HSPC Quiz 1

Chondropenia

Early loss of articular cartilage volume in a joint.

Crepitus

A clicking, popping, or crunchy sound or feeling that occurs during range of motion of a joint.

DMARD

Disease-modifying antirheumatic drug; medication used to limit inflammation and slow disease progression.

Juvenile idiopathic arthritis (JIA)

Previously called juvenile rheumatoid arthritis; an autoimmune condition that leads to painful and stiff joints.

Gout

Inflammatory arthritis caused by a buildup of uric acid crystals around the joints.

Hyperuricemia

High uric acid levels in the blood.

Osteoarthritis (OA)

A condition in which cartilage around the joints wears down over time.

Pannus

An aggressive, thickened layer of inflamed joint lining (synovium) that grows inside the joint space.

Rheumatoid arthritis (RA)

An autoimmune condition that attacks the synovial fluid, causing joint inflammation.

Systemic lupus erythematosus (SLE)

An autoimmune condition in which the body attacks its own healthy organs and tissues.

MCP

Metacarpophalangeal joint.

PIP

Proximal interphalangeal joint.

DIP

Distal interphalangeal joint.

NSAID

Nonsteroidal anti-inflammatory drug. Examples listed in the lecture include Aleve, Advil, Motrin, and aspirin.

Biologics

Engineered drugs that target specific inflammatory cells, cellular interactions, and cytokines involved in RA-related tissue damage.

THA

Total hip arthroplasty.

TKA

Total knee arthroplasty.

TSA

Total shoulder arthroplasty.

ERA

Enthesitis-related arthritis; a subtype of JIA most closely related to spondyloarthritis in adults.

What are the two major classifications of arthritis?

Inflammatory and non-inflammatory.

What characterizes inflammatory arthritis?

Chronic inflammation of the synovial joints, swelling, redness, warmth, corrosion of cartilage, and an autoimmune response.

What causes non-inflammatory arthritis?

Mechanical forces.

What genetic factors are associated with inflammatory arthritis?

HLA-DR4 and HLA-DR1.

What environmental factor is associated with inflammatory arthritis?

Smoking.

What is the typical age of onset for inflammatory arthritis?

Approximately 35-60 years old, with JIA being an exception.

What are risk factors for inflammatory arthritis?

Genetics, female sex, and smoking.

What are early signs/symptoms of inflammatory arthritis?

Fatigue and generalized weakness.

What other signs and symptoms can occur with inflammatory arthritis?

Loss of ROM, joint guarding/bracing, and edema.

What medications may be used to medically manage inflammatory arthritis?

NSAIDs, DMARDs, biologic agents, steroids, and corticosteroids.

What hand deformities are associated with rheumatoid arthritis?

Swan neck deformity and boutonnière deformity.

What causes gout?

Uric acid crystal buildup in the synovial fluid.

What factors primarily drive gout?

Metabolism deficits and diet.

What medication class is listed for gout management?

Xanthine oxidase inhibitors (XOIs).

What happens in SLE?

The immune system attacks healthy tissues and organs.

What proportion of people with SLE are female?

About 9 in 10.

How does SLE prevalence differ among women according to the lecture?

Women of color are 2-3 times more likely to have SLE.

What factors can influence SLE severity?

Environmental stressors and social/economic factors.

How can socioeconomic conditions affect SLE?

Lower household income, less education, and unstable employment are associated with more severe symptoms and faster organ damage accrual.

What was JIA previously called?

Juvenile rheumatoid arthritis.

When does JIA begin?

Before age 16.

How many types of JIA are identified in the lecture?

Five.

What complications can JIA cause?

Growth problems, joint issues, and eye inflammation.

What are risk factors for non-inflammatory arthritis/OA?

Age, weight, previous joint injury, female sex, genetics, and occupation/repetitive strain injury.

Which areas are primarily affected by OA?

Knees, hips, hands, and spine.

Is OA likely to have a full-body impact?

No; the lecture states that OA is not likely to have a full-body impact.

What are common OT assessment components for arthritis?

Functional assessment of mobility, ADLs and IADLs; ROM; MMT; COPM; pain scale; Arthritis Hand Function Test; Rheumatoid Arthritis-Work Instability Scale; and McMaster Toronto Arthritis Patient Preference Questionnaire.

What should arthritis OT intervention be based on?

The patient's goals with a focus on returning to preferred occupations.

What are common OT interventions for arthritis?

Splinting, adaptation, joint protection, pain-free exercise, assistive technology, home modifications, energy conservation, disease-based education, and psychosocial intervention.

How can socioeconomic status affect people with arthritis?

Lower socioeconomic status and fewer resources are associated with worse disease.

What financial barriers may people with arthritis experience?

Costly medications, home adaptations, therapy, and splints.

How can arthritis affect employment and income?

The disease group can lead to disability and loss of income.

What age-related barriers can affect arthritis care?

Difficulty driving to appointments and changes in cognitive function.

How can OTs advocate for patients with arthritis?

Advocate when providers are not listening, provide clear education and repetition, connect patients with local resources, help patients prepare questions for providers, and suggest budget-friendly home modifications.

What are common fracture risk factors and comorbidities?

Advanced age, malnutrition, anemia, obesity, endocrine conditions such as diabetes, birth anomalies, immunocompromise, smoking, steroids, certain medications, and occupations such as sports and construction.

How does smoking interfere with fracture healing?

Nicotine inhibits angiogenesis.

What nutritional deficiencies are particularly associated with fracture risk/healing problems?

Vitamin D and calcium deficiency.

What are traumatic causes of fractures?

Falls, sports, occupational hazards, motor vehicle accidents (MVA), and abuse/assault.

What are non-traumatic causes of fractures?

Malignancy, cyst/non-malignant tumor/insufficiency, and stress or fatigue fractures from repetitive microtrauma.

What are the five general types of bones listed in the fracture lecture?

Long, short, flat, irregular, and sesamoid bones.

Epiphysis

The distal or proximal ends of a bone.

Metaphysis

The portion of bone containing the epiphyseal plate.

Diaphysis

The central part of a bone.

Articular surface

The top or bottom of a bone that forms part of a joint.

Unstable fracture

A fracture that displaces and loses alignment with passive or active joint motion.

Potentially unstable/limited stability fracture

A fracture at high risk of losing alignment.

Clinical stability

Fracture healing through secondary healing, such as with casts, splints, or intramedullary nails.

Absolute stability

Structural stability achieved with rigid fixation and associated with primary healing.

Functional stability

The point at which the injured bone has regained enough structural strength to support normal loading during functional activities.

When may fractures fixed with plates or pins be able to move earlier?

When the fracture is stable.

Head of a bone

The top of the bone.

Neck of a bone

The portion directly underneath the head.

Shaft of a bone

The central portion of the bone.

Base of a bone

The bottom aspect of the bone.

Closed fracture

A broken bone that does not penetrate the skin.

Open/compound fracture

A broken bone that penetrates the skin and has a higher risk of infection.

Displaced fracture

A fracture in which the broken ends are not aligned.

Non-displaced fracture

A fracture in which the broken ends remain aligned.

Intra-articular fracture

A fracture that extends into a joint.

Extra-articular fracture

A fracture that does not extend into a joint.

Transverse fracture

A horizontal break.

Oblique fracture

A fracture with an angled pattern.

Spiral fracture

A twisting patterned break along the bone.

Longitudinal fracture

A vertical break.

Segmental fracture

Two breaks in the same bone that isolate a segment.

Comminuted fracture

A fracture in which the bone has shattered into three or more parts.

Greenstick fracture

An incomplete break through one cortex, seen mostly in children.

Avulsion fracture

A fracture in which a ligament or tendon dislodges a fragment of bone.

Butterfly fracture

A commonly displaced triangular fragment of bone.

Stress/fatigue fracture

A fracture resulting from repetitive microtrauma.

Compression fracture

A fracture caused by compressive forces.

Hairline fracture

A thin crack in bone caused by repetitive stress.

Buckle/Torus fracture

A compression fracture of the cortex of the bone, seen mostly in children.

What are the three major phases of bone healing?

Inflammation, repair, and remodeling.

When does the inflammation phase of fracture healing occur?

Days 1-5.

What happens during the inflammation phase?

Bleeding occurs from the fracture site and a hematoma forms.

When does the repair phase occur?

Approximately weeks 1-6.

What happens during the repair phase?

A callus forms at the fracture site, and generally active range of motion can begin.

When does the remodeling phase occur?

Beginning around week 6 and continuing for months or years.

How long can bone remodeling continue?

Long after the fracture is considered clinically healed.

What is the sequence of bony healing?

Hematoma formation → granulation tissue formation → bony callus formation → bony remodeling.