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123 Cards in this Set
- Front
- Back
Rapid division and growth of cells, or panus in the _________ stage of RA causes the synovium to thicken.
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Second
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_________ arthritis strikes mostly women in their 30s-50s while ___________ arthritis is most commonly associated with aging.
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Rheumatoid; Osteo
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Key symptoms of rheumatoid arthritis. Look for 4 or more in evaluation.
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•Morning joint stiffness lasting at least 1 hour
•Arthritis of three or more joint areas •Arthritis of the hand joints •Symmetric arthritis •Rheumatoid nodules •Abnormal amounts of serum RF •Radiographic changes |
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38 year old woman presents with pain, warmth, stiffness, redness and swelling around the joint (caused by swelling of the synovial lining). What stage of RA is she experiencing?
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First stage
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Rapid division and growth of cells, or panus in the _________ stage of RA causes the synovium to thicken.
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Second
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In the __________ stage of RA, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement.
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Third stage
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A 53 year old woma with RA presents with ulner drift, severe pain and limited use of both hands. What stage is she experiencing?
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Third stage
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Sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons
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Seizure
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3 common causes of seizures
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Cerebral lesions
Biochemical disorders Cerebral trauma |
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Lack of ________ during delivery can cause seizures in newborn.
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Oxygen
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Seizure diagnostic test
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EEG
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During a _________oxygen is consumed at a high rate and rapidly depleted, along with glucose, and lactate accumulates in brain tissue.
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Seizure
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During a _________ seizure, consciousness is not lost. Confusion or repetitive action may be present.
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Partial
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Seizures that involve an interruption to consciousness where the person experiencing the seizure seems to become vacant and unresponsive for a short period of time (usually up to 30 seconds). Slight muscle twitching may occur.
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Absence seizures
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Seizures involving the loss of muscle tone, causing the person to fall to the ground. These are sometimes called 'drop attacks'.
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Atonic seizures
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Seizures that involve an initial contraction of the muscles followed by rhythmic muscle contractions.
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Tonic–clonic seizures
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Seizures that involve an extremely brief (< 0.1 second) muscle contraction and can result in jerky movements of muscles or muscle groups.
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Myoclonic seizures
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Seizures that involve an extremely brief (< 0.1 second) muscle contraction and can result in jerky movements of muscles or muscle groups.
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Myoclonic seizures
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The telltale sensation experienced by some people before a seizure. It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences.
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Aura
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tonic seizure
FONT SIZE AAA a seizure characterized by a sustained increase in muscle tone, of abrupt or gradual onset and offset, lasting a few seconds to a minute, usually 10–20 seconds; tonic seizures affecting proximal muscles bilaterally frequently lead to the adoption of a posture. |
Tonic seizure
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Diagnosis of Alzheimer's dimentia is made by...
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Ruling out other causes
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Mechanisms leading to dementia include...
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degeneration, compression, atherosclerosis, and trauma.
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Assessment of dementia
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Head CT
assess LOC assess cause |
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Clinical manifestations of dementia
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Forgetfulness, emotional upset, disorientation, confusion, lack of concentration, decline in abstraction, problem solving, and judgment
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Dementia associated with plaques and tangles
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Alzheimer's dementia
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Mutations on these two genes are associated with Alzheimer's
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14 and 21
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Normal intracranial pressure
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5 to 15 mm Hg
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Caused by an increase in intracranial content from tumor growth, edema, excessive CSF, or hemorrhage
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IICP
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Clinical manifestations of this neurological disorder include: nClinical manifestations include decreasing levels of arousal or central neurogenic hyperventilation, widened pulse pressure, bradycardia, and pupils that become small and sluggish
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IICP
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Diagnosis of IICP
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Cerebral blood flow
ICP monitoring MRI or CT scan |
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Type of trauma that results when head strikes hard surface or a rapidly moving object strikes the head. The dura remains intact and brain tissues are not exposed to the environment
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Closed trauma
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Type of head trauma that causes focal (local) or diffuse (general) brain injuries
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Closed trauma
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Injury breaks the dura and exposes the cranial contents to the environment
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Open trauma
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Type of head trauma that causes primarily focal injuries
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Open trauma
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Brain injury directly below the point of impact
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Coup injury
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Brain injury on the pole opposite the site of impact
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Contrecoup injury
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What type of brain injury are contusions and hematomas?
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Focal brain injury
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Diagnostic test for head injury
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CT w/o contrast
MRI |
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Diagnostic test used to differentiate head injury from stroke
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CT w/o contrast
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Symptoms of brain injury
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IIP
LOC Altered Neuro Exam |
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Hematoma between the skull and dura mater
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Epidural hematoma
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Hematoma between the dura mater and arachnoid mater
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Subdural hematoma
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Hematoma which forms within the brain
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Intracerebral hematoma
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Traumatic injury of vertebral and neural tissues as a result of compressing, pulling, or shearing forces
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Spinal cord trauma
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Most common location for spinal cord trauma
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C1, C2, C4-C7, and T11-L2 lumbar vertebrae
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Leading cause of spinal cord injury
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Automobile/motorcycle accidents
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A single break in a vertabra usually affecting transverse or spinous processes
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Simple fracture
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Vertebral body shattered into several fragments
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Comminuted (burst) fracture
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Vertebral body compressed anteriorly.
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Compressed (wedged) vertebral fracture
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Int the early phase of spinal cord injury, what makes it difficult to distinguish longterm loss of function from short term loss of function?
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Spinal cord swelling
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upon spinal cord injury, the entire _________ ______ is hemorrhagic and necrotic and edema in the ______ ________ occurs, impairing the microcirculation of the cord.
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gray matter, white matter
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The traumatized spinal cord is replaced by acellular collagenous tissue in __________. Meninges thicken as part of the scarring process.
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3 to 4 weeks
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Degenerating axons are engulfed by macrophages in the first _________ after spinal cord injury.
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10 days
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Phagocytes appear __________ hours after spinal cord injury, Red cells then begin to disintegrate, and resorption of hemorrhages begins.
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36 to 48 hours
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_________ and _________ most commonly produce occlusion, but _________ and _________ are the dominant underlying processes.
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Cerebral thrombi and cerebral emboli;
atherosclerosis and hypotension |
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In __________ infarcts, the affected area becomes slightly discolored and softens 6 to 12 hours after the occlusion. Necrosis, swelling around the insult, and mushy disintegration appear by 48 to 72 hours after infarction.
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ischemic
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In ___________ infarcts, bleeding occurs into the infarcted area when blood flow is restored. The embolic fragments may be moved or lysed, or compressive forces may lessen, allowing blood flow to be reestablished.
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hemorrhagic
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_________ aneurysms occur frequently (in approximately 2% of the population) and probably result from congenital abnormalities
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nSaccular (berry) aneurysms
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_________ aneurysms occur as a result of diffuse arteriosclerotic changes and are found most commonly in the basilar arteries or terminal portions of the internal carotid arteries
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Fusiform (giant) aneurysms
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Intracranial aneurysms may result from...
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arteriosclerosis, congenital abnormality, trauma, inflammation, and cocaine.
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Intracranial aneurisms are typically as symptomatic, but can be diagnosed by...
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History
CT scan MRI. |
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Twenty percent of persons with ALS have a genetic mutation in ______________ on the glial cells surrounding the motor neuron.
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copper-zinc superoxidase dismutase (SODI)
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ALS diagnostic tests
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Electromyography and muscle biopsy verify lower motor neuron degeneration and denervation.
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Disease leading to progressive weakness leading to respiratory failure and death. Patient has normal intellectual and sensory function until death
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ALS
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results from a defect in nerve impulse transmission at the neuromuscular junction related to blocking and destruction of ___________ receptors by _________ antibodies.
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Acetylcholine receptors; IgE antibodies
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Diagnosis of myasthenia gravis is made on the basis of a response to...
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edrophonium chloride (Tensilon)
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Major symptoms of myasthenia gravis
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History of recurring upper respiratory tract infections.
Muscle fatigue and progressive weakness. The muscles of the eyes, face, mouth, throat, and neck usually are affected first. |
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Relatively rare, hereditary, degenerative disorder diffusely involving the basal ganglia and cerebral cortex.
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Huntington's Disease
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nThe onset of Huntington disease is usually between ____ and ___ years of age, when the trait may already have been passed to the person's children.
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30 and 50
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Genetic inheritance pattern of Tay- Sacs disease
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Autosomal recessive
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Huntington's disease is passed through ________ inheritance with high penetrance. The gene has been isolated and cloned on chromosome __.
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autosomal dominant; chromosome 4
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Risk factor for Tay-Sacs disease
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Two parents of Askanazi Jewish heritage
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Basal ganglia and nigral depletion of ______, an inhibitory neurotransmitter, is the principal biochemical alteration in Huntington disease.
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GABA
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Symptoms of Tay-Sacs disease
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Seizures
Noticeable behavior changes, such as the infant stops smiling, crawling or rolling over and loses the ability to grasp or reach out Increased startle reaction Decreased eye contact Listlessness Increasing irritability Slow body growth with increasing head size Delayed mental and social skills Feeding difficulties Abnormal body tone Loss of motor skills Blindness Deafness Loss of intellectual skills |
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Symptoms of Huntington's disease
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Abnormal movement (face, arms first then whole body) and progressive dysfunction of intellectual and thought processes (dementia).
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Huntington's disease is diagnosed through...
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Family history and clinical presentation of the disorder.
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Diagnosis of Tay-Sacs disease
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Cherry-red" spot in the back of the eyes
Blood test for Hex A activity DNA testing of parents |
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Onset of symptoms in Tay Sachs
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6 months
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Vertebral defect that allows the protrusion of the neural tube contents
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Spina bifida occulta
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Certain cutaneous or subcutaneous abnormalities suggest underlying spina bifida, including
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Abnormal growth of hair along the spine
A midline dimple with or without a sinus tract A cutaneous angioma, usually of the “port wine” variety A subcutaneous mass, usually representing a lipoma or dermoid cyst |
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It is recommended that all women of childbearing age take ________ to reduce incidence of neural tubal defects in offspring.
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Follic acid
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Inherited metabolic disorders involving defects in amino acid metabolism, including Phenylketonuria (PKU)
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Encephalopathies
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PKU is caused by phenylalanine hydroxylase deficiency and is an _________ genetic disorder.
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autosomal recessive
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Inflammation of the brain in children associated with ingestion of aspirin or aspirin-containing products during illness and lead poisoning
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Reye syndrome
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Embryonal tumor originating in neural crest cells.
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Nueroblastoma
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Nueroblastoma has an ___________ pattern of inheritance
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autosomal dominant
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More than 90% of children with neuroblastoma have increased amounts of _________ and associated metabolites in their urine.
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catecholamines
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________ skull fractures include breaks in the posterior skull base or anterior skull base. Cary increased risk of vascular and nerve damage.
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Basilar
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Fracture type where bone protrudes through skin
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Open: (Compound)
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Fracture type with no tear in skin
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Closed: (Simple)
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Temporary displacement of two bones, loss of contact between articular cartilage
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Dislocation
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Contact between articular surfaces is only partially lost
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Subluxation
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Fracture assessments
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Pain: continuous causing immobilization
Loss of function Deformity: arm or leg is compared to the uninsured one Shortening Crepitus Swelling and discoloration |
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Population at highest risk for hip fracture
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elderly
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Fracture complication r/t hip repair surgery
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DVT leading to PE
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Loss of blood from bone can cause...
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Shock
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Bone fracture can cause fat emboli. What is sign of fat emboli?
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Pettichii
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Delayed union after a fracture Janice common in what population?
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Elderly
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term of when fracture heals but not in good position.
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Malunion
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Fracture of the pelvis is a medical emergency and can cause...
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Intraabdominal injury to organs
Paralytic ileus Hemorrhage Laceration of urethra, bladder or colon |
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Tear or injury to a tendon
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Strain
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Complete separation of a tendon or ligament from its bony attachment site
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Avulsion
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Tear or injury to a ligament
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Sprain
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How are strains and sprains treated in the acute phase?
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RICE: Rest, Ice, Compression and Elevation
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Signs of dislocation
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pain, changing contour of joint, change in length, loss of mobility
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Diagnostic test to confirm dislocation
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X-ray
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Common bone disease in which bone becomes more thin and porous.
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Osteoporosis
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The underlying mechanism in all cases of osteoporosis is an imbalance between ________ and _________.
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bone resorption and bone formation
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Symptoms of osteoporosis
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Fractures of the vertebrae, wrists or hips
Low back pain Neck pain Bone pain or tenderness Loss of height over time Stooped posture |
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Osteoporosis is diagnosed with a _________ scan, whic measures ___________.
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DEXA; bone mineral density
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Metabolic bone disease characterized by excessive breakdown of bone tissue, followed by abnormal bone formation
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Paget's disease
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Symptoms of Paget's disease...
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Bone pain (may be severe and persistent)
Joint pain or joint stiffness Headache Bowing of the legs Warmth of skin overlying affected bone Fracture Neck pain Reduced height Hearing loss |
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Piaget disease typically occurs in ______ over the age of ___
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Men over the age of 40
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Diagnostic tests for Piaget's disease
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Elevated serum alkaline phosphatase
Elevated markers of bone breakdown (for instance, N-telopeptide) Serum calcium |
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Infection of bone by vascular ulcer, bone surgery, blood borne from other sites
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Osteomylitis
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Symptoms of osteomylitis
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Sudden onset, client has fever, chills, pain, swelling
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Bacteria most often responsible for osteomyllitis
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Staph aureus
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__________ and _________ increase risk of osteomylitis.
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Diabetes and arteriovascular disease
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Assessment Osteomyelitis
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Physical exam and area swollen red warm to touch
X-ray shows soft tissue swelling Bone scan shows increased uptake Blood cultures positive increased WBC Wound culture positive Erythrocyte sedimentation rate (ESR) Complete blood cell count (CBC) w/differential C-reactive protein (CRP) Radiography, magnetic resonance imaging (MRI) Bone biopsy and culture |
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Thoracic spine in convex posteriorly
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kyphosis
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Lumbar spine is convex anteriorly.
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lordosis
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Rotational curvature of the spine
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Scoliosis
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Symptoms of scoliosis
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Uneven shoulders
Prominent shoulder blade or shoulder blades Uneven waist One hip elevated as compared to the opposite side Leaning to one side |