Week 8 CYU

"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."

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.

The most common source of osteomyelitis is

an infection that migrates via the bloodstream.

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

autoimmune mechanisms.

A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F. This information is most consistent with

meningitis.

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

migraine

Anticholinesterase inhibitors may be used to manage

myasthenia gravis.

Bone healing may be impaired by

nicotine use

The physiologic mechanisms involved in the pain phenomenon are termed

nociception.

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

osteomalacia.

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.

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

Nystagmus

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency?

Osteomalacia

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.

The earliest manifestation of scleroderma is

Raynaud phenomenon

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission?

Slower rate of action potential conduction

Which statement is true about the incidence of multiple sclerosis?

The age of onset ranges from 20 to 50 years.

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.

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.

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.

The physiologic change most likely to lead to an increase in intracranial pressure is

cerebral vasodilation.

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.

It is true that epidural bleeding is

characterized by a lucid interval immediately after injury.

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

comminuted.

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

during the night.

A risk factor for osteoporosis is

early menopause

In older women, osteoporosis is thought to be primarily because of

estrogen deficency.

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

The first indication of brain compression from increasing intracranial pressure (ICP) may be

sluggish pupil response to light.

Compartment syndrome occurs secondary to

soft tissue damage

In the acute phase of stroke, treatment is focused on

stabilization of respiratory and cardiovascular function.

Enteropathic arthritis is associated with

inflammatory bowel disease.

Healing of a fractured bone with a poor alignment is called

malunion

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

Anticonvulsants

Which group of clinical findings indicates the poorest neurologic functioning?

Assumes decorticate posture with light touch, no verbal response.

________ edema occurs when ischemic tissue swells because of cellular energy failure.

CYTOTOXIC

Intracranial pressure normally ranges from ______ mm Hg.

0 to 15

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

Amyotrophic lateral sclerosis

Tophi are

deposits of urate crystals in tissues

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

tophaceous gout.

Slow pain sensation is transmitted primarily by

unmyelinated C fibers.

"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

"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

The person at highest risk of a greenstick fracture from falling off a tall ladder is age

8

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

Absence

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.

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of

amyotrophic lateral sclerosis.

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

amyotrophic lateral sclerosis.

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

decrease pain signal transmission in the spinal cord.

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for

delayed healing.

Paget's disease is characterized by

excessive bone resorption followed by excessive formation of fragile bone.

Pain that waxes and wanes and is exacerbated by physical exertion is likely related to

fibromyalgia syndrome.

Acceleration-deceleration movements of the head often result in polar injuries in which

focal injuries occur in two places at opposite poles.

Seizures that involve both hemispheres at the outset are termed

generalized.

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

An example of inappropriate treatment for head trauma would be

hypoventilation.

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.

It is true that scleroderma involves

inflammation and fibrosis of connective tissue.

Ankylosing spondylitis is characterized by

inflammation, stiffness, and fusion of spinal joints.

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.

Ankylosing spondylitis causes

intervertebral joint fusion.

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.

Clinical manifestations of a stroke within the right cerebral hemisphere include

left-sided muscle weakness and neglect.

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

maintaining an airway.

Pain with passive stretching of a muscle is indicative of

noncontractile tissue injury.

Before making a diagnosis of Alzheimer disease

other potential causes of dementia must be ruled out.

It is true that Bell palsy is a

paralysis of the muscles innervated by the facial nerve.

The most common presenting sign/symptom with rheumatic fever is

polyarthritis.

The displacement of two bones in which the articular surfaces partially lose contact with each other is called

subluxation.

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

sudden, severe headache.

In contrast to osteoarthritis, rheumatoid arthritis may be associated with

systemic aching in the musculoskeletal system.

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be

systemic manifestations of inflammation.

A unique characteristic feature of fibromyalgia is the presence of

tender point pain.