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