Anatomical changes of growth and development

Question 1

Primary ossification centre

Answer 1

In long bones is in diaphysis

Question 2

Secondary ossification centre

Answer 2

Forms epiphysis and lengthens bones - growth plates

Question 3

How do secondary ossification centres appear on x-ray?

Answer 3

Little white dots above the bones

Question 4

Why do babies have intra-abdominal bladders/uteruses?

Answer 4

very small pelvis

Question 5

Achondroplasia

Answer 5

Short-limb dwarfism
G380R mutation in FGFR3
Autosomal dominant condition affecting the conversion of cartilage to bone growth
Sx: short stature, hypoplasia, macrocephaly, trident-like hands

Question 6

Rhizomelic

Answer 6

Proximal line shortening

Question 7

Mesomelic

Answer 7

Middle segment shortening

Question 8

Acromelic

Answer 8

Distal segment shortening

Question 9

Hypochondroplasia

Answer 9

Mutation in FGFR3 gene

Milder sc than achondroplasia

Question 10

Gigantism

Answer 10

Too much GH or IGF-1 in puberty (before epiphyseal plates fuse)
Sx: extreme height, large organs/muscles/hand and feet

Question 11

Acromegaly

Answer 11

Too much GH after epiphyseal closure
Commonly caused by pituitary tumour
Causes big hands and feet, coarse facial features/thick nose/big tongue/hirsutism

Question 12

Craniosynostosis

Answer 12

Premature fusion of sutures - affects cranial shape and brain growth

Question 13

When do you begin to grow teeth ?

Answer 13

6 months

Question 14

When do you start to lose teeth

Answer 14

6 years

Question 15

Mandibular development

Answer 15

Mandible starts as two halves until 2 years old
Fused by symphysis meant
Mandible covers teeth

Question 16

How do breasts develop in puberty ?

Answer 16

Oestrogen surge stimulates stromal and parenchymal growth - increased adipose tissue increases size - causes parenchymal development
Parenchymal growth causes ductal elongation and lactation

Question 17

Osteoarthritis

Answer 17

• Degenerative joint disorder caused by loss of hyaline cartilage
• Sx: loss of joint space, osteophytes, subchondral cysts/sclerosis
• Knees, hips, DIPS, PIPs, thumb, CMC
• Pain worse on movement/end of day
• Stiffness worse after rest
• Heberdens nodes (DIP) and Bouchard’s nodes (PIP)
• Mx: rest, analgesia, physiotherapy, walking aids, steroid injections, stem cell therapy, surgery

Question 18

Osteoporosis

Answer 18

progressive skeletal systemic disease caused by reduced bone mass and deterioration
Caused by steroids, hyperthyroidism, age, thin, testosterone low, early menopause, renal failure, erosive bone disease, dietary calcium low

Question 19

Cervical spondylosis

Answer 19

• Disc degeneration with herniation of disc material, calcification and osteophytosis
• Leads to radiculopathy and myelopathy
• Sx: neck stiffness +/- crepitus, stabbing arm pain, upper limb motor and sensory disturbance

Question 20

Solar keratosis

Answer 20

Can progress to SCC, monitor and treat with fluorouracil

Question 21

BCC

Answer 21

Can become invasive, usually removed with surgery or trearment with fluorouracil

Question 22

Seborrheic keratosis

Answer 22

Not pathological, normal part of ageing