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ABOS PART I > Basic Science > Flashcards

Basic Science Flashcards

1
Q

Factors that direct mesenchymal stem cells into osteoblasts

A

RUNX2, BMP

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2
Q

osteoblasts form bone under _ strain and _ oxygen tension

A

low, high

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3
Q

osteoblasts form cartilage under _ strain and _ oxygen tension

A

intermediate, low

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4
Q

osteoblasts form fibrous tissue under _ strain and _ oxygen tension

A

high, low

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5
Q

PTH effect on bone

A

Stimulates osteoblasts to form bone if pulsed, inhibits if constant

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6
Q

1,25 Vit D effect on bone

A

stimulates osteoclasts through RANKL to resorb bone

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7
Q

Calcitonin effect on bone

A

inhibits osteoclasts to resorb bone

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8
Q

RANKL is produced by _ and activates _

A

osteoblast, osteoclast

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9
Q

TNF-alpha function

A

inhibits osteoblasts

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10
Q

Wnt function

A

stimulates osteoblasts

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11
Q

Sclerostin is formed by _ and inhibits _

A

mature osteocytes, osteoblasts

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12
Q

Sclerostin is released in response to _, and decreased under _.

A

Low stress concentration, high stress concentration

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13
Q

Osteoclasts are derived from _.

A

Myeloid origin (hematopoietic) in macrophage lineage

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14
Q

_ (native hormone) binds RANKL to inhibit signalling

A

Osteoprotegerin

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15
Q

_ (pharmacologic agent) binds RANKL to inhibit signalling

A

Denosumab

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16
Q

Bone resorption occurs in this part of osteoclast

A

how ship lacunae where the matrix is acidified and destroyed

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17
Q

IL-1 _ osteoclasts

A

activates

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18
Q

IL-10 _ osteoclasts

A

inhibits

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19
Q

Most abundant non collagen protein in bone

A

Osteocalcin

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20
Q

Lysomal enzyme in osteoclasts that resorb bone

A

Cathepsin K

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21
Q

In bone provides tensile strength

A

collagen I

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22
Q

In bone provides compressive strength

A

calcium hydroxyapetite

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23
Q

Nutrient arteries supply the _ of bone

A

inner 2/3

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24
Q

Periosteal capillary arteries supply _ of bone

A

outer 1/3

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25
Q

Type of bone formation during distraction osteogenesis

A

intramembranous

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26
Q

Fracture callus is _ bone formationo

A

enchondral

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27
Q

Deficiency of this enzyme inhibits bone formation in Howship lacunae

A

Carbonic anhydrase

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28
Q

Physical cellular zones from epiphysis to diaphysis

A

reserve zone, proliferative zone, hypertrophic zone, Zone of provisional calcification

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29
Q

Achondroplasia affects this part of physis

A

proliferative zone

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30
Q

Growth hormone affects this part of physis

A

proliferative zone

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31
Q

This zone of physis widens in rickets

A

hypertrophic zone due to insufficient calcification

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32
Q

SCFE occurs through which zone?

A

Hypertrophic

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33
Q

SCFE in renal osteogenesis occurs in what zone?

A

metaphysis

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34
Q

B- cantenin increases _ osteoblast activity

A

increases

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35
Q

SOX9 controls _

A

chondrocyte production

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36
Q

PTH effect on sclerostin

A

Increase sclerostin (decreases osteoblast activity)

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37
Q

Calcitonin effect on sclerostin

A

Decreases sclerostin (increases osteoblast activity); calcitonin also decreases osteoclast activity to decrease bone resorption

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38
Q

tartrate resistant acid phosphate does what and is produced by what enzyme?

A

Acidifies bone matrix in howship lacunae; formed by carbonic anhydrase

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39
Q

Osteopetrosis is caused by a defect in _, thereby _.

A

carbonic anhydrase, decreasing bone resorption

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40
Q

Groove of Ranvier and Ring of Lacroix contribute to _.

A

Width growth at the physis

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41
Q

Enchondral bone formation _ involve a cartilage phase

A

does

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42
Q

intramembranous bone formation _ involve a cartilage phase

A

does not, formed directly from MSCs that differentiate into osteoblasts

43
Q

In soft callus what type of collagen forms first?

44
Q

BMP-2 is indicated for treatment in _

A

Acute open tibia fractures

45
Q

BMP-7 is indicated in _

A

tibia non unions

46
Q

Role of Cox-2 in bone?

A

Required for normal enchondral ossification

47
Q

Effect of low intensity pulse ultrasound?

A

strengthens callus

48
Q

Quinolone antibiotics effect on bone?

A

toxic to chondrocytes, inhibit fracture healing

49
Q

TGF-B effect on osteoblasts

A

stimulates osteoblast to produce collagen, found in fracture hematomas

50
Q

Highest compressive strength of any graft material

A

Calcium phosphate cement

51
Q

Calcium sulfate cements are associated with _

A

wound drainage

52
Q

Centigrays of radiation to prevent HO

53
Q

Primary regulators of serum calcium

A

PTH and 1,25 VitD3

54
Q

Cartilage in soft callus is degraded by _

A

MMP-13 secreted by chondrocytes

55
Q

Systemic effect of PTH

A

increased Ca, Decreased Phosphate

56
Q

Systemic effect of Calcitonin

A

Decreases calcium (no effect on phosphate)

57
Q

Active form of Vit D

A

1,25 Vit D

58
Q

Form of Vit D measured in serum tests

59
Q

liver does what conversion to Vit D

A

Vit D -> 25 Vit D

60
Q

Effect of 1,25 Vit D

A

Increases intestinal absorption of Ca, Phosphate. Stimulates Osteoclasts via RANKL through osteblast binding

61
Q

Where is PTH produced?

A

Chief cells of parathyroid

62
Q

Where is 1,25 Vit D produced

A

proximal tubule of kidney

63
Q

Where is calcitonin produced?

A

parafollicular cells of thyroid

64
Q

What stimulates PTH production?

A

low serum Ca

65
Q

What stimulates calcitonin production

A

high serum Ca

66
Q

What stimulates 1,25 Vit D production?

67
Q

Effect of PTH on kidney

A

Increased Ca resorption, increased phosphate excretion, 1,25VitD production; Net increase Ca, decrease Phosphate

68
Q

Metabolic findings of hyperparathyroidism

A

high Ca, low Phosphate

69
Q

Renal Osteodysphtrophy causes _ (2)

A

decreased 1,25 Vit D production, decreased Phosphate excretion

70
Q

Overall effect of rickets

A

widening of physis through zone of provisional calcification and thin cortexes with bowing

71
Q 
Serum findings of nutritional rickets:
Ca
PTH
Phosphate
Alk Phos
25Vit D
1,25VitD
A

Ca: low to normal (decreased Intestinal absorption)
PTH: High (due to decreased intestinal Ca absorption)
Phosphate: Low (Increased kidney excretion from high PTH)
Alk Phos: High (from bone turnover of PTH)
25Vit D: low
1,25VitD: low

72
Q 
Serum findings of Ca deficient rickets:
Ca
PTH
Phosphate
Alk Phos
25Vit D
1,25VitD
A

Ca: decreased or normal
PTH: Increased (due to decreased Ca absorption)
Phosphate: decreased (due to high PTH)
Alk Phos: increased (due to high bone turnover)
25Vit D: normal
1,25VitD: high

73
Q

Type 1 Hereditary Vit D Dependent Rickets is defect in _?

A

1alpha 25VitD hydroxylase that makes active VitD

74
Q

Treatment for Vit D Dependent Rickets?

A

Oral 1,25VitD (Calcitrol)

75
Q

Most common form of rickets

A

Familial hypophosphatemic rickets

76
Q 
Serum findings of familial hypophos rickets:
Ca
PTH
Phosphate
Alk Phos
25Vit D
1,25VitD
A 
Ca: normal
PTH: Normal
Phosphate: decreased
Alk Phos: 
25Vit D
1,25VitD
77
Q

Cause of familial hypophos rickets

A

Impaired renal tubular resorption and Vit D response

78
Q

Type 2 Hereditary Vit D Dependent Rickets is defect in _?

A

intracellular Vit D receptor

79
Q

Treatment for Hereditary Vit D Dependent Rickets is?

A

Burosmab (anti FGF 23 antibody), Phosphate

80
Q

Osteoporosis Z score is

A

less than -2.5

81
Q

Osteopenia Z score is

82
Q

Effect of Bisphosphanates

A

Direct inhibition of osteoclasts, prevents formation of ruffled border (where bone resorption happens), and causes apoptosis

83
Q

Nitrogen containing bisphosphonates are _ times more potent than non nitrogen containing

84
Q

Specific risk of bisphosphonate therapy

A

AVN of jaw

85
Q

Scurvy has what effect on the physis

A

widening of zone of provisional calcification

86
Q

Paget disease is characterized by

A

abnormal osteoclast function with virus like inclusions in the cell

87
Q

Clonazepam _ sclerostin

A

increases (thereby decreasing bone production)

88
Q

Teriparatide is called _ and is a synthetic analog of _

A

Forteo; PTH

89
Q

Contraindications to the use of Forteo (2)

A

Paget’s dz, previous history of bone mets

90
Q

Myasthenia Gravis is a caused by?

A

IgG antibody to ACH receptor

91
Q

Type I muscle fibers are:

A

Slow twitch, oxidative, red; high triglyceride content

92
Q

Type I fibers are increased in _ activities

93
Q

Type II fibers are

A

fast twitch, glycolytic, “white”

94
Q

Type II fibers are increased in _ activities

A

high intensity, short duration

95
Q

Immobilization causes what effect on muscle healing

96
Q

TGF-B has what effect on muscle healing?

A

stimulates myofibroblasts, increases fibrosis

97
Q

What is Decorin?

A

proteoglycan in tendons that links adjacent collagen molecules, regulates tendon diameter, decreases TGF-B effect

98
Q

First type of Collagen formed in tendon healing?

99
Q

Order of nerve layers:

A

Axon, myelin sheath, endoneurium, fascicles, perineurium, epineurium

100
Q

Neuropraxia is caused by:

A

local conduction block caused by ischemia, selective demyelination; reversible

101
Q

Axonotemesis

A

Disruption of myelin sheath, epineurium intact, Mullerian degeneration distally

102
Q

Neurotemesis

A

Complete nerve transection; Mullerian degeneration distally

103
Q

4 zones for tendon to bone connection

A

Tendon, fibrocartilage, Sharpey’s mineralized fibrocartilage, Bone

104
Q

Tendon healing weakest at what point

A

7-10 days after repair

ABOS PART I (7 decks)

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