Osteoporosis
What are risk factors of osteoporosis?
female, age, family history, ethnicity, stature, early menopause, nutrition, lifestyle, smoking/etoh, meds
What is osteoarthritis?
leading cause of disability for elderly, progressive, and non-inflammatory. It's chronic, idiopathic, and can be related to repetitive activity and obesity
What is the fat embolism triad?
lungs (sob, hypoxia, tachypnea)
neuro (ams, visual changes, aphasia)
capillary changes (petechia) seen after lungs and neuro symptoms
What is the pathology of parkinsons?
destruction of dopamine pathways and an increase in acetylcholine
What are osteoblasts vs osteoclasts?
osteoblasts: build bone
osteoclasts: restore bone/repair
What does a DEXA scan tell us?
how dense your bones are (T score) want tightly packed bone
normal: > -1
ostopenia: between -1 and -2.5
osteoporosis: < -2.5
you will see this in all bones of the body. it is a symmetric disease
What are symptoms of osteoarthritis?
stiffness, crepitation, affects joints asymmetrically
normally seen in knees, hips, and ankles
What is a dopaminergic?
Increase dopamine concentrations and neurotransmission of dopamine
(levodopa + carbidopa = sinemet) toxic sign is twitching of eyelids
How do we diagnose parkinsons?
if they have symptoms (must have at least 2 of the cardinal signs), give meds that will help, and if they work, probably parkinsons and look at CSF which may show decrease in dopamine levels
What foods contain calcium?
milk, beans, nuts, seeds, leafy greens
What are symptoms of osteoporosis?
-may not know until a fracture
-vertebral collapse
-dowagers hump
-protruding abdomen
How do we treat osteoarthritis?
balance rest and activity, heat or cold therapy, weight reduction, arthroscopy, joint replacement
What is the difference between nonunion and malunion?
nonunion: fails to heal after extended recovery
malunion: heals in an abnormal position
What are the cardinal signs of parkinsons?
tremor (resting)
rigidity
akinesia/bradykinesia
What is the difference between a sprain/strain?
Sprain: injury to a ligament
Strain: injury to muscle or tendon
What is the most effective way to prevent osteoporosis?
Exercise!! walking 30min 3x a week
How do we diagnose osteoarthritis?
x-ray (can see osteophytes), R/O RA (positive RA factor, elevated ESR, aspirate fluid for infection), bone scan, MRI
What are complications of hip surgery?
-nonunion/malunion
-DVT
-UTI
-Osteomyelitis
-Pneumonia
-Fat embolism
What are progressive/secondary signs of parkinsons?
postural instability, facial appearance, speech, visual, fine motor, autonomic disturbances, cognitive/behavioral changes
What is Volkman's contracture?
ischemia leading to contracture of flexors and extensors in the forearm due to lack of blood flow to area, cast on wrong, lack of ROM
What are some other drug treatment options for osteoporosis?
-biphosphates (alendronate inhibits osteoclast activity) must sit up when taking and drink with a glass of water
-SERIs (raloxifene that acts as estrogen)
-monoclonal antibody (denosumab that stops osteoclast activity
What drug is the best choice for osteoarthritis?
Tylenol because osteoarthritis is an anti-inflammatory disease
What is compartment syndrome?
pain that seems greater than expected for the severity of the injury and will cure with fasciotomy (6 hours to treat or they can lose limb)
What is the etiology of parkinsons?
degenerative, viral (from flu A), drug induced by psych meds or alcohol, led poisoning, hypoparathyroidism, genetics, head trauma, atherosclerosis
What are the 6 Ps for compartment syndrome?
pain, paresthesia, pallor, polar, paralysis, pulses