Pharm 2 Test 3 Part 2

Front 1

osteoporosis

Back 1

reduced density or mass of bone

Front 2

osteoporosis not enough bone to maintain

Back 2

skeletal integrity or mechanical support

Front 3

osteoporosis common in (2)

Back 3

older women, a metabolic disorder

Front 4

cause of osteoporosis (2)

Back 4

postmenopausal, elderly

Front 5

postmenopausal

Back 5

decreased levels of estrogen

Front 6

elderly

Back 6

not certain why

Front 7

possibility in elderly

Back 7

think osteoblasts and osteoclasts shrink or undergo alterations that diminish their activity

Front 8

decreased physical activity in elderly because

Back 8

preservation of bone mass depends on skeletal stress through muscle contraction and weight bearing

Front 9

other causes of osteoporosis (4)

Back 9

insufficient calcium, excess caffeine, alcohol and nicotine intake, endocrine dysfunction

Front 10

causes of osteoporosis in men

Back 10

decreased levels of testosterone

Front 11

endocrine dysfunctions (2)

Back 11

excess parathyroid, thyroid or growth hormones

Front 12

patho osteoporosis - normal resorption

Back 12

normally bone is resorpted, new bone is formed and amount resorption equals amount replaced

Front 13

patho osteoporosis - 3 causes

Back 13

increase in rate of resorption, delay in rate of bone formation, deficient cells in unit needed for this process

Front 14

patho osteoporosis - another rationale is that the

Back 14

basic units needed for the remodeling cycle bone goes through is lost or inadequate

Front 15

osteoporosis sns (4)

Back 15

pain, bone deformity, fractures, bone mineral density

Front 16

3 tx for osteoporosis

Back 16

prevention, replace calcium, replace estrogen/progestins or testosterone

Front 17

main side effect of calcium is

Back 17

GI

Front 18

3 ways of preventing osteoporosis

Back 18

raloxifene, calcium supplements, vit D

Front 19

raloxifene aka

Back 19

evista

Front 20

osteoporosis tx main one

Back 20

calcitonin salmon

Front 21

calcitonin salmon comes in

Back 21

nasal spray

Front 22

3 sub groups of calitonin salmon

Back 22

rotate nostrils, fasmax, avist

Front 23

fosamax approved for

Back 23

post menopausal osteoporosis

Front 24

osteomalacia deficiency of

Back 24

vit D

Front 25

osteomalacia vit d deficiency results in

Back 25

a shortage or loss of calcium salts

Front 26

osteomalacia low calcium salts causes

Back 26

bones to become increasinlgy soft, flexible, brittle, and deformed

Front 27

osteomalacia is an adult form of

Back 27

rickets

Front 28

5 other causes of osteomalacia

Back 28

liver disease, cancer, illness inhibiting normal metabolism of vit d, anticonvulsant drugs, diabetes

Front 29

main cause of osteomalacia

Back 29

diabetes

Front 30

patho osteomalacia - vit d enhances what

Back 30

absorption of calcium ions from intestine

Front 31

patho osteomalacia - lack of vit d causes

Back 31

plasma calcium level to drop

Front 32

patho osteomalacia - low vit d leads to increased

Back 32

secretion of PTH

Front 33

patho osteomalacia - increased PTH secretions raises what and lowers what

Back 33

serum calcium and lowers phosphate

Front 34

patho osteomalacia - loweres po4 because why

Back 34

stimulation for increased renal clearance

Front 35

patho osteomalacia - what affects mineralization of bone

Back 35

decreased level of po4

Front 36

osteomalacia sns (3)

Back 36

rheumatic pain, anemia, progressive weakness

Front 37

rheumatic pain where (4)

Back 37

limbs, spine, thorax, pelvis

Front 38

osteomalacia tx

Back 38

nutritional supplements

Front 39

ankylosing spondylitis (AS) is what

Back 39

chronic inflammatory joint disease

Front 40

AS characterized by

Back 40

stiffening and fusion of the spine and scroiliac joint

Front 41

fusion aka

Back 41

ankylosis

Front 42

AS differs from RA by

Back 42

the site of inflammation

Front 43

AS occurs where

Back 43

in the enthesis

Front 44

enthesis is what

Back 44

point at which ligaments, tendons, and the joint capsule are inserted into the bone

Front 45

patho AS - caused by

Back 45

unknown, possibly genetic

Front 46

patho AS - what may trigger inflammatory response

Back 46

klebsiella

Front 47

patho AS - what is inflamed

Back 47

fibrocartilage in cartilaginous joints

Front 48

patho AS - inflammation leads to

Back 48

repair beginning by macrophages and lymphocytes

Front 49

patho AS - repair starts with

Back 49

proliferation of fibroblasts

Front 50

fibroblasts secrete what

Back 50

collagen

Front 51

collagen forms what

Back 51

scar tissue that eventually calcifies

Front 52

patho AS - scar tissue evnetually replaces

Back 52

the cartilaginous structures of joint

Front 53

patho AS - scar tissue causes

Back 53

loss of flexibility, joint fuses

Front 54

patho AS - after scar tissue, what is healed

Back 54

eroded bone with osteoblasts and osteoclasts

Front 55

patho AS - the repair changes what

Back 55

the contour of the bone

Front 56

patho AS - what happens to spinal ligaments

Back 56

calcified spinal ligaments lose their concave anterior contour and appear square

Front 57

AS sns classic sign

Back 57

bamboo spine

Front 58

AS sign similar to RA

Back 58

early morning stiffness with difficulty getting up

Front 59

paget disease

Back 59

a state of increased metabolic activity in bone

Front 60

paget disease characterized by

Back 60

abnormal and excess bone remodeling, both resorption and formation

Front 61

patho paget - excessive resorption of what replaced by what

Back 61

excessive resorption of spongy bone replaced by extremely vascular fibrous tissue

Front 62

patho paget - what follows resorption

Back 62

abnormal new bone at an accelerated rate

Front 63

patho paget - what is disorganized, causing what

Back 63

collagen fibers are disorganized causing bone formation to thicken and enlarge

Front 64

paget sns (10)

Back 64

altered mental states (dementia if skull involved), sensory abnormalities, impaired motor function, deafness, atrophy of optic nerve, headaches (if cranial nerves involved), displaced teeth, malocclusions of facial bones, curvature of extremities, pain

Front 65

paget tx

Back 65

often no tx required with no symptoms present. if active disease, pain relief, deformity and fracture prevention

Front 66

osteoarthritis compared to

Back 66

RA

Front 67

RA review

Back 67

inflammatory, pain when rising, less pain with activity, joint deformity

Front 68

osteoarthritis (OA) is non

Back 68

inflammatory

Front 69

patho OA - erosion of what and becoming what

Back 69

erosion of articular cartilage, cartilage becomes thin and may be absent in some areas

Front 70

patho OA - sclerosis of because of what

Back 70

bone underneath cartilage because of being unprotected

Front 71

patho OA - pain comes from

Back 71

sclerosis, unprotected bone

Front 72

patho OA - formation of

Back 72

bone spurs which grossly alter bony contours and enlarge the joint

Front 73

OA sns (4)

Back 73

deformity, pain (relieved by rest), joint stiffness, crepitus

Front 74

OA pain - staying bed all day will

Back 74

also cause bad pain, encourage activity (with rest) even though pain persists through activity

Front 75

5 OA tx

Back 75

rest in afternoon, ROM, NSAIDS, cane or walker, surgery for artificial implants

Front 76

gout

Back 76

high levels of uric acid in blood and synovial fluid

Front 77

gout aka

Back 77

gouty arthritis

Front 78

elevated uric acid in blood aka

Back 78

hyperuricemia

Front 79

patho gout - uric acid is breakdown product from

Back 79

purine nucleotides

Front 80

patho gout - some people have accelerated rate of what accompanied by what

Back 80

accelerated rate of purine synthesis accompanied by overproduction of uric acid

Front 81

patho gout - when uric acid reaches certain concentration in fluids it does what forming what

Back 81

it crystalizes forming insoluble precipitates

Front 82

patho gout - insoluble precipitates deposited where

Back 82

in connective tissues throughout the body

Front 83

gout pain where

Back 83

big toe

Front 84

patho gout -insoluble precipitates deposit in synovial fluid causing

Back 84

acute painful inflammation of joint

Front 85

patho gout - at the kidney

Back 85

fitration of urate is sluggish and urate crystals can be deposited in renal interstitial tissues causing impaired urine flow and kidney stones

Front 86

patho gout - pain is usually

Back 86

in a peripheral joint and just one joint

Front 87

gout sns (4)

Back 87

severe peripheral joint pain (big toe), joint swelling and redness, trophi in lower extremities, renal stones

Front 88

trophi

Back 88

small white nodules visible through the skin

Front 89

gout tx goal

Back 89

terminated acute attacks, prevent recurring attacks, and prevent complications (stones)

Front 90

gout tx (3)

Back 90

antiinflammatory drugs, uricosuric agents, low purine diet

Front 91

gout diet

Back 91

limit beer, wine, shellfish, legumes

Front 92

antigout drugs aka

Back 92

uricosuric

Front 93

uricosuric action (3)

Back 93

control acute inflammation of gout attack, increase excretion of uric acid, decrease production of uric acid

Front 94

gout SE

Back 94

kidney stones

Front 95

gout NI (4)

Back 95

increase fluid intake, comply with tx and diet, monitor cbc, provide relief for GI SE

Front 96

gout NI - fluid intake

Back 96

2-3 L / day

Front 97

fibromyalgia

Back 97

chronic difficulty in managing pain in muscles and soft tissues surrounding joints

Front 98

4 terms for dx of fibromyalgia

Back 98

fibromyitis, fibromyositis, fibrositis, tension myalgia

Front 99

fibromyalgia does not have what characteristic

Back 99

inflammation

Front 100

9 precipitating factors with fibromyalgia

Back 100

viral illness, chronic fatigue, HIV, lyme disease, physical trauma, persistent stress, chronic sleep disturbance, family line, statins

Front 101

statins given for

Back 101

high cholesterol

Front 102

fibromyalgia sns (6)

Back 102

flu symptoms, chronic fatigue, diffuse pain, tender points, light sleepers, irritable bowel syndrome

Front 103

diffuse pain is what and where

Back 103

burning or gnawing in muscles

Front 104

fibromyalgia tx (4)

Back 104

benzodiazepine, antidepressant, low dose opioid, plenty of rest and exercise

Front 105

benzodiazepine

Back 105

low dose at night to relax muscles

Front 106

antidepressant

Back 106

SSRI, to release serotonin to relax muscles

Front 107

SSRI stands for

Back 107

selective serotonin reuptake inhibitors

Front 108

low dose opioid

Back 108

for daytime breakthrough pain, usually only 2 x day

Front 109

plenty of rest and exercise

Back 109

decrease stress