Human Pathophysiology - Module 4 Learning Guide

Module 4 Learning Guide MODULE REFLECTION – In the box below, reflect on the course material & activities for this module. If you did not complete all the activities, did you have any questions or comments relating to this? What content did you find the most interesting and why? This should be a 4-5 sentence paragraph. I feel that this module, like the past ones, has been very relevant to my future career. I would say that I really like the format of this learning guide since it also has a column for pathophysiology. The previous learning guides did not contain this column, and I felt like everything was jammed into the etiology in a way. By adding this extra column to the learning guide, I feel that it has made the diseases clearer and the guide easier to look at and understand. MODULE 4 DISORDERS OR DISEASES Diseases to know for Module 4, include etiology, typical signs and symptoms, diagnostic testing, and general treatment (or prognosis). Use your textbook and/or supplemental PowerPoint for the completion of this table. Complete sentences are NOT required. It is important to be succinct in your analysis of each disease and choose the most important components to look for in a clinical setting. For this reason, do not include more than 5 different components in each box. Disease or Disorder (Chapter) Osteoporosis (Ch. 38) Osteoarthritis (OA) (Ch. 38) pg. 1 of 3 Signs & Symptoms of Disease (Clinical Presentation) / Risk Factors Etiology (cause) Pathophysiology Prolonged negative calcium balance due to poor diet, lack of exercise, and lack of sunlight. Reduction in bone density due to imbalance of osteoclasts and osteoblasts. Silent, not diagnosed until after the patient has suffered a fracture. Back pain that radiates around trunk, loss of height. Result of stress applied to joints, especially weightbearing ones. Chronic with degeneration, results of the breakdown of chondrocytes and adjacent subchondral bone. Slow progressive, degenerative, and inflammatory. Excess pressure wears down the cartilage surface, which exposes the subchondral bone. Deep aching joint pain occurs w/ exercise and goes away with rest. Joint pain w/ cold weather, stiff when rising, crepitus, swelling, abnormal gait, limited ROM. Diagnosis / Treatment (General) Dual Energy x-ray Absorptiometry (DEXA). Bone Mineral Density(BMD) measurements. Lifestyle change. Supportive devices, Vitamin D, medications. Serum osteocalcin and hyaluronic acid levels. Clinical exam. X-ray shows joint narrowing w/ osteophyte and subchondral sclerosis. Tx: relieve pain, exercise, medication, supportive measures, surgery. Module 4 Learning Guide Disease or Disorder (Chapter) Degenerative Disc Disease (DDD) (Ch. 38) Osteomyelitis (Ch. 39) Lyme Disease (Ch. 39) Gout (Ch. 39) pg. 2 of 3 Etiology (cause) Pathophysiology Signs & Symptoms of Disease (Clinical Presentation) / Risk Factors Diagnosis / Treatment (General) Discs of spine deteriorate which creates malalignment of spinal column. Disc looses moisture w/ age and is more rigid and less elastic. Discs flatten and collapse. Back pain, weakness, numbness in lower limb. Cervical: neck pain, weakness, numbness to upper limb. Physical exam. X-ray, CT, myelography, MRI. CBC. Tx: pain management, physical therapy, chiropractor, surgery. Infection w/ S. aureus. Sickle cell dz caused by Salmonellae species. Bacterial infection. Bones invaded w/ bacteria via bloodstream and form an abscess. Bone dies and becomes necrotic. Chills, fever, malaise, local tenderness, erythema, edema, pain on movement. Tick-transmitted spirochete B. burgdorferi. No fully understood. Immune response contributes to disease manifestation. Vague. Arthralgias, myalgias, fatigue, headache. 3 stages: early localized, early disseminated, late disseminated. Thorough history. Difficult to diagnose. CBC, MRI, CT, ultrasound, needle aspiration, bone biopsy. Tx: Antibiotic therapy IV followed by PO. Debridement. Symptoms, clinical findings, history of exposure. ELISA test. Tx: Doxycycline Primary: metabolic disorder, 90 % of cases. Defect in renal excretion of uric acid. Secondary: myeloproliferative, lymphoproliferative, neoplastic, glycogen storage dz, or psoriasis and sarcoidosis. Associated w/ obesity, lead intoxication, alcoholism. When uric acid levels are high it becomes deposited in the body which can be painful and cause inflammation of joints. 15-20 yrs of constant asymptomatic levels of hyperuricemia. Sudden onset of inflammation and extreme pain in one joint, generally the big toe. History. Diagnostic tests. 24 hours urine uric acid of more than 900 mg. X-rays. Ultrasound. Aspiration of joint fluid. Module 4 Learning Guide CHAPTER 39: INFECTION SYSTEM – AND I NFLAMMATORY DISORDERS OF THE MUSCULOSKELETAL Describe the stages of bone infection below: Stage Description of Stage Inflammation Initial inflammation w/ congestion of the vessels and increased pressure of the interior bone. Blood flow is obstructed, and intravascular thrombosis occurs. Suppuration Infection that is present in the bones makes its way out forcefully through the Haversian system which then forms an abscess under the surface of the bone. pg. 3 of 3 Picture of the Stage (Find Online) Module 4 Learning Guide Stage Description of Stage Sequestrum This is when the pressure increases, vascular obstruction, and thrombi are compromised to the inner and outer bone causing a loss in blood supply and creating necrosis. Generally, occurs at day 7. Involucrum New bone formation from the surface of the periosteum. Resolution or Progression to complication In the early stages of the dz, antibiotics and surgery can be treated w/o complications. If not treated complications such as gangrene can occur. pg. 4 of 3 Picture of the Stage (Find Online) Module 4 Learning Guide MODULE 4 OTHER TERMS TO KNOW The terms below outline some additional pathophysiology terms to know for the final exam in Module 8. You are NOT required to define them in this module learning guide; however, all terms can be seen in the Module Knowledge Check and Final Exam. Chapter 38: Degenerative Disorders of the Musculoskeletal System Terms          Arthropathy Arthritis Degeneration of Bone Articular Cartilage Degeneration Chondrocytes Osteophytes Osteopenia Arthritic nodes Sciatica pg. 5 of 3 Chapter 39: Infection and Inflammatory Disorders of the Musculoskeletal System Terms      Rheumatology Myositis Hematogenous spread Erythema migrans Hyperuricemia