QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
Qualifying factors for acute rehab - ANS>>- ability to tolerate 3 hours of therapy per day
-do not need to be able to shower themselves
Which patient population do best in acute rehab? - ANS>>- stroke
- total joint
- hip fractures
- head injuries
Tertiary prevention: - ANS>>treating the complications of a disease
HMO: - ANS>>A group plan offering prepaid medical care to its members. Negotiated fees,
paid by diagnosis
LTAC Medicare reimbursement criteria: - ANS>>Patients who have been in the ICU at least 3
days and will be on the vent at the LTAC for 96 hours
Hospice medicare reimbursement - ANS>>Most people only qualify for home hospice, but
medicare will only cover intermittent care, comfort related medications
Respite care - ANS>>a type of care provided for caregivers of homebound ill, disabled, or
elderly patients. 1 week per benefit period.
Red flag for spinal injury - ANS>>- Incontinence
- Altered sensation to extremities
compartment syndrome - ANS>>4 P's
- pain
- pallor
- pulselessness
- paresthesia
Example of pathological fracture - ANS>>CA - tumor causing bone to break
, Frailty fracture - ANS>>osteoporosis
What chronic comorbidity is very common and often associated with bone demineralization
and frailty fractures? - ANS>>CKD
- hyperparathyroidism causes bone demineralization and frailty fracture
- Hypercalcemia = calcification of vascular system (coronaries, valves)
Should geriatric patients with fractured hip wait to see ortho? - ANS>>NO, hip fractures are
urgent. Early stabilizations improves outcomes
Fibromyalgia - ANS>>diffuse pain
Fibromyalgia comorbidities - ANS>>psych / depression
Fibromyalgia treatment - ANS>>antidepressants, NSAIDs, physical therapy, trigger point
injections (Opiates contraindicated)
How does spinal stenosis present? - ANS>>Neurogenic claudication (legs hurt on ambulation/
worsening pain when standing = compression)
Symptom management for osteoarthritis medication: - ANS>>- Acetaminophen: safest in elderly
adults with HTN, GI bleed, or CKD
- NSAIDs: works better but higher risks
When do you consider joint replacement for osteoarthritis? - ANS>>After failed conservative
management
Would you promote someone with severe COPD to have a hip replacement? - ANS>>No, they
wouldn't have improved mobilization or quality of life
How do you tell the difference btw osteoarthritis and inflammatory arthritis: - ANS>>- Bilateral
significant inflammation in inflammatory arthritis
_ Inflammatory is worse in the morning, whereas worse in the night for osteoarthritis
Term for boney abnormalities associated with osteoarthritis: - ANS>>Herberden: most distal
Bouchard: pip joints
What medicine can cause musculoskeletal disease? - ANS>>- Steroids: demineralization of bone
- ABX: tendon rupture (quinolones)
- Statin: myopathy