Podcast
Questions and Answers
Which of the following is the MOST important goal of pre-operative care for a geriatric patient undergoing musculoskeletal surgery?
Which of the following is the MOST important goal of pre-operative care for a geriatric patient undergoing musculoskeletal surgery?
- Optimizing surgical outcomes. (correct)
- Preventing surgical site infections.
- Reducing post-operative pain.
- Minimizing the length of hospital stay.
A 75-year-old patient is scheduled for a total knee arthroplasty. Which pre-operative assessment is MOST critical in identifying potential risks?
A 75-year-old patient is scheduled for a total knee arthroplasty. Which pre-operative assessment is MOST critical in identifying potential risks?
- Identifying the patient's risk factors. (correct)
- Measuring calf circumference.
- Assessing lower extremity edema.
- Evaluating range of motion.
What is the primary reason for obtaining a detailed medication history during the pre-operative assessment of a geriatric patient?
What is the primary reason for obtaining a detailed medication history during the pre-operative assessment of a geriatric patient?
- To simplify the medication regimen.
- To determine the patient's adherence to medication.
- To educate the patient on their medications.
- To identify potential drug interactions. (correct)
Which of the following diagnostic tests is routinely performed as part of a pre-operative cardiac evaluation for geriatric patients undergoing musculoskeletal surgery?
Which of the following diagnostic tests is routinely performed as part of a pre-operative cardiac evaluation for geriatric patients undergoing musculoskeletal surgery?
An appropriate acute care unit for patients should include which of the following ratios?
An appropriate acute care unit for patients should include which of the following ratios?
What is the primary goal of post-operative care in geriatric musculoskeletal patients?
What is the primary goal of post-operative care in geriatric musculoskeletal patients?
Which of the following interventions is MOST important in preventing pulmonary complications in the post-operative care of a geriatric patient?
Which of the following interventions is MOST important in preventing pulmonary complications in the post-operative care of a geriatric patient?
Which of the following is a common cardiac complication that should be monitored for in the post-operative care of geriatric patients who have undergone musculoskeletal surgery?
Which of the following is a common cardiac complication that should be monitored for in the post-operative care of geriatric patients who have undergone musculoskeletal surgery?
A 70-year-old patient reports pain that is worse with activity. Radiographs reveal narrowed joint space. This is consistent with what condition?
A 70-year-old patient reports pain that is worse with activity. Radiographs reveal narrowed joint space. This is consistent with what condition?
Which of the following statements BEST describes the typical pain associated with osteoarthritis?
Which of the following statements BEST describes the typical pain associated with osteoarthritis?
Which of the following best describes how osteoarthritis affects the joint?
Which of the following best describes how osteoarthritis affects the joint?
An X-ray of a patient's knee with osteoarthritis is MOST likely to reveal which of the following findings?
An X-ray of a patient's knee with osteoarthritis is MOST likely to reveal which of the following findings?
Which treatment is MOST appropriate as an initial intervention for managing osteoarthritis pain?
Which treatment is MOST appropriate as an initial intervention for managing osteoarthritis pain?
According to the information provided, what percentage of individuals over the age of 70 are affected by osteoarthritis?
According to the information provided, what percentage of individuals over the age of 70 are affected by osteoarthritis?
A patient with osteoarthritis is prescribed celecoxib. The provider should monitor for which of the following?
A patient with osteoarthritis is prescribed celecoxib. The provider should monitor for which of the following?
A patient being treated for osteoarthritis is recommended to undergo joint replacement. This should be considered:
A patient being treated for osteoarthritis is recommended to undergo joint replacement. This should be considered:
According to the provided text, which of the following conditions is NOT a common complication of arthritis?
According to the provided text, which of the following conditions is NOT a common complication of arthritis?
According to the information provided, in which of the following situations is it MOST appropriate to obtain X-rays of a joint?
According to the information provided, in which of the following situations is it MOST appropriate to obtain X-rays of a joint?
A patient is diagnosed with osteopenia, which is characterized by a bone density that is:
A patient is diagnosed with osteopenia, which is characterized by a bone density that is:
Which of the following is the MOST accurate method for assessing bone density in a patient suspected of having osteoporosis?
Which of the following is the MOST accurate method for assessing bone density in a patient suspected of having osteoporosis?
Which of the following is a modifiable risk factor for osteoporosis?
Which of the following is a modifiable risk factor for osteoporosis?
Which of the following endocrine disorders is associated with secondary osteoporosis?
Which of the following endocrine disorders is associated with secondary osteoporosis?
According to the information, when should treatment for osteoporosis begin to prevent fractures and maintain bone health?
According to the information, when should treatment for osteoporosis begin to prevent fractures and maintain bone health?
Which of the following is the MOST appropriate initial behavioral recommendation for treating osteoporosis?
Which of the following is the MOST appropriate initial behavioral recommendation for treating osteoporosis?
Which bisphosphonate can be administered yearly?
Which bisphosphonate can be administered yearly?
A patient with osteoporosis who is prescribed denosumab (Prolia) should be monitored for:
A patient with osteoporosis who is prescribed denosumab (Prolia) should be monitored for:
A patient is diagnosed with hyperkyphosis. This is characterized by kyphosis GREATER THAN:
A patient is diagnosed with hyperkyphosis. This is characterized by kyphosis GREATER THAN:
Which of the following is a potential consequence of hyperkyphosis?
Which of the following is a potential consequence of hyperkyphosis?
All of the following are aspects of the treatment of hyperkyphosis, EXCEPT:
All of the following are aspects of the treatment of hyperkyphosis, EXCEPT:
An elderly patient presents with sudden onset hip pain a day after falling. Which of the following mechanisms is MOST likely to be associated with a hip fracture?
An elderly patient presents with sudden onset hip pain a day after falling. Which of the following mechanisms is MOST likely to be associated with a hip fracture?
What is a major risk factor associated with hip fractures?
What is a major risk factor associated with hip fractures?
A patient is diagnosed with an intertrochanteric fracture of the hip. This refers to which of the following?
A patient is diagnosed with an intertrochanteric fracture of the hip. This refers to which of the following?
Mortality rates from hip fractures may be doubled in men due to what factor?
Mortality rates from hip fractures may be doubled in men due to what factor?
An elderly patient presents with hip pain. Claudication is a symptom of which potential cause of hip pain?
An elderly patient presents with hip pain. Claudication is a symptom of which potential cause of hip pain?
Which of the following exam findings is MOST indicative of a hip fracture?
Which of the following exam findings is MOST indicative of a hip fracture?
For which type of patient may a nonoperative management be considered for a hip fracture?
For which type of patient may a nonoperative management be considered for a hip fracture?
Vertebral compression fractures commonly occur in which region of the spine?
Vertebral compression fractures commonly occur in which region of the spine?
What is a common activity that may lead to compression fractures?
What is a common activity that may lead to compression fractures?
A patient is being evaluated for a possible vertebral compression fracture. Which physical exam finding would MOST strongly suggest a compression fracture?
A patient is being evaluated for a possible vertebral compression fracture. Which physical exam finding would MOST strongly suggest a compression fracture?
How long should a brace be worn for treatment of a vertebral compression fracture?
How long should a brace be worn for treatment of a vertebral compression fracture?
In which timeframe should kyphoplasty be completed for maximum effectiveness?
In which timeframe should kyphoplasty be completed for maximum effectiveness?
In a patient who has undergone kyphoplasty, what is a benefit of the procedure?
In a patient who has undergone kyphoplasty, what is a benefit of the procedure?
Which of the following questions addresses a patient's social determinants of health?
Which of the following questions addresses a patient's social determinants of health?
In the post-operative care of a geriatric patient, what is the rationale behind elevating the head of the bed to 30 degrees?
In the post-operative care of a geriatric patient, what is the rationale behind elevating the head of the bed to 30 degrees?
A 72-year-old female is diagnosed with osteopenia. According to established guidelines, her T-score would likely fall within which of the following ranges?
A 72-year-old female is diagnosed with osteopenia. According to established guidelines, her T-score would likely fall within which of the following ranges?
Which mechanism of injury is MOST likely to result in a hip fracture in an elderly patient?
Which mechanism of injury is MOST likely to result in a hip fracture in an elderly patient?
An elderly patient presents with a suspected vertebral compression fracture. Palpation of the spinous processes elicits significant pain. What does this exam finding suggest?
An elderly patient presents with a suspected vertebral compression fracture. Palpation of the spinous processes elicits significant pain. What does this exam finding suggest?
You are evaluating a patient who has been diagnosed with hyperkyphosis. Which of the following would be the MOST appropriate initial intervention?
You are evaluating a patient who has been diagnosed with hyperkyphosis. Which of the following would be the MOST appropriate initial intervention?
An 82-year-old woman presents with chronic joint pain that worsens with activity and at night. Imaging confirms osteoarthritis. Which of the following treatments is initially recommended?
An 82-year-old woman presents with chronic joint pain that worsens with activity and at night. Imaging confirms osteoarthritis. Which of the following treatments is initially recommended?
A 75-year-old man presents after a fall. Examination reveals shortened and externally rotated right leg. Which of the following is the most likely diagnosis?
A 75-year-old man presents after a fall. Examination reveals shortened and externally rotated right leg. Which of the following is the most likely diagnosis?
A 79-year-old female with osteoporosis has acute-onset thoracic pain following a minor fall. Radiography reveals a vertebral compression fracture. What is the most appropriate initial intervention?
A 79-year-old female with osteoporosis has acute-onset thoracic pain following a minor fall. Radiography reveals a vertebral compression fracture. What is the most appropriate initial intervention?
During preoperative evaluation, which screening is specifically recommended for elderly patients undergoing elective surgery to reduce postoperative complications?
During preoperative evaluation, which screening is specifically recommended for elderly patients undergoing elective surgery to reduce postoperative complications?
What is the primary clinical goal in managing postoperative care of a geriatric patient after orthopedic surgery?
What is the primary clinical goal in managing postoperative care of a geriatric patient after orthopedic surgery?
A geriatric patient scheduled for elective orthopedic surgery is undergoing pre-operative evaluation. Which test is specifically indicated for assessing potential postoperative pulmonary complications?
A geriatric patient scheduled for elective orthopedic surgery is undergoing pre-operative evaluation. Which test is specifically indicated for assessing potential postoperative pulmonary complications?
A 72-year-old woman with chronic hip pain due to osteoarthritis asks about non-pharmacologic interventions. Which intervention has the best evidence for reducing pain and improving function in osteoarthritis?
A 72-year-old woman with chronic hip pain due to osteoarthritis asks about non-pharmacologic interventions. Which intervention has the best evidence for reducing pain and improving function in osteoarthritis?
An 85-year-old man has osteoporosis and presents with an acute thoracic compression fracture. Conservative management is recommended initially. Which intervention is indicated as part of this conservative approach?
An 85-year-old man has osteoporosis and presents with an acute thoracic compression fracture. Conservative management is recommended initially. Which intervention is indicated as part of this conservative approach?
A 70-year-old man diagnosed with osteoporosis has a history significant for excessive alcohol use, smoking, and inactivity. Besides calcium and vitamin D supplementation, what additional recommendation is essential in managing this patient's osteoporosis?
A 70-year-old man diagnosed with osteoporosis has a history significant for excessive alcohol use, smoking, and inactivity. Besides calcium and vitamin D supplementation, what additional recommendation is essential in managing this patient's osteoporosis?
An elderly patient reports joint pain worse at the end of the day and with prolonged activity. Which radiographic finding would most likely support a diagnosis of osteoarthritis?
An elderly patient reports joint pain worse at the end of the day and with prolonged activity. Which radiographic finding would most likely support a diagnosis of osteoarthritis?
A 69-year-old female patient presents with complaints of difficulty performing household tasks, specifically cleaning and preparing meals. These limitations are best classified as impairment in which area?
A 69-year-old female patient presents with complaints of difficulty performing household tasks, specifically cleaning and preparing meals. These limitations are best classified as impairment in which area?
Flashcards
Pre-Op Care
Pre-Op Care
Optimize surgical outcomes and provide anticipatory guidance.
Pre-Op Assessment
Pre-Op Assessment
Benefits must outweigh risks; assess cognition and screen for depression.
Pre-Op Diagnostic Tests
Pre-Op Diagnostic Tests
CBC, CMP, U/A, Coags, CXR, and EKG/stress test.
Post-Op Care
Post-Op Care
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Post-Op Essentials
Post-Op Essentials
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Post-Op Complications
Post-Op Complications
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Osteoarthritis
Osteoarthritis
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Osteoarthritis Pain
Osteoarthritis Pain
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OA on X-ray
OA on X-ray
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OA Complications
OA Complications
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OA Treatment
OA Treatment
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When to Get X-rays
When to Get X-rays
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Osteoporosis
Osteoporosis
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Osteoporosis Characteristics
Osteoporosis Characteristics
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Osteopenia Value
Osteopenia Value
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Osteoporosis Value
Osteoporosis Value
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Osteoporosis Risk Factors
Osteoporosis Risk Factors
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Other Osteoporosis Causes
Other Osteoporosis Causes
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Peak Bone Mass
Peak Bone Mass
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Postmenopausal Osteoporosis
Postmenopausal Osteoporosis
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Osteoporosis Treatment
Osteoporosis Treatment
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Osteoporosis Medications
Osteoporosis Medications
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Bisphosphonates
Bisphosphonates
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Denosumab (Prolia)
Denosumab (Prolia)
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Hyperkyphosis
Hyperkyphosis
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Hyperkyphosis Causes
Hyperkyphosis Causes
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Hyperkyphosis Treatment
Hyperkyphosis Treatment
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Hip Fractures
Hip Fractures
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Hip Fracture Risk Factors
Hip Fracture Risk Factors
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Hip Fracture Mechanism
Hip Fracture Mechanism
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Types of Hip Fractures
Types of Hip Fractures
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Hip Pain DDX
Hip Pain DDX
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Hip Fracture Signs
Hip Fracture Signs
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Hip Fracture Treatment
Hip Fracture Treatment
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Vertebral Compression Fractures
Vertebral Compression Fractures
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Vertebral Compression Fractures (Causes)
Vertebral Compression Fractures (Causes)
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Treatment for Vertebral Compression Fractures
Treatment for Vertebral Compression Fractures
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Percuss Spinous Process
Percuss Spinous Process
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Kyphoplasty
Kyphoplasty
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Social Questions for Patients w/Musculoskeletal issues.
Social Questions for Patients w/Musculoskeletal issues.
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OA Initial Treatment
OA Initial Treatment
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Vertebral Fracture Treatment
Vertebral Fracture Treatment
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Elderly Pre-op Evaluation
Elderly Pre-op Evaluation
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Denosumab Contraindication
Denosumab Contraindication
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Hyperkyphosis Definition
Hyperkyphosis Definition
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Kyphoplasty Benefits
Kyphoplasty Benefits
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Acute Compression Fracture Treatment
Acute Compression Fracture Treatment
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Osteoarthritis (X-ray)
Osteoarthritis (X-ray)
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IADLs Impairment
IADLs Impairment
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Study Notes
Osteoarthritis
- Pain is worse with activity and at night.
- Initial therapy includes NSAIDs, topical therapy, and assistive devices.
- Non-pharmacologic management of osteoarthritis includes exercise, hot/cold therapy, weight loss, bracing, and physical therapy.
- Joint space narrowing and osteophytes (bone spurs) are characteristic radiographic findings.
Hip Fractures
- A shortened, externally rotated leg is a characteristic clinical sign.
Vertebral Compression Fractures
- Acute vertebral compression fractures are initially treated with bracing or kyphoplasty, which restores vertebral height and reduces pain promptly.
- Conservative treatment for acute vertebral compression fractures includes bracing; vertebroplasty or kyphoplasty is considered if conservative therapy fails.
Osteoporosis
- Lifestyle modifications, like cessation of alcohol, smoking, and caffeine, as well as increased physical activity, are crucial alongside calcium/vitamin D for osteoporosis management.
- Denosumab is contraindicated in hypocalcemia due to the risk of severe side effects like osteonecrosis of the jaw.
Hyperkyphosis
- Defined as thoracic curvature >40 degrees, associated with osteoporosis and vertebral fractures.
Post-Op Care
- Early ambulation post-op is essential in geriatrics to minimize complications like delirium, pneumonia, and thromboembolism.
Pre-Op Care
- Pre-op evaluation in elderly includes cardiac (EKG), pulmonary (CXR), cognition, nutrition, and falls assessment.
- Pre-operative geriatric evaluation includes cardiac (EKG) and pulmonary (CXR) assessments to minimize postoperative complications.
ADLs
- Difficulties with complex tasks like house cleaning, meal preparation, and shopping indicate impairment in IADLs (Instrumental Activities of Daily Living).
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