Back Pain
Osteoporosis
Osteomyelitis
Fractures
LABS
100

What electrolyte is important in Bone Health and give examples of food that contain it

Calcium 

-milk, yogurt, cheese, kale, broccoli, oysters, tofu, cereals, fruit drinks

100

What are risk factors?

genetics, age, nutrition, physical exercise, lifestyle choices and medications

100

What types of patients are at risk?

those who are poorly nourished, elderly, or obese. Other patients at risk include those with impaired immune systems, those who are IV drug users, those with chronic illnesses (e.g., diabetes, rheumatoid arthritis, neuropathy, and arterial insufficiency), and those receiving long-term corticosteroid therapy or immunosuppressive agents.

100

what fracture involves a break across the entire cross-section of the bone and frequently is displaced (removed from its normal position)?

complete fracture 

100

normal HbA1c

<7

200

Name diagnostic procedures for low back pain 

what is xray of spine, bone scan and blood studies, CT, MRI, and EMG

200

How is Osteoporosis diagnosed?

by dual-energy x-ray absorptiometry (DEXA), which provides information about BMD at the spine and hip

200

Why are bone infections difficult to treat?

Bone infections are more difficult to eradicate than are soft tissue infections because the infected bone is mostly avascular (without blood vessels) and not accessible to the body’s natural immune response. Also, there is decreased penetration by antibiotics.

200

what is a priority immediately after a fracture?

-immobilize the body part

-hemodynamic stability

-protect the wound (from infection, cover with sterile dressing if needed)

200

normal calcium levels

8.6-10.3

300

How can a patient relieve back pain without pain meds?

- reduce stress on back

-change positions frequently

-diaphragmatic breathing and relaxation

-diverting attention


300

What are pharmacologic therapies?

-Selective estrogen receptor modulators

-Denosumab

-Calcitonin

-Calcium

-Vitamin D

300

How to diagnose?

Radioisotope bone scans, particularly the isotope-labeled white blood cell (WBC) scan, and magnetic resonance imaging (MRI) help with early definitive diagnosis. Blood studies reveal leukocytosis (elevated WBCs) and an elevated ESR and C-reactive protein in hematogenous and acute osteomyelitis, but those counts may be normal in chronic contiguous osteomyelitis. Wound and blood culture studies are performed to identify the offending organisms so appropriate antibiotic therapy can be instituted.

300

thirst, anxiety, tachycardia, weak pulse, hypotension, cool skin, decreased UO, are s/s of what?

hypovolemic shock

300

TSH

0.5 to 5.0

400

What is the first line drug treatment for back pain?

Nonprescription analgesics

400

What is the mechanism of calcitonin?

Calcitonin directly inhibits osteoclasts, thereby reducing bone loss and may increase osteoblast activity; it also helps to regulate calcium via bone, renal, and GI effects. Calcitonin is administered by nasal spray or by subcutaneous or intramuscular injection

400

Ways to prevent osteomyelitis

-postpone surgery if sick

-prophylactic ABX

-remove drains and catheters ASAP

-aseptic wound care

-control blood sugars in DM

400

risk factors for fat emboli

(fat globules released when the bone was fractured may occlude the small blood vessels that supply the lungs, brain, kidneys, and other organs)

trauma, crash inquiries, fracture of long or pelvic bones, orthopedic surgery

400

T4 and T3

t4: 5-12

t3:80-220

500

What can contribute to low back pain?

obesity, stress, depression, age

500

What is secondary osteoporosis related to?

associated with many disease states, nutritional deficiencies, and medications. Coexisting medical conditions, such as gastric bypass, malabsorption syndromes, lactose intolerance, malnutrition, alcohol abuse, kidney failure, liver failure, Cushing syndrome, hyperthyroidism, and hyperparathyroidism, contribute to bone loss and the development of osteoporosis. Medications, including corticosteroids, antiseizure medications, heparin, tetracycline, aluminum-containing antacids, and thyroid supplements, affect the body’s use and metabolism of calcium

500

Medical management osteomyelitis

-surgical debridement

-IV ABX

500

late signs of compartment syndrome

pallor and loss of pulses (may need a fasciotomy)

500

fasting blood glucose

70-110