NURS617 FINAL EXAM ACTUAL COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
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juvenile osteochondrosis ✔✔ANSWER✔✔A group of children's diseases
in which one or more growth ossification centers undergoes a period of
degeneration, necrosis, or inactivity that is followed by regeneration
and usually deformity
types of scoliosis ✔✔ANSWER✔✔1. congenital: during embryonic
development
2. neuromuscular: d/t myopathic dx (cerebral palsy, muscular
dystrophy)
3. idiopathic (most common): usually during adolescence
scoliosis: s/s, tx ✔✔ANSWER✔✔-S/S: Unilateral hip or shoulder
prominence, backaches, altered gait, SOB d/t decreased chest
expansion
-TX: brace if mild. severe=spinal fusion surgery
RANKL and OPG ✔✔ANSWER✔✔RANKL=enhances osteoclast
activity/bone loss
OPG=opposes RANKL to stop bone remodeling
,-estrogen increases OPG; protective. RANKL dominates during
menopause and increases osteoclast activity
-steroid rx: increases RANKL, decreases OPG; results in bone loss
osteopenia ✔✔ANSWER✔✔-thinner than average bone density
-score is -1 to -2.5 on bone mass density scale; can evolve into
osteoporosis
-causes: decreased bone formation (low OPG/high RANKL), malnutrition
(poor calcium/vit d/c), excessive bone deossification
osteoprogenitor cells: differentiation ✔✔ANSWER✔✔1.
osteoprogenitor cells stimulated by fibroblast growth factor (FGF), IGF,
platelet derived growth factor (PDGF)
2. differentiate into osteoblasts, fibrocytes, etc; NOT OSTEOCLASTS
-osteoclasts originate from hematopoietic progenitors in bone marrow
osteoporosis: causes ✔✔ANSWER✔✔-low dietary intake of Calcium/vit
D, lack of physical exercise, frequent use of alcohol, smoking
-long term steroid use, antacids, anticonvulsants
-female athletes d/t low body fat causing low estrogen and lower OPG
osteoporosis: screening ✔✔ANSWER✔✔-Women 65 and older or
younger women with risk factors (smoking, family hx, low BMI, lack of
menstrual period)
,-bone mass density = -2.5 to -4.0
-increased risk for vertebral compression fracture; causes decrease in
high, dowager hump/kyphosis
osteoporosis: tx ✔✔ANSWER✔✔-Bisphosphonates; calcium and
vitamin D supplementation, estrogens, calcitonin (inhibit osteoclasts)
-low impact weight bearing exercises (swimming, walking)
rheumatoid arthritis (RA): cause/what it is ✔✔ANSWER✔✔-chronic
systemic autoimmune dx characterized by remissions/exacerbations;
genetic component (+human leukocyte antigen/HLA)
-helper t cells activated, produce cytokines & IgRF (autoantibody) that
destroys cartilage + bone
-pannus develops (network of new blood vessels in synovial membrane
that covers articular cartilage & isolates it from synovial fluid); increased
capillary permeability=swelling
-lysosomal enzymes released cause joint destruction
rheumatoid arthritis (RA): s/s ✔✔ANSWER✔✔-Morning stiffness lasting
more than 1 hour is almost always present, UNLIKE stiffness of
osteoarthritis, which is relieved in minutes
-weakness, fatigue, anorexia, weight loss, muscle aches and tenderness,
and warmth and swelling of the affected joint
-usually B/L, symmetrical locations
-reduced joint movement eventually causes ankylosis d/t fibrosis
, -can cause splenomegaly/neutropenia, thrombocytosis (elevated ESR),
neuropathy
rheumatoid arthritis: dx ✔✔ANSWER✔✔(+) Rheumatoid Factor
(sensitive but not specific); Increased CRP and ESR
(+) Anti-citrullinated peptide antibodies/anti-CCP antibodies (most
specific for RA)
-synovial fluid is cloudy is appearance, increased WBC
lupus: cause + s/s + tx ✔✔ANSWER✔✔-cause:
genetic/hormonal/environmental influences cause b-cell
hyperreactivity and autoantibodies are produced
-most specific marker=anti-DNA antibody; may also reveal leukocytosis,
thrombocytopenia (elevated ESR)
-s/s: HTN, butterfly rash, splinter hemorrhage, seizure, hemolytic
anemia, acute kidney dx or glomerulonephritis, lymphadenopathy
-tx: hydrochloroquin, immunosuppressive drugs, corticosteroids
systemic sclerosis/scleroderma ✔✔ANSWER✔✔-Autoimmune;
overproduction of collagen (chondrocytes) w/ thickening and tightening
of skin d/t fibrosis
-s/s: ABCDCREST
Autoantibodies
Bibaslar pulmonar fibrosis
