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The Musculoskeletal

Disease Chapter 15

Osteomyelitis is an inflammation of bone and bone marrow.
A common cause of osteomyelitis is staph ( ) aureus
Osteomyelitis is a common complication of an open FX ( ) AKA compound FX.
Signs and symptoms of osteomyelitis include: 1. Pain. 2. Chills. 3. Pyrexia ( ). 4. Leukocytosis ( ).
A complication of osteomyelitis is bone necrosis ( ) called sequestrum
This infection responds well to antibiotics.
Tuberculosis (TB) is primarily a disease of the lungs.
Pulmonary TB ( ) left untreated can spread to the bones.
Pott’s disease is TB that affects the vertebral column of children.
Pott’s disease can lead to vertebral deformities and paralysis.
These vertebral deformities may require surgical correction. TB ( ) responds well to antibiotics ( ).
Rickets is a disease affecting infants and young children.
Rickets is caused by a deficiency of Ca ( ) and/or vitamin D.
The bones of the child with rickets are soft and tend to bend causing deformities ( ).
The child’s muscles are flaccid ( ) because muscles need Ca ( ) for proper muscle contraction.
Teething may be delayed and there is a characteristic pot belly.
Rickets is associated with malabsorption syndrome ( ).
The most common prophylaxis ( ) and Tx ( ) for rickets is sunlight ( ) and the RDA ( ) of Ca ( ) with vitamin D.
Osteomalacia (OM) is a softening and decalcification of the bones in adults.
The bones particularly affected by OM ( ) include the vertebral column, pelvis, and legs.
The bones tend to bend, deform, and FX ( ) easily.
OM ( ) is associated with malabsorption syndrome ( ).
The most common prophylaxis ( ) and Tx ( ) for OM ( ) is sunlight ( ) and the RDA ( ) of Ca ( ) with vitamin D.
Vitamin D deficiency has been associated with breast cancer, colon cancer, prostate cancer, MS ( ), OP ( ), heart disease, DM ( ) and HTN
Osteitis fibrosa cystica (OFC) usually results from hyperparathyroidism which causes bone decalcification.
Signs and symptoms of OFC ( ) include nephrolithiasis ( ), bone deformities, and spontaneous FXs ( ).
Tx of OFC ( ) includes: removal of parathyroid tumor or parathyroidectomy
Osteoporosis (OP) is a loss or thinning of BMD ( ) AKA osteopenia ( ).
Risk factors for OP include: 1 - 7 1. Female gender 2. Family hx 3. Deficient vitamin D and/or Ca in the diet. 4.Sedentary lifestyle 5.Smoking. 6. Thin or small frame. 7. 1-2 ETOH ( ) drinks/day doubles the risk of OP
Risk factors for OP include: 8 -11 8.Excessive caffeine consumption. 9.Being Caucasian or Asian. 10.Estrogen level reduction associated with menopause. 11.Prolonged use of SAIDs Al antacids, diuretics, tetracycline antibiotics, and antiseizure medications.
The degree of OP ( ) risk also depends on amount of BMD ( ) acquired between ages 25-35.
Signs and symptoms of OP ( ) include: 1. A predisposition to FXs especially the wrists, pelvis, and vertebrae. 2. Kyphosis ( ). 3. Loss of HT
Dx of OP ( ) depends on patient hx ( ), bone densitometry, and DEXA
Tx of OP ( ) includes: 1. Sunlight and 500mg x 3 daily of Ca ( ) with vitamin D.Do not exceed 2500mg/day. 2. Regular exercise. 3. ERT AKA HRT for postmenopausal women. 4. The use of calcitonin in extreme cases.
Bone density tests are recommended for the following: 1. Type I DM ( ). 2. Liver or kidney disease. 3. Menopause. 4. Over age 50.
Paget’s disease is AKA osteitis deformans.
Paget’s disease is an idiopathic ( ) possibly genetic overproduction of abnormal bone tissue.
Signs and symptoms of Paget’s disease include: 1. Osteomalacia ( ). 2. Easy FXs ( ). 3. Deformities of the legs. 4. Abnormal curvatures in the vertebral column
A complication of Paget’s disease is OS ( ) which is a primary bone malignancy.
The most common benign bone tumor is an osteoma.
An osteoma can be asymptomatic
If pain, decreased mobility, or swelling occurs, surgery is performed to remove the tumor.
A primary bone malignancy is called an osteogenic sarcoma (OS).
OS is more common in young adults
A common sign of OS ( ) is easy FXs ( ).
Tx ( ) of OS includes: 1. Chemotherapy ( ). 2. Surgical removal of tumor
Most commonly, malignant bone tumors are secondary tumors that have metastasized ( ) from another site.
These secondary bone tumors cause easy FXs ( ) and extreme pain
The Px ( ) for a secondary bone malignancy is poor
Arthritis is an inflammation of a joint(s).
Arthritic symptoms include: pain, edema ( ), and stiffness of the joints especially upon waking.
Joints commonly affected by arthritis include: lumbar vertebrae, hips, knees, and fingers.
Rheumatoid arthritis (RA) is considered autoimmune and genetic.
Rheumatoid arthritis (RA) is the most serious form of arthritis and can cause contractures
Signs and symptoms of RA ( ) include pain, edema ( ), erythema ( ), warmth, and stiffness of the joints especially on waking.
RA ( ) is systemic so it can affect all of the joints.
RA ( ) can cause scar tissue to fuse the ends of the bones causing immobility
RA can cause enlargement of the joints called rheumatoid nodules.
Tx of RA ( ) includes: 1. ROM ( ) exercises. 2. Rest. 3. NSAIDs ( ) { }. 4. Enbrel, Orencia, Humira & Simponi
Osteoarthritis (OA) is the most common form of arthritis and can accompany aging.
OA commonly affects joints in the fingers, neck, low back, knees, and hips.
Other causes of OA ( ) include: 1. Chronic irritation or injury. 2. Heredity. 3. Obesity
The primary symptoms of OA are pain and stiffness of the joint(s).
OA ( ) can cause DJD ( ) causing irregular bone deposits called spurs.
There is no cure for OA but the Tx ( ) includes: 1.ROM exercises. 2.Rest. 3.Heat therapy. 4.Vitamins D,C,E, and beta carotene. 5. Green tea. 6. SAIDs + NSAIDs 7. THR + TKR
Gout is a form of arthritis that usually affects great toes and is caused by hyperuricemia causing deposits of uric acid crystals in the joints and kidneys.
The onset of gout is usually sudden and frequently affects men over the age of 40
Complications of gout include: 1. Joint deformities. 2. Kidney damage.
Tx ( ) of gout includes: 1. Refrain from consuming organ meat, anchovies, sardines, and beer. 2. Antigout medication
Carpal tunnel syndrome (CTS) is caused by compression of the median nerve in the wrist.
CTS is more common in women and usually strikes around ages 35-40.
Signs and symptoms of CTS ( ) include: numbness and tingling in the hand progressing to pain that can radiate up the arm to the shoulder
CTS is a RSI
CTS ( ) usually develops when a wrist is kept in a flexed position for extended periods to perform repetitive tasks.
High risk groups for CTS include: 1. Computer users. 2. Beauticians. 3. Dentists. 4. Playing musical instruments. 5. Use of vibrating tools.
Dx of CTS ( ) is confirmed with: 1. A hx ( ) of repetitive hand movements with a flexed wrist. 2. EMG
Tx ( ) of CTS includes: 1. Proper wrist alignment. 2. Avoidance of repetitive movements. 3. Braces and splints. 4. NSAIDs ( ) { }. 5. Surgery.
A herniated intervertebral disk (HID) is AKA a slipped or ruptured or bulging disk.
A HID occurs more frequently in the lower lumbar region of the back and is many times caused by poor body mechanics.
The primary complication of a HID ( ) is pressure exerted on the spinal cord and/or spinal nerve(s) causing weakness, tingling, numbness, and extreme pain.
A common spinal nerve affected by a HID is the sciatic nerve causing sciatica
Tx of a HID ( ) includes: 1. Bed rest on a firm mattress. 2. Muscle relaxants 3. Narcotic analgesics 4. Heat application. 5. Trx 6. TENS 7. Surgery
Muscular dystrophy (MD) is a hereditary disease of which there are several forms causing muscle degeneration ( ) which totally disables the individual
The most common and serious form of MD ( ) is called Duchenne.
MD ( ) can appear at any age but generally starts appearing at age 3 to 5.
Most individuals with MD do not live to adulthood.
Death is caused by the effect of MD on the heart and respiratory muscles.
Dx of MD ( ) is confirmed by an EMG ( ) and muscle Bx
Tx ( ) of MD includes: PT ( ), OT ( ), and orthopedic assistance devices
Myasthenia gravis (MG) is an idiopathic ( ) autoimmune neuromuscular disorder.
MG occurs more often in women.
MG is caused by a defect in the transmission of nerve impulses to the muscles.
MG ( ) has been linked to abnormal antibodies produced by the thymus.
Muscles commonly involved in MG include: 1. Eye movement. 2. Eyelid movement. 3. Facial expressions. 4. Chewing. 5. Talking. 6. Swallowing.
Tx ( ) for MG ( ) includes: 1. Thymectomy ( ). 2. Immunosuppressants
A hernia is a protrusion of a structure through the tissue in which it is normally enclosed.
A HH ( ) is a protrusion of the stomach through the diaphragm AKA diaphragmatic hernia.
An UH ( ) is a protrusion of the intestine through the umbilicus.
An IH ( ) usually refers to a protrusion of the small intestine into the scrotum.
A strangulated ( ) hernia can cause ischemia ( ) and/or necrosis ( ) to the tissue it surrounds.
Tx ( ) of a hernia includes: 1. Abdominal supports ( ). 2. Hernioplasty
An acute contagious skin disease caused by staph ( ) + strep ( ) especially in children is impetigo.
Impetigo is characterized by: 1. Erythema 2. Oozing vesicles ( ). 3. Pustules ( ) with a honey colored crust.
Tx ( ) of impetigo includes: 1. Wash with soap and water. 2. Keep lesions dry ( ). 3. Topical antibiotics
Lyme disease is a bacterial disease transmitted by the bite of a deer tick.
Signs and symptoms of Lyme disease usually occur 3-30 days after exposure and include: 1. “Bull’s eye rash” 2. Flu like signs and symptoms such as: a.Malaise b. Cephalalgia c. Chills. d. Pyrexia e. Arthralgias f. Myalgias ( ). g. Lymphadenopathy
Treatment (Tx) of Lyme disease includes antibiotics
Untreated Lyme disease can cause permanent damage to the heart, joints, and nervous system.
HSV I causes herpetic stomatitis AKA “cold sores” or “fever blisters”
Herpetic stomatitis is usually found near the oral labiae
The HSVI ( ) can be dormant in the body for months but frequently becomes active when a person is under stress or when their immune system is weakened
Treatment (Tx) of the herpes simplex virus I (HSVI) includes antiviral drugs
Tinea refers to fungal infections.
Tinea corporis is AKA ringworm.
Tinea corporis causes erythematous ( ) ringed shaped pruritic ( ) lesions.
Tinea pedis is AKA athlete’s foot.
Tinea pedis frequently attacks the skin between the toes causing fissures ( ), pruritus ( ), and pain.
Tinea cruris is AKA jock itch.
Tinea cruris causes erythematous ( ) ring-like areas with vesicles
Areas of the body susceptible to tinea are usually warm, dark, and moist environments.
Tx ( ) of tinea includes: 1. Keeping susceptible areas dry. 2. Topical antifungal medications
Pediculosis is AKA lice.
Pediculosis ( ) can infest the head, pubic area ( ), and the body.
Head lice are common among children and are transmitted by direct contact or fomites such as combs, scarves, hats, and bed linen.
The primary symptom of pediculosis ( ) is pruritus
Pediculosis (lice) are difficult to see but their white eggs ( ) can be located on the hair shaft.
Tx ( ) of pediculosis ( ) includes: 1. Medicated shampoos 2. Use of a fine toothed comb. 3. Washing clothes in hot water ( ) and machine drying. 4. Leave the house for 55 hours to allow the lice to die.
Some studies show that lice are becoming resistant to the medicated shampoos.
Scabies is a contagious skin infestation caused by the “itch mite.”
Signs and symptoms of scabies include vesicles ( ), pustules ( ), and intense pruritus
Scabies are usually transmitted by skin to skin contact.
Tx ( ) of scabies includes: 1. Scrubbing with medicated soaps and shampoos ( ) in hot baths. 2. Washing clothes in hot water ( ) and machine drying.
Allergic contact dermatitis (ACD) is a noncontagious inflammation of the skin caused by an allergic response.
Common allergies include: 1. Plants such as poison ivy or oak 2. Chemicals found in clothing dyes, soaps, and perfumes. 3. Metals such as nickel found in costume jewelry etc.
Signs and symptoms of ACD ( ) include: 1. Erythema ( ). 2. Vesicles ( ). 3. Pruritus
Treatment (Tx) of ACD ( ) includes: 1. Removal of the allergen. 2. Topical SAIDs ( ) { }. 3. Antihistamines ( ). 4. Antipruritic medications
Atopic dermatitis (AD) is AKA eczema.
Eczema is an idiopathic ( ) skin disorder causing erythematous ( ), dry, and crusted patches on the skin.
AD ( ) usually affects those with allergies and asthma.
Eczema outbreaks will disappear in half of all children effected by adolescence.
Tx ( ) of atopic dermatitis (AD) includes the use of SAIDs
A nevus is AKA mole.
A nevus ( ) is a benign skin lesion that can become malignant.
Signs and symptoms that indicate a possible change of a nevus ( ) to a malignant lesion include: 1. Change in the size or shape. 2. Pruritus ( ). 3. Soreness. 4. Discharge. 5. Darkening of the nevus
The ABCDEs of moles include: Asymmetry or one half does not match the other half. Border or edges are ragged, blurred, or irregular. Color is not the same throughout. Diameter is larger than the eraser of a pencil. Elevated or raised from the skin.
Tx ( ) of a suspect nevus ( ) involves: surgical removal or cryosurgery
Basal cell carcinoma (BCC) is the most common skin cancer that is slow growing and usually nonmetastasizing.
BCC ( ) usually develops on the face or neck of light skinned men ( ) who are over exposed to UV ( ) light
Treatment (Tx) of basal cell carcinoma (BCC) involves: 1. Surgical removal of the tumor. 2. Radiation therapy. 3. Chemotherapy
Squamous cell carcinoma (SCC) is a more serious skin lesion because it metastasizes ( ) through the lymph vessels.
SCC ( ) usually develops on the face, ears, neck, lips, and back of the hands of light skinned men ( ) who are over exposed to UV ( ) light
Treatment (Tx) of SCC ( ) involves 1. Surgical removal of the tumor. 2. Radiation therapy. 3. Chemotherapy
Malignant (metastatic) melanoma (MM) is the most serious form of skin cancer because it metastasizes ( ) early.
MM ( ) can develop from a nevus ( ) and is associated with overexposure to UV ( ) light ( ) in Caucasians
Treatment (Tx) of malignant (metastatic) melanoma (MM) involves: surgical removal of the tumor and surrounding lymph nodes.
The prognosis (Px) for MM ( ) depends on the degree of metastasis
Tanning beds emit ____-____% more UVA rays than the sun. 50-75
Exposure to tanning beds for people under 30 increases skin cancer risk 75%.
To protect your skin from UVA + UVB, sunscreen should contain mexoryl or avobenzone.
Acne vulgaris (AV) is caused by a clogging of the sebaceous ( ) glands.
Characteristics of AV ( ) include: 1. Comedones ( ) indicate noninflammatory acne. 2. Pustules ( ) indicate inflammatory acne.
Treatment (Tx) of AV ( ) includes: 1. Benzoyl peroxide. 2. Stridex. 3. Keeping the hands away from the face. 4. Gentle cleaning of the skin twice a day.
Rosacea is an idiopathic ( ) cyclic progressive inflammatory skin disease that causes facial erythema ( ), edema ( ), papules ( ), pustules ( ), and pain.
Treatment (Tx) of rosacea includes: 1. Avoidance of triggers ( ). 2. Topical vitamin A ( ). 3. Oracea.
Psoriasis is an idiopathic ( ) autoimmune chronic ( ) skin disease with a hereditary basis of which there is no cure.
The psoriasis lesions are erythematous ( ) patches with white or silvery scales.
The psoriasis lesions primarily form on the elbows and knees but the trunk, arms, legs, and scalp can be affected.
Psoriasis can be exacerbated ( ) by: 1. Stress. 2. Changes in climate. 3. NSAIDs ( ). 4. Injuries to the skin. 5. Infections.
Treatment (Tx) of psoriasis includes controlling lesions with: 1. Coal-tar medications ( ). 2. SAIDs ( ). 3. UV light therapy
Created by: willowsalem