Comprehensive FNP Clinical Review: Bone and Cardiovascular Disorders

Vocabulary-style practice flashcards generated from lecture notes covering musculoskeletal disorders (Osteomyelitis, Osteoporosis, Rheumatoid Arthritis, Vitamin D) and cardiovascular disease/diagnostics (Pulmonary Edema, ACS, Aortic Aneurysms, Vascular Insufficiency, Cardiac Diagnostics/Markers, Pharmacology).

Osteomyelitis

An infection involving bone resulting from bacteria in the bloodstream, adjoining soft tissue infection, a septic joint, or direct injection from trauma or surgery, leading to progressive bone destruction and formation of dead bone fragments without blood supply.

Acute Osteomyelitis

An infection of the bone characterized by a disease duration of less than 2 weeks.

Staphylococcus aureus (in Osteomyelitis)

The primary pathogen responsible for causing bone infections in osteomyelitis.

Osteoporosis

A chronic skeletal condition characterized by compromised bone structure and density, resulting in increased bone fragility and heightened susceptibility to fractures due to a bone quantity issue.

Osteomalacia

A condition caused by poor bone mineralization and low vitamin D levels, presenting as bone softening and pain without fracture (bone quality issue).

T-Score

A Bone Mineral Density (BMD) score measured by DEXA that compares a patient's bone density to that of a healthy 25–35 year old to quantify fracture risk ($<-2.5$ = Osteoporosis, $-1$ to $-2.5$ = Osteopenia, $>-1$ = Normal).

Z-Score

An age-matched DEXA Bone Mineral Density comparison matching a patient's bone density to others of the same sex, age, and ethnicity; scores $<-2$ suggest secondary causes.

FRAX

An assessment tool that estimates a patient's 10-year probability of having a major osteoporotic fracture (score $>20\%$) or hip fracture (score $>3\%$).

Antiresorptive Agents

A class of osteoporosis medications, including bisphosphonates (e.g., Alendronate, Risedronate, Ibandronate, Zoledronic acid) and Denosumab, that inhibit osteoclast-induced bone resorption.

Anabolic Agents (Osteoporosis)

Medications such as Teriparatide (Forteo) and Abaloparatide (Tymlos) that stimulate osteoblastic bone formation, typically limited to 2 years of use.

Rheumatoid Arthritis

A systemic autoimmune disease marked by chronic, symmetrical inflammation of synovial joints, affecting at least 3 joints and potentially leading to irreversible joint damage.

Ulnar Deviation

A hand deformity characterized by lateral deviation of the fingers to the ulnar side due to inflammation at MCP joints causing joint laxity and extensor tendon imbalance.

Swan Neck Deformity

A joint deformity where the PIP joint is hyperextended while the DIP joint is flexed due to inflammation disrupting tendons and ligaments.

Boutonniere Deformity

A joint deformity where the PIP joint is flexed while the DIP joint is hyperextended, caused by rupture of the central slip of the extensor tendon.

Ergocalciferol (Vitamin D2)

A plant-based form of vitamin D.

Cholecalciferol (Vitamin D3)

The most potent and effective form of vitamin D, obtained from animal-based sources or synthesised in the skin following UVB exposure.

Calcitriol (1,25-hydroxyvitamin D)

The active form of vitamin D converted in the kidneys; it enhances intestinal absorption of calcium and phosphorus, suppresses PTH release, and promotes bone remodeling.

Rickets

A pediatric condition resulting from vitamin D deficiency, characterized by bowing of the legs, costochondral beading ('rachitic rosary'), delayed growth, delayed fontanelle closure, and dental enamel defects.

Acute Cardiac Related Pulmonary Edema

A clinical state where heart failure causes fluid overload leading to third-spacing of fluid into the lung interstitial spaces, causing dyspnea, cough with blood-tinged frothy sputum, cyanosis, and crackles/wheezes.

Stable Angina

Exercise-induced, short-lived ischemic chest pain that is relieved by rest or nitroglycerine.

Unstable Angina

A progressive change in stable angina pattern marked by increased pain, persistent duration $>5\text{ minutes}$, and lack of response to rest or nitroglycerine.

Variant Angina (Prinzmetal)

Angina resulting from coronary artery spasms occurring cyclically or at rest, often associated with smoking, alcohol, or illicit stimulants.

Dissecting Aortic Aneurysm

A condition in which the wall of the aorta is torn, allowing blood to flow between layers of the wall, dilating and weakening it until it is at risk of rupture.

DeBakey Classification Type 1

An aortic dissection that begins in the ascending aorta but may spread to include the aortic arch and descending aorta ($60\%$ of cases).

DeBakey Classification Type 2

An aortic dissection restricted solely to the ascending aorta ($10\text{--}15\%$ of cases).

DeBakey Classification Type 3

An abdominal aortic dissection restricted solely to the descending aorta ($25\text{--}30\%$ of cases).

Peripheral Arterial Insufficiency

Vascular insufficiency characterized by intermittent claudication or severe shooting pain, weak or absent pulses, pale/cool/shiny skin with hair loss, deep necrotic ulcers on pressure areas, and minimal edema.

Peripheral Venous Insufficiency

Vascular insufficiency characterized by aching/cramping pain, strong/present pulses, brownish skin discoloration around the ankles/tibia, superficial irregular ulcers on the malleolus, and moderate to severe edema.

Acute Peripheral Vascular Insufficiency

Sudden occlusion of a blood vessel leading to tissue ischemia, cellular death, and necrosis; presents with the 6 Ps (Pain, Pallor, Pulseless, Poikilothermia, Paresthesia, Paralysis).

Transesophageal Echocardiogram (TEE)

An invasive ultrasound procedure offering superior image quality without radiation, indicated for investigating subacute bacterial endocarditis, embolic sources, or atrial thrombi.

Transthoracic Echocardiogram (TTE)

A non-invasive, fast bedside ultrasound test ideal for evaluating heart murmurs, cardiac output, heart failure, pericardial effusion, and valve function.

Ankle Brachial Index (ABI)

The ratio of ankle systolic pressure divided by arm systolic pressure used to evaluate Peripheral Artery Disease (PAD), where a score $<0.90$ indicates PAD.

Coronary Artery Calcium Screening

A specialized CT scan evaluating the presence and extent of calcified plaques in coronary arteries (Scoring: $0$ = no calcification, $1\text{--}100$ = some calcification, $>100$ = significant plaque with increased risk for cardiac event).

Troponin I

A cardiac protein specific for myocardial damage that begins to rise in $4\text{--}6\text{ hours}$, peaks in $14\text{--}18\text{ hours}$, and remains elevated for $5\text{--}7\text{ days}$; more specific for MI than Troponin T.

Troponin T

A cardiac marker released during myocardial injury that begins to rise earlier ($3\text{--}4\text{ hours}$) than Troponin I and remains elevated for $10\text{--}14\text{ days}$.

CK-MB

A creatine phosphokinase isoenzyme concentrated in cardiac muscle that rises $4\text{--}6\text{ hours}$ after MI onset, peaks in $24\text{ hours}$, returns to normal in $48\text{--}72\text{ hours}$, and is useful for identifying re-infarction.

Myoglobin

An oxygen storage protein found in skeletal and cardiac muscle that rises early ($2\text{--}4\text{ hours}$) after myocardial infarction but lacks cardiac specificity.

B-type Natriuretic Peptide (BNP)

A hormone released from cardiac muscle when ventricles are distended; levels $>400\text{ pg/mL}$ are consistent with heart failure.

High-sensitivity C-reactive Protein (hs-CRP)

An acute-phase reactant and marker for inflammation used to stratify cardiac risk ($<1$ low risk, $1\text{--}3$ average risk, $3\text{--}10$ high risk, $>10$ systemic inflammation).

Loop Diuretics

Short-acting antihypertensive medications (e.g., Bumetanide, Ethacrynic Acid, Furosemide) that inhibit reabsorption of sodium and chloride in the ascending loop of Henle to decrease preload and edema.