NSG 555 Quiz 3 Module 6 Musculoskeletal –
Questions With Accurate Answers
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Terms in this set (94)
often labs are normal. if chronic indolent bone infection
elevated WBC, ESR, CRP. ALP elevated, Ca, phos, uric
Workup for suspected acid, LFTs, etc.
bone ca _________ orthogonal digital radiographs, or possibly bone scan,
pet scan, etc. coordinate with orthopedic oncology if
needed.
inflammation of a the fluid sac between joints. common
Bursitis _______ in pseudogout, repetition, RA, TB, DM,
immunosupression, etc.
shoulder (subacromial)bursitis
Neer and hawkins
impingement signs ______
posterior elbow swelling, often
due to septic bursitis by staph
Olecranon bursitis ___________ aureu. dx for this would be fluid
aspiration for culture and start
abx
, Over greater trochanter of the
femur - can
Create pressure over the bursa
Bursa - fluid filled sac that
reduces friction
Of tendons that cross the bony
prominence.
When the bursa is irritated from
Hip bursitis _______
too much
Pressure from the tendons, it
becomes
Inflamed.
S/S - snapping of the hip when
they climb
Stairs
TX - PRICES - reduce activity
# of areas the pt has had pain
over last week, score # of areas.
Fibromyalgia widespread Then score symptom severity
pain index ______ during last 6 months and add if
HA, pain/cramps in low abd. and
depression.
1. widespread pain index >7 and symptoms severity
score >5 OR wpi of 4-6 and SSS of >9
2. generalized pain (pain in at least 4 out of 5 regions)
Fibromyalgia diagnostic
3. symptoms present for at least 3 months
criteria
4. dx of fibromyalgia irrespective of other dx, does not
exclude the presence of other clinically important
illnesses
, unclear. more likely a CNS dysfunction and not muscle,
autoimmune or viral.
pain at periphery processed in spinal cord and
transmitted to brain. for some reason becomes loud @
level of spinal cord and brain (central sensitization).
prain responds with pain recognition @ lower thershold
Pathophysiology FMS
decreased GH, insulin like growth factor (IGF) and
possibly prolactin may contribute in FMS patients, these
are released during sleep, disturbance with non-REM
sleep-->fatiuge
tx with GH inc. IGF and improves pain and sleep but is
$$$$$$$$$$$$$$$$
widespread pain + chronic fatiuge. may have other
PE and presentation of
somatic fomplaints: cognitive difficulties, nonrestorative
fibromyalgia and
sleep, auditory, ocular, rhinitis, ax, migraines,
myofascial pain syndrome
palpitations, I/bs, etc
mainly to rule out other differentials:
CBC, ESR or CROP
vit D
workup for fibromyalgia
TSH
ANA, rheum. factor and ACPA ONLY if suggestive of RA
or SLE
lupus, myofascial pain syndrome, hypothyroid, bursitis,
differential dx for
depression/anxiety, RA, polymyalgia rheumatic,
fibromyalgia
polymositis
CBT, sleep, exercise, TCAs @ low toses like amitriptyline
10 mg 2-3 hrs before bedtime
flexeril (also a TC med)
tx of fibromyalgia SSRI or SNRI (SNRI preferred)
gabapentin, pregabalin, zolpidem,
NSAIDs do not help.
determine pain generator and treat these
systemic metabolic disease due to accumulation of uric
acid instead of converting it to excretable substance.
gout Many people with hyperuricemia never develop gout.
can be caused by low dose asa, obesity, ckd, metabolic
syndrome, and diuretics
Questions With Accurate Answers
Save
Terms in this set (94)
often labs are normal. if chronic indolent bone infection
elevated WBC, ESR, CRP. ALP elevated, Ca, phos, uric
Workup for suspected acid, LFTs, etc.
bone ca _________ orthogonal digital radiographs, or possibly bone scan,
pet scan, etc. coordinate with orthopedic oncology if
needed.
inflammation of a the fluid sac between joints. common
Bursitis _______ in pseudogout, repetition, RA, TB, DM,
immunosupression, etc.
shoulder (subacromial)bursitis
Neer and hawkins
impingement signs ______
posterior elbow swelling, often
due to septic bursitis by staph
Olecranon bursitis ___________ aureu. dx for this would be fluid
aspiration for culture and start
abx
, Over greater trochanter of the
femur - can
Create pressure over the bursa
Bursa - fluid filled sac that
reduces friction
Of tendons that cross the bony
prominence.
When the bursa is irritated from
Hip bursitis _______
too much
Pressure from the tendons, it
becomes
Inflamed.
S/S - snapping of the hip when
they climb
Stairs
TX - PRICES - reduce activity
# of areas the pt has had pain
over last week, score # of areas.
Fibromyalgia widespread Then score symptom severity
pain index ______ during last 6 months and add if
HA, pain/cramps in low abd. and
depression.
1. widespread pain index >7 and symptoms severity
score >5 OR wpi of 4-6 and SSS of >9
2. generalized pain (pain in at least 4 out of 5 regions)
Fibromyalgia diagnostic
3. symptoms present for at least 3 months
criteria
4. dx of fibromyalgia irrespective of other dx, does not
exclude the presence of other clinically important
illnesses
, unclear. more likely a CNS dysfunction and not muscle,
autoimmune or viral.
pain at periphery processed in spinal cord and
transmitted to brain. for some reason becomes loud @
level of spinal cord and brain (central sensitization).
prain responds with pain recognition @ lower thershold
Pathophysiology FMS
decreased GH, insulin like growth factor (IGF) and
possibly prolactin may contribute in FMS patients, these
are released during sleep, disturbance with non-REM
sleep-->fatiuge
tx with GH inc. IGF and improves pain and sleep but is
$$$$$$$$$$$$$$$$
widespread pain + chronic fatiuge. may have other
PE and presentation of
somatic fomplaints: cognitive difficulties, nonrestorative
fibromyalgia and
sleep, auditory, ocular, rhinitis, ax, migraines,
myofascial pain syndrome
palpitations, I/bs, etc
mainly to rule out other differentials:
CBC, ESR or CROP
vit D
workup for fibromyalgia
TSH
ANA, rheum. factor and ACPA ONLY if suggestive of RA
or SLE
lupus, myofascial pain syndrome, hypothyroid, bursitis,
differential dx for
depression/anxiety, RA, polymyalgia rheumatic,
fibromyalgia
polymositis
CBT, sleep, exercise, TCAs @ low toses like amitriptyline
10 mg 2-3 hrs before bedtime
flexeril (also a TC med)
tx of fibromyalgia SSRI or SNRI (SNRI preferred)
gabapentin, pregabalin, zolpidem,
NSAIDs do not help.
determine pain generator and treat these
systemic metabolic disease due to accumulation of uric
acid instead of converting it to excretable substance.
gout Many people with hyperuricemia never develop gout.
can be caused by low dose asa, obesity, ckd, metabolic
syndrome, and diuretics
