Pathophysiology
What types of cells build up bones, what types break down bones?
OsteoBlasts-They Build up the bone
OsteoClasts-They Crumble down the bone
What is a T score in a DEXA scan?
standard deviations above or below normal bone density for a young adult
For osteoporosis we want calcium in the presence of what?
Vitamin D
What causes the "big dip" in bone mass for women that can lead to osteoporosis?
menopause
Osteoporosis is all about the...?
Fractures!!
What stimulates the prostate to make dihydrotestosterone (DHT)
Androgens
Between 40-60 testosterone levels decrease, and DHT builds up in the prostate
Where do polyneuropathies usually start? And are polyneuropathies only on one side or bilateral?
Starts in the toes and goes up, bilateral
What is the most common medication for osteoporosis? And what do they need for avoid for the next 30-60 min?
Fosamax-biphosphenate (blocks osteoclasts)
Lying down
True or false: BPH correlates with prostate cancer
false
Is weakness in polyneuropathy associated with efferent or afferent neurons?
Efferent
What types of cells in the neuron are demyelinated and are left vulnerable and damaged in peripheral neuropathy?
Schwann cells
Name 3 different labs and 2 different exams used to diagnose BPH
Labs: testosterone, testosterone estrogen ratio, PSA, BUN, creatinine, UA
Exams: uroflowmetry (measures rate of urine flow), Cystoscopy (visualize urinary tract), DRE (feel size of prostate and possible nodules), Prostate biopsy
What type of OTC meds should BPH patients NOT take?
Cold/flu (Pseudoephedrine)
Also shouldn't take DHT supplements and no tricyclic antidepressants
What type of syndrome can contribute to BPH?
Metabolic (insulin resistance d/t to lifestyle and can lead to DM type 2)
Is carpal tunnel a mononeuropathy or polyneuropathy?
mononeuropathy
What is often the first type of fragility fracture to occur in osteoporosis?
Compression fracture of the spine
Name 4 different LUTS (lower urinary tract symptoms) in BPH
frequency, nocturia, incomplete emptying, weak stream, pain, hesitancy, dribbling, blood
List 4 types or name of medications that can create a risk for osteoporosis/lead to secondary osteoporosis
Corticosteroids (ex: prednisone), antiepileptic drugs (ex: phenytoin), heparin, thyroid replacing drugs (synthroid) and progestins (for birth control, ex: Depo Provera)
Name 3 things that result in polyneuropathy
1. Genetic disorder (charcot marie tooth)
2. Complication of primary disease (diabetes)
3. idiopathic
What is TURP syndrome?
Absorption of irrigation fluid from TURP
<Na, <Hct, >BP (from fluid overload), <HR, nausea vomiting, confusion
What pathogen is most commonly linked to Guillian Barre syndrome?
Campylobacter
Associated with COVID and zika virus as well
Name one diagnostic test for charcot marie tooth disease
nerve conduction study (measure strength and speed of conduction in nerves)
electromyography (thin needle electrode inserted into muscle and electricity is measured as you tighten and relax muscle)
nerve biopsy
genetic testing
Name the three categories of drugs OR the name of three drugs used for BPH and name the antibiotic given before a TURP
Alpha blockers: relax muscles of prostate
ex: tamulosin (flomax), doxasozin (cardura)
5-alpha reductase inhibitors: block production of DHT (shrink the prostate)
ex: finasteride AVOID THESE WITH NITRATES
3. anticholinergics-for bladder spasms
ex: tolterodine (detrol)
Antibiotic: neomycin-given in case for a perineal incision
What kind of vitamin deficiency could cause polyneuropathy?
Vitamin B
What are the two functions/reasons we use a 3 way catheter post TURP?
Traction (puts pressure on the bottom of the bladder) and irrigation