WEEK 8 PATHO

"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is

"No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone."

A tool used to assess levels of consciousness is

Glasgow Coma Scale (GCS).

The stage of spinal shock that follows spinal cord injury is characterized by

absent spinal reflexes below the level of injury.

What type of fracture generally occurs in children?

Greenstick

Ascending paralysis with no loss of sensation is characteristic of

Guillain-Barré syndrome.

_________ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord.

Meningocele

________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.

Nystagmus

The disorders characterized by softening and then enlargement of bones is referred to as

Paget disease.

Orthostatic hypotension may be a manifestation of

Parkinson disease.

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes

a butterfly pattern rash on the face across the bridge of the nose.

Parkinson disease is associated with

a deficiency of dopamine in the substantia nigra.

Pain is thought of as

a subjective experience that is difficult to measure objectively.

Most muscle strains are caused by

abnormal muscle contraction.

Leakage of CSF from the nose or ears is commonly associated with

basilar skull fracture.

It is true that encephalitis is usually

because of a viral infection in brain cells.

The most important preventive measure for hemorrhagic stroke is

blood pressure control.

People who have osteoporosis are at risk for

bone fractures.

A severe complication of elevated intracranial pressure is

brain herniation.

Secondary injury after head trauma refers to

brain injury resulting from the body's response to tissue damage.

A compound, transverse fracture is best described as a bone that is

broken and protruding through the skin.

Inflammation of the sacs that overlie bony prominences is called

bursitis.

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to

cerebral vasospasm.

Pain in fibromyalgia involves

changes in pain transmission in the spinal cord.

A fracture in which bone breaks into two or more fragments is referred to as

comminuted.

Following a bone fracture, the most likely event to occur is

development of a blood clot beneath the periosteum.

The pain of nonarticular rheumatism ("growing pain") is worse

during the night.

A risk factor for osteoporosis is

early menopause.

Modulation of pain signals is thought to be mediated by the release of

endorphins.

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is

positive antinuclear antibodies.

Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots.

posterior

The classic manifestations of Parkinson disease include

rest tremor and skeletal muscle rigidity.

Systemic disorders include

rheumatoid arthritis.

The disease that is similar to osteomalacia and occurs in growing children is

rickets.

Compartment syndrome occurs secondary to

soft-tissue damage.

In the acute phase of stroke, treatment is focused on

stabilization of respiratory and cardiovascular function.

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is

uric acid.

Rickets is characterized by soft, weak bones resulting from a deficiency of

vitamin D.

Enteropathic arthritis is associated with

inflammatory bowel disease.

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache.

migraine

The most common presenting sign/symptom with rheumatic fever is

polyarthritis.

Which treatment is helpful in neuropathic pain but not used for acute pain?

Anticonvulsants

Intracranial pressure normally ranges from ______ mm Hg.

0 to 15

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage.

3

The most common type of osteomyelitis is

hematogenous.

What type of seizure usually occurs in children and is characterized by brief staring spells?

Absence

Which neurologic disorder is commonly referred to as Lou Gehrig disease?

Amyotrophic lateral sclerosis

Myasthenia gravis is an autoimmune disease in which

acetylcholine receptors are destroyed or dysfunctional.

Risk factors for hemorrhagic stroke include

acute hypertension.

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is

air embolus.

Upper extremity weakness in association with degeneration of CNS neurons is characteristic of

amyotrophic lateral sclerosis.

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be

an autoimmune process.

Rheumatoid arthritis involves joint inflammation caused by

autoimmune injury.

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to

autoimmune mechanisms.

The gate control theory of pain transmission predicts that activity in touch receptors will

decrease pain signal transmission in the spinal cord.

The chief pathologic features of osteoarthritis are

degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium.

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because

demyelination is mediated by immune mechanisms.

Paget's disease is characterized by

excessive bone resorption followed by excessive formation of fragile bone.

Muscular dystrophy includes a number of muscle disorders that are

genetically transmitted.

One of the most common causes of acute pain is

headache.

Prosthetic joint infection is most often because of

hematogenous transfer.

Autonomic dysreflexia is characterized by

hypertension and bradycardia.

The pathophysiology of rheumatoid arthritis involves

immune cells accumulating in pannus and destroying articular cartilage.

Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of

immune injury to basement membranes.

The pathophysiology of osteomalacia involves

inadequate mineralization in the osteoid.

Gouty arthritis is a complication of

inadequate renal excretion of uric acid.

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they

increase dopamine activity in the basal ganglia.

It is true that scleroderma involves

inflammation and fibrosis of connective tissue.

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to

initiate action to have the cast split or removed.

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for

intervention.

The stroke etiology with the highest morbidity and mortality is

intracranial hemorrhage.

The most important determinant for prescribing therapy for acute stroke is

ischemic versus hemorrhagic cause.

The initial treatment of an individual experiencing a seizure is concentrated on

maintaining an airway.

It is recommended that women of childbearing age take folic acid daily for prevention of

neural tube defects.

The physiologic mechanisms involved in the pain phenomenon are termed

nociception.

Pain with passive stretching of a muscle is indicative of

noncontractile tissue injury.

A bone disorder that results from insufficient vitamin D is referred to as

osteomalacia.

It is true that Bell palsy is a

paralysis of the muscles innervated by the facial nerve.

Rupture of a cerebral aneurysm should be suspected if the patient reports

sudden, severe headache.

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to

sympathetic nervous system activation.

In contrast to osteoarthritis, rheumatoid arthritis may be associated with

systemic aching in the musculoskeletal system.

Complete healing of a bone fracture occurs when

the callus has been completely replaced with mature bone.

The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that

the lack of airway maintenance can lead to hypoxia.

The ________ is the level of painful stimulation required to be perceived.

threshold

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called

tophaceous gout.