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Ortho ITE > Basic Science > Flashcards

Basic Science Flashcards

0
Q

Multifunctional transcription factor that directs transformation of undifferentiated mesenchymal stem cells to osteoblast

A

RUNX2

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1
Q

Derived from undifferentiated mesenchymal stem cells

A

Osteoblasts

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2
Q

Produced by osteoblast

A 
Type 1 collagen
Alkaline phosphatase
Osteocalcin
Bone sialoprotein
RANKL
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3
Q

Constitute 90 percent of cells in the mature skeleton

A

Osteocyte

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4
Q

Important for control of extracellular calcium and phosphorus concentration, and are less active in matrix production

A

Osteocyte

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5
Q

Derived from hematopoietic cells in the macrophage lineage

A

Osteoclast

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6
Q

Produced by osteoblast
Binds to immature osteoclasts, and stimulates differentiation into active, mature cells that result in an increase bone resorption

A

Osteoclast

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7
Q

Inhibits bone resorption by binding and inactivating RANKL

A

Osteoprotegerin

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8
Q

Lysosomal proteolytic digestion enzyme of osteoclast

A

Cathepsin K

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9
Q

Osteoclast bind to bone surfaces by means of

A

Integrins

Vitronectin receptor

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10
Q

Directly inhibit osteoclastic bone resorption

A

Bisphosphonate

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11
Q

How do bisphosphonates inhibit resorption

A

Inhibiting farsenyl pyrophosphate synthase in the melavonate pathway

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12
Q

Bone matrix composition

A

60% inorganic (mineral)

40% organic

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13
Q

Constitutes the majority of inorganic matrix

A

Calcium hydroxyapatite

Ca10(PO4)6(OH2)2

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14
Q

90% of organic component

A

Type 1 collagen

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15
Q

Most abundant noncollagenous protein in bone

A

Osteocalcin

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16
Q

Law that states that remodeling occurs in response to mechanical stress

A

Wolff’s law

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17
Q

Law that states that compressive forces inhibit growth, whereas tension stimulate it

A

Hueter-Volkmann law

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18
Q

Three major types of bone formation

A

Enchondral formation
Intramembranous formation
Appositional formation

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19
Q

Bone replaces a cartilage model

A

Enchondral ossification

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20
Q

Formation occurs without a cartilage model

A

Intramembranous formation

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21
Q

Osteoblast lay down new bone on existing bone

A

Appositional formation

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22
Q

Supplies the chondrocytes

A

Groove of Ranvier

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23
Q

Three stages of fracture repair

A

Inflammation
Repair
Remodeling

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24
Q

Closed treatment fracture healing type

A

Periosteal bridging callus

Interfragementary enchondral ossification

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25
Q

Fracture healing type compression plate

A

Primary cortical healing

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26
Q

BMP

A

BMP2 - acute open tibia fractures
BMP7 - tibial non union
BMP3 - no osteogenic activity

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27
Q

Properties of bome grafts

A

Osteoconduction
Osteoinduction
Osteogenic

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28
Q

Osteoconduction

A

Acts as scaffoLd for bone growth

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29
Q

Osteoinduction

A

Invilves growth factors that stimulate bone formation

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30
Q

Osteogenic

A

Contain primitive mesenchymal cells, osteoblasts, osteocytes

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31
Q

Primary hemeostatic regulators of serum calcium

A

PTH

1,25(OH2)2 - vitamin D3

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32
Q

Increased serum calcium

Decreased inorganic phosphate

A

PTH

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33
Q

Age range when bone mass is at its peak

A

16-25

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34
Q

Most common cause of hypercalcemia

A

Malignancy

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35
Q

Chronic renal disease

Phosphorus retention and secondary hyperparathyroidism

A

Renal osteodystrophy

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36
Q

Failure of mineralization

A

Children - rickets

Adults - osteomalacia

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37
Q

Width of the zone of provisional calcification is increased, which caused physeal widening and cupping

A

Rickets

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38
Q

Defined as a lumbar bone density of 2.5 or more SD less than the peak bone mass of a healthy 25 y.o.

A

Osteoporosis

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39
Q

T score

A

Peak bone mass of a healthy 25 y.o.

40
Q

Amount of calcium supplement in osteoporosis

A

1000-1500mg/day

41
Q

Ascorbic acid deficiency

Decrease in chondroitin sulfate synthesis and ultimately defective collagen growth and repair

A

Scurvy

42
Q

Mutation in genes responsible for metabolism and synthesis of type 1 collagen

A

Osteogenesis imperfecta

43
Q

Articular cartilage composition

A

65-80% water (wet weight)
10-20% collagen
10-15% proteoglycan
5% chondrocytes

44
Q

Master switch

Mesenchymal precursors to chrondrocytes

A

SOX9

45
Q

Responsible for myelinating peripheral nerve axons

A

Schwann cells

46
Q

Gaps between Schwann cells

A

Nodes of ranvier

47
Q

Four transitional tissues of tendon insertion

A

Tendon
Fibrocartilage
Mineralized fibrocartilage (sharpey’s fibers)
Bone

48
Q

Early tendon healing collagen type

A

Type 3

49
Q

Tendon repair timeline

A

Weakest at 7-10 days

Maximum strength - 6 months

50
Q

Types of ligament insertion

A

Indirect

Direct

51
Q

Superficial ligament fibers insert at acute angles into the periosteum

A

Indirect insertion

52
Q

Both superficial and deep fibers insert through ligament, fibrocartilage, sharpey’s fibers, and bone

A

Direct insertion

53
Q

Collagen nucleus pulposus

A

Type 2

54
Q

Collagen annulus fibrosis

A

Type 1

55
Q

Infectino of subcutaneous fat and deep fascia

A

Necrotizing fasciitis
Diabetis risk factor
Group A beta hemolytic streptococcus in healty individuals

56
Q

Most sensitive monitor of course of infection

A

CRP

Short half life
Dissipates about 1 week after effective treatment

57
Q

Osteomylelitis 0-4 months

A

S. Aureus
Gram neg bacilli
Group b steptococcus

58
Q

Osteomyleitis 4 months - 21 years

A

S. Aureus

Group A streptococci

59
Q

Epiphyseal osteomyelitis

A

S. Aureus

60
Q

Osteomyelitis after 21 years

A

S aureus

Coagulase negative staph

61
Q

Osteomyelitis patients with sickle disease

A

S aureus

Salmonella

62
Q

Osteomyelitis patients with open fracture

A

S aureus
P aeruginosa
Gram neg bacilli

63
Q

Osteomyelitis diabetic

A

Polymicrobial

64
Q

Osteomyelitis intravenous drug abusers

A

S aureus
Serratia
Pseudomonas

65
Q

Osteomyelitis meat handlers

A

Brucella

66
Q

Osteomyelitis fisherman

A

Mycobacterium

67
Q

Septic arthritis 0-3 months

A

S aureus
Enterobacteriaceae
Group b strep
N gonorrhea

68
Q

Septic arthritis 3mos-14 y.o.

A

S aureus
S pyogenes
H influenza
Gram neg bacilli

69
Q

Septic arthritis sexually active adults

A

N gonorrhea
S aureus
Streptococci
Gram neg bacilli

70
Q

Septic arthritis non sexually active adults

A

S aureus
Streptococci
Gram neg bacilli

71
Q

MRI best for contrasting normal and abnormal tissues

A

T2 (water)

72
Q

MRI best demonstrates anatomic structure

A

T1 (fat)

73
Q

Intensity of internal force

Force/area

A

Stress

Measured in pascal

74
Q

Measure of deformation resulting from loading

Change in length/original length

A

Strain

75
Q

Measure of material stiffness

Ability to resist deformation in tension

A

Young’s modulus of elasticity

76
Q

Cierny’s anatomic classification of adult chronic osteomyelitis

A

Medullary
Superficial
Localized
Diffuse

A - normal
B - local or mild systemic deficiency
C - major nutritional or systemic disorder

77
Q

Site of calcium absorption

A

Duodenum and jejunum

78
Q

Amount calcium absorbed and lost

A

200-300mg absorbed

150-200mg renal and GI losses

79
Q

Recommended calcium daily intake 0-6 mos

A

210mg/day

80
Q

Recommended calcium intake 6-12mos

A

270mg/day

81
Q

Recommended calcium intake 1-3yrs

A

500mg

82
Q

Recommended calcium intake 4-8

A

800

83
Q

Recommended calcium intake 9-18

A

1300mg

84
Q

Recommended calcium intake 19-50

A

1000mg

85
Q

Recommended calcium intake >50

A

1200mg

86
Q

Effect of PTH on serum Ca and PO4

A

Increase Ca

Decrease PO4

87
Q

Effect of Calcitonin on serum Ca and PO4

A

Decrease Ca

No effect PO4

88
Q

Effect of Vit D on serum Ca and PO4

A

Increase Ca

Increase PO4

89
Q

Types of Osteoporosis

A

Type 1: post menopausal
Type 2: senile (>70)
Type 3: secondary

90
Q

Low Ca, PO4,
High ALP, PTH
Normal Vit D

A

Rickets Ca Deficiency

91
Q

Low or normal Ca
Low PO4
High ALP, PTH
low Vit D

A

Rickets vit D

92
Q 
High Ca
Normal or Low PO4
Normal or high ALP
High PTH
Normal or high Vit D
A

Primary Hyperparathyroid

93
Q

High Ca
Normal or high PO4, ALP, Vit D
Normal or low PO4

A

Malignancy

94
Q

Recombinant PTH
Paradoxically stimulates bone formation
Intermittent dose

A

Teriparatide

95
Q

Incorporated into bone in place of Ca
Stimulates secretion of OPG
Stimulates osteoblasts differentiation

A

Strontium ranelate

96
Q

Selective inhibitor of Cathepsin K

A

Odanacatib

97
Q

Competitive inhibitor of RANKL

A

Denosumab

OPG

98
Q

Direct inhibition of osteoclast activity by binding into osteclast

A

Calcitonin

Ortho ITE (7 decks)

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