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Tri 6 - Tumors > 6. Nutritional/Metabolic/Endocrine > Flashcards

6. Nutritional/Metabolic/Endocrine Flashcards

1
Q

most common metabolic bone

disorder

A

Osteoporosis

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2
Q

low bone mass
and microarchitectural deterioration of bone tissue, with a
consequent increase in bone fragility and susceptibility to fracture”

A

Osteoporosis

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3
Q

Reduction of bone

quantity of otherwise normal bone

A

Osteoporosis

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4
Q

poverty of
bone with increased
radiolucency

A

Osteopenia

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5
Q

decreased bone

density in majority of skeleton, especially axial and proximal long bones

A

Generalized Osteoporosis:

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6
Q

Complex Regional Pain Syndrome and Reflex Sympathetic Dystrophy
Syndrome is also called

A

Sudeck’s atrophy

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7
Q

T1 -MR of hips
shows a diffuse zone of low signal intensity in the femoral
head and neck consistent with
marrow edema

A

Transient Osteoporosis of Hip (TOH)

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8
Q

Localized Osteoporosis

A

focal loss of bone density affecting

a small area of bone

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9
Q

bone mass decreases at what age

A

35 yo

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10
Q

Complications of osteoporosis include

A

Spinal compression fractures, Increasing thoracic kyphosis and other fractures

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11
Q

effective to restore AS posture

A

spine osteotomy

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12
Q

Subtrochanteric

femoral fractures are a complication of

A

Bisphosphonates

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13
Q

According to a 2009 Swedish study by
Aspberger, the incidence of mid femur stress
fracture is 50 times higher for patients on
_________ compared to untreated women

A

Bisphosphonates

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14
Q

Fosamax

and Actonel are

A

bisphosphonate drugs

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15
Q

if patient presents

with pain upon coughing, sneezing or straining, suspect

A

acute compression fracture

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16
Q

Progressive angular kyphotic deformity within 1 year of spinal compression fracture may result in

A

spinal

stenosis

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17
Q

are neurological abnormalities common with spinal compression fracture?

A

NO

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18
Q

Cement injected into vertebral body which usually provides
immediate/substantial
results in pain and function

A

Vertebroplasty

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19
Q 
procedure consists of an image-guided
injection of polymethylmethacrylate
(PMMA), which is an acrylic bone cement
meant to stabilize and strengthen a
collapsing vertebral body
A

Percutaneous Vertebroplasty

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20
Q

uses balloon dilatation of vertebral body,

with subsequent instillation of polymethylmethacrylate.

A

Kyphoplasty

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21
Q

In Weightbearing Bones (vertebrae) there is preferential resorption of non-essential supporting
trabeculae and relative sparing of the major, ______
oriented stress trabeculae

A

vertical

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22
Q

why is Single Photon Absorptiometry unreliable?

A

High false negative rates

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23
Q

DEXA stands for

A

Dual Energy X-ray Absorptiometry

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24
Q

Dual Photon Absorptiometry is applied to the

A

spine and prox femur

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25
Q

DEXA scores are reported as

A

“T-scores” and “Z-scores.”

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26
Q

comparison of a person’s bone density with that of a healthy 30-year-old of the same sex.

A

T-score

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27
Q

comparison of a person’s bone density with that of an average person of the same age and sex

A

Z-score

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28
Q

T-score of -1 and above

A

normal bone density

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29
Q

T-score of -1 to -2.5

A

osteopenia

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30
Q

T-score of -2.5 and below

A

osteoporosis.

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31
Q

may suggest that something other than aging is causing abnormal bone
loss.

A

Z-score of -2 or less

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32
Q

Most commonly used to assess the strength of vertebrae in assessment of fracture risk

A

Quantitative CT

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33
Q

200-250 mRad

A

Quantitative CT

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34
Q

Dual photon beam is passed through a vertebral body

A

Quantitative CT

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35
Q

Advantages of quantitiative CT over DEXA for Dx osteopororsis

A
  1. Ability to separate cortical and trabecular bone
  2. Provides true volumetric density in units of mg/cc
  3. No errors due to spinal degenerative changes or
    aortic calcification
  4. Information on bone morphometry
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36
Q

Roentgen Signs of Osteoporosis

A

Cortical Thinning and Altered Trabecular Patterns

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37
Q

Pencil thin cortices and

Endosteal scalloping

A

Cortical Thinning seen in Osteoporosis

38
Q

Trabecular resorption with accentuation of remaining trabeculae especially in weight bearing regions of bone and Washed-out appearance of bone in severe stages

A

Altered Trabecular Patterns seen in Osteoporosis

39
Q

During resorption of trabeculae, typically the transverse vertebral body
trabeculae are resorbed first which gives a

A

Pseudohemangioma appearance

40
Q

compression of anterior and posterior portions of

vertebral body

A

Vertebra Plana (Pancake Vertebra)

41
Q

Loss of anterior vertebral body height most common in mid T and TL regions

A

Wedge Vertebra

42
Q

Magnetic resonance imaging of the thoracic cord shows a wedgeshaped
deformity with increased
signal intensity of T7 indicating
an acute

A

severe compression

fracture

43
Q

Due to pressure of nucleus pulposus

upon weakened endplates (Hourglas/Fish vertebrae)

A

Biconcave Deformities:

44
Q

present with marked

sacral tenderness on physical examination

A

Sacral Insufficiency Fractures

45
Q

present with pain in the low back, groin, or hip

A

rami fractures

46
Q

characteristic “H pattern” or Honda sign may be seen with a

A

sacral insufficiency fracture

47
Q

stress fractures on nuclear bone scans show ares of increased or decreased tracer uptake?

A

increased

48
Q

Acute onset of painful regional osteoporosis

usually following trivial trauma

A

Reflex Sympathetic Dystrophy Syndrome (RSDS)

49
Q

Progressive pain, stiffness, swelling, atrophy, contracture
usually in hand and shoulder region
50 + yo

A

Reflex Sympathetic Dystrophy Syndrome (RSDS)

Aka Complex Regional Pain Syndrome (CRPS)

50
Q

Hyperemia of bone augments osteoclastic
resorption resulting in rapid osteoporosis
with slow recovery and may never recover fully

A

Reflex Sympathetic Dystrophy Syndrome (RSDS)

Aka Complex Regional Pain Syndrome (CRPS)

51
Q

Rapid progressive osteoporosis with normal Joint spaces and margins

A

Reflex Sympathetic Dystrophy Syndrome (RSDS)

52
Q

Severe osteoporosis especially of femoral head with sudden pain, antalgia and limp

A

Transient Osteoporosis of Hip

53
Q

Full recovery of Transient Osteoporosis of Hip expected in

A

3-12 months

54
Q

Transient Osteoporosis of Hip may be associated with

A

pregnancy

55
Q

In Disuse and Immobilization Osteoporosis
X ray changes begin after ___ days and are most pronounced
by ___ months

A

7-10, 2-3

56
Q

4 patterns of Disuse Osteoporosis

A
  • Uniform
  • Spotty
  • Bands
  • Cortical
57
Q

Lack of calcium deposited in osteoid altered quality of bone

A

Osteomalacia (“soft bones”

58
Q

Bilateral and symmetrical fractures at right angles to cortex seen in Osteomalacia

A

Pseudofractures, aka Looser or Milkman Lines

59
Q

Radiographic Findings of osteomalacia

A
  • Osteopenia
  • Pseudofractures
  • Bone deformities
60
Q

unmineralized osteoid along anterior rib cage

A

Rachitic Rosary

61
Q

In there will be soft tissue swellings around growth plates due to

A

hypertrophied

cartilage

62
Q

With rickets at the physis, cartilage cells grow normally, but fail to

A

calcify

63
Q
  • Absent zone of provisional calcification
  • Widening of growth plates due to accumulation of osteoid
  • Irregular, frayed, cupped metaphyseal margins
  • “Paint brush” frayed zones of provisional calcification
A

Rickets

64
Q

Bowing deformities, fractures, osteopenia, scoliosis,

pseudofractures, abnormal bone length

A

Rickets

65
Q

“Paint brush” frayed zones of provisional calcification

A

Rickets

66
Q

suppression of osteoblastic activity; decreased production of
collagen and osteoid

A

scurvy

67
Q

in scurvy you need at least __ months avitaminosis C before symptoms and skeletal changes occur

A

4

68
Q

Clinical Hallmark of scurvy

A

spontaneous hemorrhages from

capillary fragility

69
Q
  • Generalized osteopenia
  • White Line of Frankel
  • Wimberger’s Ring
  • Corner Sign
  • Pelken’s Spurs
  • Scorbutic Zone (Trummerfeld Zone)
  • Subperiosteal Hemorrhage
A

scurvy

70
Q

dense zone of provisional

calcification

A

White Line of Frankel

71
Q

dense peripheral ring epiphysis

A

Wimberger’s Ring

72
Q

infractions of the epiphyseal—metaphyseal

margins

A

Corner Sign

73
Q

spurs at metaphyseal margins extending

perpendicular to cortex

A

Pelken’s Spurs

74
Q

poor osteoid
formation located along metaphyseal side of ZOPC which
appears as a radiolucent band

A

Scorbutic Zone (Trummerfeld Zone)

75
Q

Osteoclastic resorption with fibrous tissue replacement

A

Osteitis Fibrosa Cystica

76
Q

Accumulation of fibrous tissue produces localized cyst like destructive bone lesions that are brown in color

A

Brown Tumors in Hyperparathyroidism

77
Q

Pathologic Hallmark of hyperparathyroidism
and occurs along outer cortex at insertional points of ligaments
and tendons

A

Subperiosteal Bone Resorption

78
Q
  • Radial margins 2nd and 3rd digits of hand
  • Lacelike appearance
  • SI erosion
A

Subperiosteal Bone Resorption in Hyperparathyroidism

79
Q

Salt and Pepper Skull

A

Hyperparathyroidism

80
Q

Erosion of Lamina Dura

A

Hyperparathyroidism

81
Q

Rugger Jersey Spine and Aortic Calcification

A

Hyperparathyroidism

82
Q

Subperiosteal Resorption,

Osteopenia, and Rugger Jersey Spine

A

Hyperparathyroidism

83
Q

Calcification within subcutaneous, articular, muscular, vascular and visceral organs is common in

A

Hyperparathyroidism

84
Q

disease of medium-sized muscular arteries

A

Monckeberg medial calcific sclerosis

85
Q

Calcium deposits in media portion of artery of people over 50

A

Monckeberg medial calcific sclerosis

86
Q
  • Hepatosplenomegaly
  • Yellowing of skin
  • Dermatitis
  • Pruritis
  • Alopecia
A

Hypervitaminosis A

87
Q

Solid periosteal reactions on

shafts of long bones:

A

Hypervitaminosis A

88
Q

Secretory Eosinophilic Adenoma of anterior pituitary gland produces intramembranous bone tissue growth, and subcutaneous tissue hypertrophy

A

Acromegaly

89
Q
  • Enlarged sella turcica
  • Widened mandibular angle
  • Sinus overgrowth
  • Prominent ungual tufts
A

Acromegaly

90
Q

Spade like appearance of ungual tufts

A

Acromegaly

91
Q

Dense metaphyseal bands

A

Lead Poisoning, or Plumbism (Pb)

92
Q

In children, lead deposition affects the

A

distal femur, both ends of the tibia, and distal radii

Tri 6 - Tumors (12 decks)

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