HTHRHSC 2500 Med Term Application 4
The HPI also notes that Ms Ryder has a history of osteoarthritis, which is _____________. Her history indicates she had what type of surgery in 2000?
a degenerative joint disease characterized by the wearing away of the articular cartilage within the joints; rt THR
In the HPI, Ms Ryder is described as having a "history of significant osteoporosis". This condition is described as ______. The x-ray noted that she had ____ fractures of the T12 and lumbar vertebrae.
marked loss of bone density and an increase in bone porosity that is frequently associated with aging; compression
This 13 y/o male fell from a tree and presents in the ED with pain and swelling in his left forearm. The emergency physician is evaluating Tommy Fallon's forearm. Tommy's mother is standing beside the hospital cart. Dr. Emergin palpates the left forearm, gently moves it and says that Tommy likely has a fracture because crepitation is present when moving the arm. An x-ray is ordered. Mrs. Fallon asks Dr. Emergin to explain what crepitation means in non-medical terms.
"Crepitation is the grating sound you hear when the ends of a broken bone move together."
Joanie Witherspoon is a 22 y/o female with rheumatoid arthritis. She is experiencing moderately severe pain in her left knee. We have referred her to an orthopedist for arthroscopic knee surgery. After the procedure, Dr. Bonz met with Joanie and her mother, "Ms. Witherspoon, we evaluated your knee and found synovitis with significant swelling of your synovial membrane. We performed a synovectomy which should give you some pain relief and increased mobility." Joanie's mother asked Dr. Bonz to explain in non-medical terms what he actually did when he did the synovectomy.
"Mrs. Witherspoon, the rheumatoid arthritis has thickened and inflammed the membrane that allows your daughter to move her knee freely and without pain. The synovectomy is a procedure to cut away the diseased membrane, so Joanie has less pain and can bend her knee."
Progress Note: This 10-month-old Asian male presents to our clinic with difficulty crawling. The mother says that her son whimpers and cries when trying to crawl. He is not pulling himself up or trying to stand. Upon evaluation, the muscles appear weak with some spasms and tenderness to palpation; particularly in the lower extremities. Both legs are bowed with poor growth for his age. He is breast-fed and not eating solid foods. The mother is a vegan [often this is a diet low in vitamin D and calcium]. Both mother and son do not spend much time in the sun [darker skin pigmentation blocks ultraviolet light absorption, which allows for vitamin D production]. Lab values for both mother and son are normal except for significantly low vitamin D and calcium levels. Diagnosis: Rickets Plan: multivitamin supplement; vitamin D supplement; dietitian consult today. The dietitian describes rickets and what causes it. She also takes a diet history to identify ways the mother and son can get calcium and vitamin D into their vegan diet.
"Rickets is a condition that affects growing bones - so it only occurs in children. Bones are made strong with calcium. If there isn't enough calcium it makes the bones softer and weaker than normal and also causes weak muscles. This is probably why your son is not crawling or walking. The main cause of rickets is a lack of vitamin D. It is this vitamin working with calcium which helps the bone-building process."
Tom Jones is a 36 y/o male with non-Hodgkins lymphoma. The oncologist recommends that he have a bone marrow transplant. Dr. Ben Trans explains that they will try an autologus bone marrow transplant; however, if this is not feasible, they will do an allogenic transplant. Tom does not understand the difference between the two types of transplants and asks Dr. Trans to explain so that he can understand.
"Tom, an autologous transplant occurs when you receive some of your own bone marrow cells that have been removed, cleaned, treated and stored. We will then destroy your remaining diseased marrow. Your healthy bone marrow cells are transfused through an IV into your blood stream. If this is not possible, we will check your brother and sister to see if their marrow cells are a match with yours. If we have a perfect match, we will destroy your diseased marrow and replace it with his or her healthy bone marrow by transfusing it into your blood stream. This second option is called an allogenic transplant because we are using healthy bone marrow from a donor match."
Justin Case is a 58-year-old male, who presents to the clinic with hip pain and bowing of legs bilaterally. Radiographs of hips and lower extremities indicate bone enlargement and bowing of the bilateral femurs. Bone scintigraphy demonstrates areas of increased uptake in the hips and legs. Blood studies indicate elevated alkaline phosphatase. The doctor diagnoses Paget's disease and explains the condition to Justin in layperson's terms.
Paget's disease interferes with your body's normal ability to replace old bone tissue with new bone tissue. Because the bones in your pelvis and legs are affected they become weak, enlarged, and misshaped. We will treat you with medication that will help strengthen your bones.
Ralph Payne is a 75 y/o male with moderate bilateral osteoarthritis of the hips and spondylosis of the lumbar spine. His family physician starts him on a course of ibuprofen and tells Mr. Payne to let him know if the routine dose of this NSAID provides him with relief of his hip and low back pain. Mr. Payne asks the doctor to tell him what the term "NSAID" means in plain English.
The family doctor explains that NSAID is an abbreviation for non-steroidal anti-inflammatory drug, like ibuprofen. "The ibuprofen reduces inflammation in the muscles and tissues around your hip and spine joints - this should help relieve your pain."
Jane Doe is a 52 y/o Caucasian female with small bones and a history of cigarette smoking. She is post-menopausal. Recently her 76 y/o mother suffered a rt hip fx after a fall. Because of her risk factors we will schedule Mrs. Doe for a DXA scan. Dr. Rand hands Mrs. Doe a prescription for the scan and tells her that the office staff will schedule it for her. Mrs. Doe asks the scheduler to explain the DXA scan and what it is used for. The scheduler asks the office nurse to explain in layperson's terms.
The office nurse explained that DXA is an abbreviation for dual x-ray absorptiometry. "You will be asked to lay on a table while an x-ray scanner, using low levels of radiation, measures how dense your spine and hip bones are. The report will tell if you have osteoporosis. Osteoporosis affects many older women causing your bones to get thinner. You are more likely to break your bones if you fall. If you have osteoporosis, the doctor will treat you with calcium and maybe other medications to strengthen your bones."
Ralph Cramden is an 88 y/o male with a history of osteoporosis. While walking in the hallway of his apartment building, he suffered severe pain in his right hip causing him to collapse. EMS brought him to the ED. X-ray Report: oblique fracture of the head of the femur. Dx: Osteoporotic Hip Fracture Plan: Discuss scheduling surgery for ORIF with Mr. Cramden and his son. Explain the diagnosis in layperson's terms.
The orthopedic surgeon described an osteoporotic hip fracture to Mr. Cramden as a broken hip that occurred because his bones had become weakened and more porous or fragile.
Michael Lumbeau is a 26 y/o male who presents with increasing pain and stiffness in his low back and hips. He notices the stiffness upon arising in the morning or after sitting for long periods of time. He is experiencing more stiffness which is interferring with his mobility. After reviewing a CT scan of the spine and pelvis, the orthopedic physician told Michael that he had ankylosing spondylitis. The treatment plan is physical therapy for strengthening and flexibility and naproxen for pain and inflammation. During the physical therapy evaluation, Michael asked the therapist to explain what was happening to his body with this condition.
The physical therapist explained that ankylosing spondylitis is an inflammation between the bones of the spinal column. As the inflammation progresses up the spine, the bones fuse together making the spinal column stiff. Therapy and medication would prevent or delay further stiffness and deformity of his spine.
The Tylenol #3 is given 1-2 po q 4-6 h prn. Review information learned in Module 1 to respond to this question.
Tylenol #3: 1 or 2 tablets, taken orally, every 4-6 hours as needed
Patricia Parshal is a 37 y/o female who fell while skiing. She presents to the ED with severe pain in the left shoulder and inability to move her arm. Upon examination the ED physician suspected a fracture of the head of the humerus and ordered an x-ray. X-ray report: no fracture; subluxation of the head of the humerus from the glenoid. The doctor explained subluxation to Patricia in non-medical terms.
Your fall caused the bones in your shoulder to be partially pulled out of the shoulder socket.
The PMH (past medical history) for Dorothy Ryder indicates that 10 days prior to hospital admission, she "sustained a distal radius fracture of her left forearm". This fracture is also known as __________.
a Colles' fracture which results when a person tries to stop a fall by landing on the hands. The impact of this fall causes the bone weakend by osteoporosis to break
The discharge medications given to Ms Ryder include Tylenol #3 1-2 po q 4-6 h prn. Tylenol is the brand name for APAP or ____ (generic name). The pain relieving action of the Tylenol is potentiated by #3, which refers to Codeine. This is the brand name for one of the narcotics listed as ______ (category), used to treat severe to moderate pain.
acetaminophen; opioids
Also listed in discharge medications for Ms Ryder is Fosamax 5 mg qwk. Fosamax is a _______ (category) and is used to treat ______.
bone resorption inhibitor; osteoporosis
Ms Ryder will continue taking her Caltrate 250 2 tabs po tid. Caltrate is a ______(category) that _______(action).
calcium supplement; treats and prevents hypocalcemia
On the day following admission, Ms Ryder has a bone scan which revealed moderate degenerative joint disease of T&L with no acute compression fractures. Both admission and discharge diagnosis were "multiple compression fractures of T12, L1, L2, and L4". Degenerative joint disease of the spine is termed _____; and compression fractures are ______.
spondylosis; vertebral crush fractures caused by the spontaneous collapse of osteoporotic vertebrae or by an injury
According to the HPI, her osteoarthritis was so severe in her right hip that she had a THR in 2000. THR is ________ [Select all correct responses.]
total hip replacement a surgical procedure to replace the acetabulum surface with a smooth plastic lining and removal of the head of the femur to replace it with a metal ball and shaft fitted into the femur. total hip arthroplasty
After confirming the diagnosis of compression fractures, the physician ordered physical therapy (PT) for ambulation. PT trained her on ______ for her wrist splint. Providing a mechanical appliance such as a brace or splint to control, correct, or compensate for impaired limb function is a/an _________.
use of the walker and fitted it with a platform; orthotic
