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Patho Final
Muscle Skeletal
| Question | Answer |
|---|---|
| ___ is the most common metabolic bone disease. IT affects ___ in ___ women & __ in ___ men? | Osteoporosis is the most common metabolic bone disease. It affects 1 in 2 women & 1 in 5 men. |
| When does osteoporosis occur? | It occurs when the rate of bone resorption is greater than that of bone formation. |
| In ___ normal osteoblast & osteoclsatic balance is disurpted? | osteoporosis |
| In ____ minreal & protein matrix compnonets decrease and trabecula decrased amount (cells that resopnd to stress) on the bone) decrased with & bone mass leading to ____. | osteoporosis leading to fragile bones |
| WHO defines osteoporosis as "bone marrow densitiy (BMD) of ? | > 2.5 std. dev below peak BMD |
| Bone loss is influenced by age, genetics,& estrogen. What are the risk factors for osteoporosis? | family Hx, menopause (normal bone loss accelerated), small frame, caucasion or asian race, early surgical menopause use of corticosteroids, decrease Ca & Vit D diets, inactivity, increase ETOH, chronic renal disease, chronic inflammtory disease, abnormal |
| What is gout? | Gout is a heterogenous disorder where disturbanes of uric acid metabolism leads to deposition of monosodium urate salts in articular, periarticular, & subcutanous tissue. |
| ___ is characterized by hyperuricemia & urate crystals and can induce arthritis? | Gout |
| How is gout caused? | It is caused because of lack of enzyme uricase & the inability to oxidize uric acid to a soluble compound. |
| ___ is a normal waste product of ___ metabolism filtered by the kidneys, when it exceeds normal, ____ results & the deposition of crystaline sodium urate increases. | Uric acid is a normal waste product of purine metabolism filtered by the kidneys, when it exceeds normal, hyperuricemia results & the depostiion of crystalline sodium urate increases. |
| What are triggers of gout? | Traumatic event, surgery, acute illness or ETOH or drug use |
| What is osteoarthritis? | Osteoarthritis (Degenerative Joint Disease [DJD])-most common arthritis worldwide, progressive, inflammatory disease of disarthrodial joints (espec. wt bearing) |
| ___ is characterized by a progressive loss of articular cartilage & by the formation of thick subchondal bone & new bone @ the joint margins. | osteoarthritis |
| In osteoarthritis an initial injury causes release of ___ & ____ enzymes from chondrocytes. | proteolytic & collagenolytic enzymes |
| In osteoarthritis following an initial injury there is a breakdown of the matrix of ___ & ___ occurs decreasing ___ of cartilege that occurs with aging increasing the liklihood of ___ & ___? | In osteoarthritis following an initial injury there is a breakdown of the matrix of prteolycan & collagen occurs. decreasing hydration of cartilege that occurs with aging; increasing the liklihood of wear & damage |
| In osteoarthritis __ & ___ occur with stress of wt bearing | collagen fatigue & microfractures occur with stress of wt bearing |
| In ___ the ability to absorb shock decreases d/t subcortical bone & cartilage microfractures. Breakdown of ___ integrity with repair results in ____? | Osteoarthritis; breakdown of joint integrity with repair results in degenerative des. |
| Structural breakdown of the cartilage involves __,___, &___? Most commen in DJD is ____? | Structural breakdown of the cartilage invovles fissuing, pitting, & erosin. most common in DID is crepitis |
| What are the s/s of osteoperosis? | bony enlargement of joints; pain with moving; distal interphalangial joint enlargement; heberdent protimal bonchaud nodes |
| What is the difference between osteoperosis and Rheumatoid arthritis? | RA systemic/bilateral; OA usually localized/isolated joint or mult joints especially in hands-unilateral |
| ___ is systemic inflammatory disease more commen in women of all races. | RA |
| T/F RA: unknown cause, possibly due to abnormal autoimmune response that does not have a genetic predisposition | False; it is possibly due to an abnormal autoimmune response WITH a genetic predisposition |
| In RA changes occur when immune response locations in synovial tissue by an ___ trigger; __ Cells produce RF antibiodies that act aginst IgG to form ___ that potentially perpetuate inflammation of the joint leading to accumulation of dense aggregetes of _ | In RA changes occur when immune response locations in synovial tissue by an antigen trigger; B cells produce RF antibodies that act against IgG to form immune complexes that potentially perpetuate inflammation in the joint leading to accumulation of dense |
| The accumulation of dense aggregetes of immune cells in RA: infiltration of synovium leads to ___, ___, & ____ of the synoviom. | leads to edema, neovascularization, & proliferation of the synoviom |
| In RA the hypertophied synovium leads to ___ formation (vascularized sour tissue) that can erode & destory articular cartilage, resulting in ___,___ & ___? | This hypertophied synovium leads to paririus formation (vascularized sour tissue) that can erode & destroy articular cartilage, resulting in bone erosion; bone cysts; & fissures |
| What are the 7 s/s of RA? | (1) moving stiffness for 1 hr (2) soft tissue swelling (arthritis) of 3 or more areas on Right & Left (3) swelling of @ least 1 wrist, MLP or PIP joint (4) simlturinem symetric swelling in joints (5) SQ rheumatoid nodules (6) presence of rheumatoid faite |
| How many radiographic erosions must be present for Dx of RA? Name some errosions. | 4 must be presnet for Dx of RA. Malaise, fatigue, pain, ulnar drift, swan neck deformity, bentonriere deformity (see pics pg 129) decreased strength; inability to pinch, boggy wrist; limited movement; no DIP involvement; carpal tunnel syndrome; flexion co |
| iN rICKETS & OSTEOMALACIA are CHARACTERIZED deficites in mineralizets of newly formed ___ with resulting ___? | characterized by deficites in mineralizets of newly fomred bone matrix with resulting soft osteopenic bone. |
| in ___ Vit D deficiency prevents maintence of normal levels of ___ &___. | Rickets/osteomalacia Vit D deficiency prevents maintence of normal levels of Calcium & phosphate |
| In rickets, cartilege that occurs in the growing ___ fails to calcify | epiphagus |
| Cartilege is not replaced by ___ & continues to ___ in Rickets. | Cartilege is not replaced by bone & continues to enlarge |
| Bone is poorly calcified & les rigid in ____? | Rickets |
| Kyphosis, genu valgum (knoch knee) & germ varum (bow leg) are common in what? | Rickets |
| Osteomalacia is the adult conterpart of ___ that is always due to what as a result of what? | Osteomalacia is the adult conterpart of rickets that is always due to inadequate Ca+ or phosphorous concentration in the body as a result of decreased intestial absorption of Ca+, increasing urinary excretion of Ca+, loss of Ca or phosphorous during pregn |
| In the case of Vit D deficiency, calcifications fails to occur and ___ is soft. All ___ are affected, but wt bearing structures may ___ & cause ___? | osteomalacia/rickets; In the case of Vit D deficiency, calcification fails to occur & bone is soft. All bones are affected, but wt bearing structures may collapse & cause compression fype Fractures |
| What is Osteosarcoma? | An extremely malignant bone forming tumor, most common characterized by formation of bone or osteoid by tumor cells. |
| Who would you expect to see osteosarcoma in? | Majority of victims are children, adolescents & young adults 10-30yrs old. 2nd reach b/t 60-70 yrs |
| The most active ephyseal growth areas of osteosarcoma are? | the distal end of femor, protimal end of tibia, fibula & humerous are common involvemnt sites |
| In osteosarcoma lesions can also be seen in flat bones of ___, ___, ___, ___,or ___ | In osteosarcoma lesions can also be seen in flat bones of pelvis, skull, scapula, ribs, or spine |
| What are the s/s of osteosarcoma? | destruction of the cortex of the metaphyseal region predisposes it to pathologic fracture. metastasis to lungs early in development. pain consistent & progressive. joint funtion may be lost/compromised |
| ___ is a chronic, multisystem, inflammatory, autoimmune disease characterized by periods of exacerbations & remissions with multi organ systems being affected at different times. | Systemic Lupus (SLE) |
| What are some environmental factors of SLE? IS it familial? Who is it more common in (what ages) | Familial YES; environmental factos such as sunlight, thermal burns, & physical stress initiate the development of SLE, more common in women b/t 15-40 yrs old |
| ___ is the result of an abnormal reaction of the body against its own tissues, cells & serum proteins? | SLE |
| In what disease does the body have a decrease tolerance to itself? | SLE |
| One of the main mechanisims is the ___ overacting leading to excerssive autoantibodies production in SLE? | B-lymphocyte |
| SLE: As antigen=antibody complexes form, they enter the basement membranes of capillaries specifically in the ___,___,___, ___ & ___. | kidneys, heart, skin, brain & joints |
| Once in kidneys, heart, skin, brain, & joints the immune complexes then activate complement & trigger the ____ which are responsible for tissue distruction in SLE? | Immune complexes then activate complement & trigger the inflammatory responses which are responsible for tissue destruction |
| What are the s/s of SLE? | arthralgias, synovitis in joints, tendons, bones, swelling, tenderness, pain with mvt, moving stiffness, excessive damage leads to contractures, hyperextention of different joints, butterfly rash, latticeive renular skin changes, anemia, seizures, posis |
| What is Myasthenia gravis? | Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body |
| What are the causes for Myasthenia gravis? | Myasthenia gravis is caused by a defect in the transmission of nerve impulses to muscles. Occurs when normal communication between nerve & muscle is interrupted at the neuromuscular junction-the place where nerve cells connect w/ the muscles they control |
| What are the s/s of Myasthenia gravis? | may include drooping 1 or 2 eyelids (ptosis), blurred/double vision due to weakness of muscles that control eye movemnts, unstable/wadling gait, weakness in arms, hands, fingers, legs,& neck, change in facial expression, dysphagia & SOB,& dysarthria |
| What is the hallmark of myasthenia gravis? | The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest |
| What muscles are often affected by myasthenia gravis? | Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, & swallowing are often, but not always, involved in the disorder. The muscles that control breathing & neck and limb movements may also be affected. |
| What happens normally when impulses traveldown the nerve? | Normally the nerve endings release a neurotransmitter substance called acetylcholine. Acetylcholine travels through the neuromuscular junction & binds to acetylcholine receptors which are activated & generate a muscle contraction. |
| In myasthenia gravis, antibodies ___, ___, or ___ the receptors for acetylcholine at the neuromuscular junction which prevents the muscle ____ from occurring. | In myasthenia gravis, antibodies block, alter, or destroy the receptors for acetylcholine at the neuromuscular junction which prevents the muscle contraction from occurring. |
| Individuals with seronegative myasthenia gravis have no ___ at all to receptors for acetylcholine and muscle-specific ___, which is involved in cell signaling and the formation of the neuromuscular junction | Individuals with seronegative myasthenia gravis have no antibodies at all to receptors for acetylcholine and muscle-specific kinase, which is involved in cell signaling and the formation of the neuromuscular junction |
| What gland is abnormal in myasthenia gravis? What does it contain? | In adults with myasthenia gravis, the thymus gland is abnormal. It contains certain clusters of immune cells indicative of lymphoid hyperplasia - a condition usually found only in the spleen and lymph nodes during an active immune response. |
| T/F Some individuals with myasthenia gravis develop thymomas or tumors of the thymus gland. Generally thymomas are benign, but they can become malignant. | True |
| What is (diplopia)? | Blurred/dubble vision |
| What age is most commonly affected by myasthenia gravis and what ethnic group does it occur in? | Myasthenia gravis occurs in all ethnic groups and both genders. It most commonly affects young adult women (under 40) and older men (over 60), but it can occur at any age. |
| In neonatal myasthenia, the fetus may acquire ____from a mother affected with myasthenia gravis. | In neonatal myasthenia, the fetus may acquire immune proteins (antibodies) from a mother affected with myasthenia gravis. |
| Generally, cases of neonatal myasthenia gravis are transient (temporary) and the child's symptoms usually disappear within ____ months after birth | Generally, cases of neonatal myasthenia gravis are transient (temporary) and the child's symptoms usually disappear within 2-3 months after birth |
| T/F Other children develop myasthenia gravis indistinguishable from adults. Myasthenia gravis in juveniles is common. | True |
| T/F Always, children may show signs of congenital myasthenia or congenital myasthenic syndrome. These are not autoimmune disorders, but are caused by defective genes that produce proteins in the acetylcholine receptor or in acetylcholinesterase. | False: Rarely, children may show signs of congenital myasthenia or congenital myasthenic syndrome. These are not autoimmune disorders, but are caused by defective genes that produce proteins in the acetylcholine receptor or in acetylcholinesterase. |
| T/F Myasthenia gravis is not directly inherited & it is contagious. Occasionally, the disease may occur in more than one member of the same family. | False Myasthenia gravis is not directly inherited nor is it contagious. Occasionally, the disease may occur in more than one member of the same family. |
| What is a myasthenic crisis in myasthenia gravis Pt? | A myasthenic crisis occurs when the muscles that control breathing weaken to the point that ventilation is inadequate, creating a medical emergency and requiring a respirator for assisted ventilation. |
Created by:
jmilbur4
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