NWHSU NMS I Final from notes (chapter 10 and on)
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| ASO (Anti-Streptolysin Oxygen-labile) titer (concentration measurement)indicates | rheumatic fever (will be elevated)
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| Antinuclear antibody (ANA) in what ds: | SLE ( systemic lupus erythematosus)
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| HLA-B27 commonly elevated in what: | AS (Ankylosing Spondylitis)
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| bacteria in rheumatic fever: | streptococcus
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| Reiter's syndrome triad: | urethritis, conctivitis, arthritis
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| What bacteria is responsible for Acute Hematogenous Osteomyelitis | staphylococcus aureus (90%)
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| What bacteria is responsible for Acute Septic Arthritis | staphylococcus aureus (because the most common source is Acute Hematogenous Osteomyelitis)
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| What is the white blood cell count from needle aspiration of joint indicating septic arthritis | >100,000/mL
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| What is blood poisoning from bacteria | septicemia
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| pathology of osteoarthritis | narrowed joint space, bony spurs, sclerosis
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| Stiffness after rest (articular gelling) should be expected, aka | post-intertial dyskinesia
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| what are drugs that interfere with bacteria reproduction? kill organism? | bacteriostatic, bacteriocidal
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| What is acute hematogenous osteomyelitis? | blood-borne bacteria inf of the bone and its marrow in children
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| tx for chronic hematogenous osteomyelitis: | surgical removal of sequestrum, antibiotic therapy
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| Necrotizing Fasciitis mortality rate of 30% is from what 'flesh-eating' bacteria? | group A beta-hemolytic streptococcus
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| what ds has Brodie's abscess: | chronic hematogenous osteomeylitis
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| What is acute septic arthritis (pyogenic arthritis)? | destruction of the synovial jt, which leads to jt problems
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| where is acute septic arthritis most commonly at? | hip and elbow
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| What ds has cold absess? | TB (abscess is bluish or "cold")
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| What is Pott's ds? | TB osteomyelitis of the spine, 2nd to UT TB, carried via Batson's Plexus
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| What do tests show for tuberculosis arthritis? | inc ESR (erythrocycte sedimentation rate), positive skin test
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| ratio m/f in rheumatoid arth? | 3 female:1 male
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| in what age grp is rheumatoid arthritis most common? | 20-40
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| percent positive for rheumatoid factor test in rheum. arthritis? | 70%
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| T/F juvenile rheum. arth. is a chronic synovial infl. of unknown cause. | T
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| Are there many jts involved in juvenile rheum arth? | no
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| AS (Ankylosing Spondylitis) is seronegative or seropositive? | seronegative
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| Primary sign of AS(Ankylosing Spondylitis)? | bamboo spine
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| what is enthesopathy? | AS affecting the insertion of tendons, ligaments, jt capsules w/ progressive fibrosis and ossification
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| What is Ricker back? | progressive flex of back (w/AS)
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| Lab finding for AS(Ankylosing Spondylitis)? | inc ESR, positive HLA-B27
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| ratio m/f for lupus: | 8 female:1 male
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| How is Reiter's transmitted? | sexually
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| Lab for Reiter's: | positive HLA-B27 in 75%
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| What is psoriatic arthritis? | chronic skin infl; MC at DIP and spondylitis
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| MC findings for rheumatic fever: | inc ASOT; 13-14 yrs of age
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| ratio m/f for gout | 20:01:00
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| mc age for gout | after 40
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| what is podagra? | acute gout
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| What is Christmas ds? | hemophiliac arthritis (chronic bleeding into the jt)
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| Signs of DJD: | cartilage hyertrophy of subchondral bone; infl of synovial membrane (secondary); heberden's node (
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| Signs of DJD: | cartilage hypertrophy of subchondral bone; infl of synovial membrane (secondary); heberden's node (DIP), Haygarth's node (MCP-soft tissues, swelling around the jts assoc with RA)
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| Degenerative Joint Disease joints for Heberden's node | DIP
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| Degenerative Joint Disease joints for Bouchar's node | PIP
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| Primary type of DJD (Degenerative Joint Disease) mc in: | female, middle age
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| pathogenesis of DJD (Degenerative Joint Disease) | loss of proteoglycans and H2O
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| What is spondylosis, spondylitis | spur formation, inflammation
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| what is trigger finger | digital tenovaginitis stenosans a degenerative tendon and joint capsule disease also referred to as Periarticular Disease
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| etiology of neuropathic jt ds (Charcot's jt) | diabetes, syringomyelia, steroid
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| myofascial px syndrome= | traumatic induced infl/fibromyoglia
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| site of degenerative tendon and capsule ds periarticular ds: | shoulder
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| tenovaginits stenosans: | dequervains (wrist)
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| How is dequervain's (wrist) tested clinically? | finkelsteins (reactive finkelstein's test)
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| What is friction bursitis: | bunion
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| 4 phases of osteochondrosis (in order) | early phase of necrosis; phase of revascularization; phase of bone healing; phase of residual deformity (infl, necrosis, replacement, residuum)
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| 5 S's in Chandler's ds: | femoral head may collapase from: sterno, steroids, scuba divers, sickle cell anemia, SLE
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| Freiberg's | metatarsal head
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| Kohler's | tarsal navicular
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| Kienbock's | lunate
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| Panner's | capitellum
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| Osgood Schlatter | tibial tubercle
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| Scheuemann's | ant vertebral body height
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| Van necks | ischiopubic osteochondrosis
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| Madelung's Deformity | ulnar side of Radius epiphyseal growth disturbance
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| Sever's ds | calcaneus
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| Gaucher's ds | avascular necrosis of subchondral bone, a lipid metabolism disorder proliferating macrophage cells
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| sexually transmitted ds assoc with Reiter's syndrome: | chlamydia; shigella and rarely salmonella or yersinia with fecal exposure
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| other manifestations of Reiter's besides triad: | circinate balanitis, keratodermia blennorrhagicum and oral lesions
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| Where does Reiter's syndrome arthritis affect? | knees, ankles and feet
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| Is HLA in Reiters? | yes in 75%
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| Osteochondroses ds's: | Legg-Calve-Perthes, Osgood Schlatter, Freiberg's, Kohlers, Kienbochs, preisers, panners, sever's
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| Legg-Calve-Perthes ds sx (AKA juvenile coxa plana) | avasc nec of cap fem epiph; 3-12 yrs, male; bilateral (10%); insidious, traumatic or inflammatory
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| What are Legg sx seen in later stages: | sudden onset, referred knee px, pxful or pxless limp, limited mvmt (esp rot, abd, flx), px worse w/activity, disuse atrophy, appearance of leg deficiency, DJD later in life
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| How does Legg start? | infl for 2wks-2mths, fx of epiphysis (seen as bulging jt capsule on xray)
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| How does stage 2 Legg look on xray? | opacity & flattening, physis widens and irregular (snow cap sign)
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| Tx for Legg: | minimizing discomfort and deformity-slings, braces & crutch devices
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| What is Chandler's ds: | adult onset AVN of the femoral head
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| Causes of Chandlers: | mc related to chronic alcoholism and long-term steriod use; 5 S's=sterno, steroids, scuba divers, sickle cell anemia, SLE
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| Sx of Chandlers | pxful, dec ROM of hip & affected lower ext; abrupt onset
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| Course of Chandlers | heals spontaneously w/ deformity
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| Osgood Schlatter sx | very common, post-traumatic, traction of AVN of ant tib epiphysis; 10-14 yrs
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| Pain findings with Osgood: | can be bilateral, swollen tender area, px upon resisted ext of the leg
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| Osgood on xray: | prox segment fails to unite with tibial shaft and remains mobile
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| Osgood tx | avoid physical stresses; use of compression supports are very effective
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| AKA for scheuermann's ds | juvenile kyphosis dorsalis; juvenile discogenic ds
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| Is scheuermann's an AVN? | no, not a true one
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| What is scheuermann's? | very common; young person's first chiro visit, d/t congenital weakness of cartilaginous endplate complicated by excessive physical stress. Ends with cessation of growth.
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| Sx of scheuermanns: | low grade back px, stiffness and poor posture mc
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| xray of scheuermanns | multi-level vertebral end plate irregularity and sclerosis, dec disc ht, loss of ant vertebral body height creating "trapezoid-shaped segments", schmorl's nodes; hyperkyphosis
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| tx of scheuermann's | manual therapy, ext back exercises and postural training to relieve discomfort and stiffness. Bracing to minimize deformity in severe cases.
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