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109 Cards in this Set
- Front
- Back
osteoporosis |
reduced density or mass of bone |
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osteoporosis not enough bone to maintain |
skeletal integrity or mechanical support |
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osteoporosis common in (2) |
older women, a metabolic disorder |
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cause of osteoporosis (2) |
postmenopausal, elderly |
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postmenopausal |
decreased levels of estrogen |
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elderly |
not certain why |
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possibility in elderly |
think osteoblasts and osteoclasts shrink or undergo alterations that diminish their activity |
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decreased physical activity in elderly because |
preservation of bone mass depends on skeletal stress through muscle contraction and weight bearing |
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other causes of osteoporosis (4) |
insufficient calcium, excess caffeine, alcohol and nicotine intake, endocrine dysfunction |
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causes of osteoporosis in men |
decreased levels of testosterone |
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endocrine dysfunctions (2) |
excess parathyroid, thyroid or growth hormones |
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patho osteoporosis - normal resorption |
normally bone is resorpted, new bone is formed and amount resorption equals amount replaced |
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patho osteoporosis - 3 causes |
increase in rate of resorption, delay in rate of bone formation, deficient cells in unit needed for this process |
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patho osteoporosis - another rationale is that the |
basic units needed for the remodeling cycle bone goes through is lost or inadequate |
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osteoporosis sns (4) |
pain, bone deformity, fractures, bone mineral density |
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3 tx for osteoporosis |
prevention, replace calcium, replace estrogen/progestins or testosterone |
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main side effect of calcium is |
GI |
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3 ways of preventing osteoporosis |
raloxifene, calcium supplements, vit D |
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raloxifene aka |
evista |
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osteoporosis tx main one |
calcitonin salmon |
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calcitonin salmon comes in |
nasal spray |
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3 sub groups of calitonin salmon |
rotate nostrils, fasmax, avist |
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fosamax approved for |
post menopausal osteoporosis |
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osteomalacia deficiency of |
vit D |
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osteomalacia vit d deficiency results in |
a shortage or loss of calcium salts |
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osteomalacia low calcium salts causes |
bones to become increasinlgy soft, flexible, brittle, and deformed |
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osteomalacia is an adult form of |
rickets |
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5 other causes of osteomalacia |
liver disease, cancer, illness inhibiting normal metabolism of vit d, anticonvulsant drugs, diabetes |
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main cause of osteomalacia |
diabetes |
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patho osteomalacia - vit d enhances what |
absorption of calcium ions from intestine |
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patho osteomalacia - lack of vit d causes |
plasma calcium level to drop |
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patho osteomalacia - low vit d leads to increased |
secretion of PTH |
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patho osteomalacia - increased PTH secretions raises what and lowers what |
serum calcium and lowers phosphate |
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patho osteomalacia - loweres po4 because why |
stimulation for increased renal clearance |
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patho osteomalacia - what affects mineralization of bone |
decreased level of po4 |
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osteomalacia sns (3) |
rheumatic pain, anemia, progressive weakness |
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rheumatic pain where (4) |
limbs, spine, thorax, pelvis |
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osteomalacia tx |
nutritional supplements |
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ankylosing spondylitis (AS) is what |
chronic inflammatory joint disease |
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AS characterized by |
stiffening and fusion of the spine and scroiliac joint |
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fusion aka |
ankylosis |
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AS differs from RA by |
the site of inflammation |
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AS occurs where |
in the enthesis |
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enthesis is what |
point at which ligaments, tendons, and the joint capsule are inserted into the bone |
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patho AS - caused by |
unknown, possibly genetic |
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patho AS - what may trigger inflammatory response |
klebsiella |
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patho AS - what is inflamed |
fibrocartilage in cartilaginous joints |
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patho AS - inflammation leads to |
repair beginning by macrophages and lymphocytes |
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patho AS - repair starts with |
proliferation of fibroblasts |
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fibroblasts secrete what |
collagen |
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collagen forms what |
scar tissue that eventually calcifies |
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patho AS - scar tissue evnetually replaces |
the cartilaginous structures of joint |
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patho AS - scar tissue causes |
loss of flexibility, joint fuses |
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patho AS - after scar tissue, what is healed |
eroded bone with osteoblasts and osteoclasts |
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patho AS - the repair changes what |
the contour of the bone |
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patho AS - what happens to spinal ligaments |
calcified spinal ligaments lose their concave anterior contour and appear square |
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AS sns classic sign |
bamboo spine |
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AS sign similar to RA |
early morning stiffness with difficulty getting up |
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paget disease |
a state of increased metabolic activity in bone |
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paget disease characterized by |
abnormal and excess bone remodeling, both resorption and formation |
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patho paget - excessive resorption of what replaced by what |
excessive resorption of spongy bone replaced by extremely vascular fibrous tissue |
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patho paget - what follows resorption |
abnormal new bone at an accelerated rate |
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patho paget - what is disorganized, causing what |
collagen fibers are disorganized causing bone formation to thicken and enlarge |
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paget sns (10) |
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 |
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paget tx |
often no tx required with no symptoms present. if active disease, pain relief, deformity and fracture prevention |
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osteoarthritis compared to |
RA |
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RA review |
inflammatory, pain when rising, less pain with activity, joint deformity |
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osteoarthritis (OA) is non |
inflammatory |
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patho OA - erosion of what and becoming what |
erosion of articular cartilage, cartilage becomes thin and may be absent in some areas |
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patho OA - sclerosis of because of what |
bone underneath cartilage because of being unprotected |
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patho OA - pain comes from |
sclerosis, unprotected bone |
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patho OA - formation of |
bone spurs which grossly alter bony contours and enlarge the joint |
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OA sns (4) |
deformity, pain (relieved by rest), joint stiffness, crepitus |
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OA pain - staying bed all day will |
also cause bad pain, encourage activity (with rest) even though pain persists through activity |
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5 OA tx |
rest in afternoon, ROM, NSAIDS, cane or walker, surgery for artificial implants |
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gout |
high levels of uric acid in blood and synovial fluid |
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gout aka |
gouty arthritis |
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elevated uric acid in blood aka |
hyperuricemia |
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patho gout - uric acid is breakdown product from |
purine nucleotides |
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patho gout - some people have accelerated rate of what accompanied by what |
accelerated rate of purine synthesis accompanied by overproduction of uric acid |
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patho gout - when uric acid reaches certain concentration in fluids it does what forming what |
it crystalizes forming insoluble precipitates |
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patho gout - insoluble precipitates deposited where |
in connective tissues throughout the body |
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gout pain where |
big toe |
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patho gout -insoluble precipitates deposit in synovial fluid causing |
acute painful inflammation of joint |
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patho gout - at the kidney |
fitration of urate is sluggish and urate crystals can be deposited in renal interstitial tissues causing impaired urine flow and kidney stones |
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patho gout - pain is usually |
in a peripheral joint and just one joint |
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gout sns (4) |
severe peripheral joint pain (big toe), joint swelling and redness, trophi in lower extremities, renal stones |
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trophi |
small white nodules visible through the skin |
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gout tx goal |
terminated acute attacks, prevent recurring attacks, and prevent complications (stones) |
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gout tx (3) |
antiinflammatory drugs, uricosuric agents, low purine diet |
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gout diet |
limit beer, wine, shellfish, legumes |
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antigout drugs aka |
uricosuric |
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uricosuric action (3) |
control acute inflammation of gout attack, increase excretion of uric acid, decrease production of uric acid |
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gout SE |
kidney stones |
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gout NI (4) |
increase fluid intake, comply with tx and diet, monitor cbc, provide relief for GI SE |
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gout NI - fluid intake |
2-3 L / day |
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fibromyalgia |
chronic difficulty in managing pain in muscles and soft tissues surrounding joints |
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4 terms for dx of fibromyalgia |
fibromyitis, fibromyositis, fibrositis, tension myalgia |
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fibromyalgia does not have what characteristic |
inflammation |
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9 precipitating factors with fibromyalgia |
viral illness, chronic fatigue, HIV, lyme disease, physical trauma, persistent stress, chronic sleep disturbance, family line, statins |
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statins given for |
high cholesterol |
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fibromyalgia sns (6) |
flu symptoms, chronic fatigue, diffuse pain, tender points, light sleepers, irritable bowel syndrome |
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diffuse pain is what and where |
burning or gnawing in muscles |
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fibromyalgia tx (4) |
benzodiazepine, antidepressant, low dose opioid, plenty of rest and exercise |
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benzodiazepine |
low dose at night to relax muscles |
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antidepressant |
SSRI, to release serotonin to relax muscles |
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SSRI stands for |
selective serotonin reuptake inhibitors |
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low dose opioid |
for daytime breakthrough pain, usually only 2 x day |
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plenty of rest and exercise |
decrease stress |