device |
|
CPM device for |
post knee replacemnet |
|
OA topical analgesics most effective for |
hands and knees |
|
OA topical analgesics may cause |
heat or burning |
|
OA topical analgesics agent |
capsaicin found in keyan pepper |
|
OA systemic analgesics agent |
acetaminophen |
|
how much acetaminophen |
4g/day |
|
acetaminophen has what effect |
ceiling effect |
|
acetaminophen - tylenol |
one of safest drugs |
|
most common OA pain tx |
NSAIDS |
|
NSAIDS given post |
tylenol |
|
NSAIDS long term (4) |
ulcers, bleeding, inc MI risk, inc CVA risk |
|
3 NSAIDSie |
aspirin, ibuprofen, naproxen |
|
cox 2 inhibitors ie |
celebrex |
|
celebrex is anti |
inflammatory |
|
celebrex requires |
rx |
|
celebrex considered safe for |
GI tract |
|
celebrex inc risk for |
CV SE |
|
celebrex SE |
renal impairment |
|
intra articular agents are |
analgesics, cortico |
|
intra articular agents for what disease |
OA |
|
what is removed before intra articular agent injection |
synovial effusion |
|
max # of intra articular injections |
4 per year in singular joint |
|
OA - hyaluronic acid is normal component of |
joint lubrication and nutrition |
|
hyaluronic acid admin |
3-5 injections |
|
hyaluronic acid dec |
pain for longer than other intra articular therapies |
|
OA OTC |
glucosamine, chondroitin sulfate |
|
OA OTC do what and not what |
dec pain, do not grow new cartilage |
|
OA OTC doc reccommends |
3 month trial period |
|
RA affects more than just |
joints |
|
RA more common in |
women, 3:1 |
|
RA is ___ disorder |
autoimmune |
|
RA inflamed synovium does what |
invades and destroys bone and cartilage |
|
RA characterized by |
exacerbations and remissions |
|
RA disabling morning joint stiffness |
may last an hour or more |
|
RA affects what first |
fingers, hands, wrists |
|
RA affects second |
hips, knees |
|
RA hand terms |
boutonniere thumb, ulnar deviation, swan-neck fingers |
|
rheumatoid factor |
- early, + late |
|
what determines if inflammatory process is present |
ESR, CRP (erythrocyte sedimentation rate and c reactive protein) |
|
RA cortico |
prednisone 2.5-7.5mg daily |
|
long term steroid use can cause |
osteoporosis, cataracts, HTN, inc risk for infection |
|
RA NSAID |
cox 2 inhibitor (celebrex) |
|
RA DMARDs |
disease modifying antirheumatic drugs |
|
begin DMARDs within |
3 months of RA dx |
|
DMARD ie |
methotrexate |
|
DMARD dec ___, reduce/prevent ___, preserve ___ |
decrease pain and inflammation, reduce/prevent joint damage, preserve structure and function of joints |