Bone

Question 1

Bone remodelling - important hormones (3)

Answer 1

Parathyroid hormone
vit d
Oestrogen
—calcium

Question 2

Special inv for bone

Answer 2

• blood calcium - 2.20mmoll - 2.60mmoll
• osteoblast activity - serum alkaline phosphatase 30-130U/L
• Parathyroid hormone 1.6-7.5pmol/l
• vit D

Question 3

what are tori - issues

Answer 3

developmental extoses

• torus palatinus/mandibularis
• denture fitting, easily trumatised

Question 4

osteogenesis imperfecta - what and features

Answer 4

Collagen type 1 defect - inherited
associated with dentinogenesis imperfecta
-weak bones, blue sclera. Multiple fractures.

Question 5

fibrous dysplasia - what

Answer 5

Slow growing asymp bony swelling
<20yrs - during growth period
-albright’s sydrome has associated skin pigmentation with it.

Question 6

fibrous dysplasia - histology

Answer 6

Fibrous replacement of bone

1. bone resorption
2. mix of fibrous tissue and bone (radiolucent and opaque)
3. no fibrous tissue surrounding bone

Question 7

Cherubism features

Histology

Answer 7

• autosomal recessive/dominant
• multilocular lesions in multiple quadrants
• growth <7yr then stop at puberty

Histology - vascular giant cell lesions

Question 8

Osteoporosis -what, features, Rg

aetiology

Answer 8

• resorption of bone exceeds formation - loss of mineralised tissue.
• symptomless, weak bones with risk of fracture
• loss of normal bone markings

aet- age, female,genetic, cushing’s disease, activity status, diabetes mellitus

Question 9

osteomalacia/rickets
why
pathology
tests and findings

Answer 9

vit d deficiency - sunlight,diet, malabsorption, renal issues
osteoid fails to calcify
-low calcium and high alkaline phosphatase

Question 10

Hyperparathyroidism - what
what does it cause
who

Answer 10

calcium mobilised from bones - generalised osteoporosis
brown tumour - osteitis fibrosa cystica (multilocular soapbubble)
metastic calcification in kidney.
- postmenopausal women 3:1

Question 11

Giant cell lesion - diff diagnosis, who

Answer 11

Brown tumour, aneurysmal bone cyst, giant cell tumour

who - 10-25 years

Question 12

Paget's disease - what
what causes 
tests and results
clinically
complications

Answer 12

disregulation of bone turnover (increased)
greater osteoblast/clast activity
-viral?
-increased alkaline phosphatase
-bone swelling/nerve compression/severe pain
-infection or tumour

Question 13

Bone tumour - osteoma

• features
• disease associated with multiple osteomas

Answer 13

benign, cortical

multiple - Garner syndrome

Question 14

ossifying fibroma - clinical/histology

Answer 14

clin - slow growing, wide age range, mandible well def rg

-histology - cellular fibrous tissue, immature bone, fibrous dysplasia

Question 15

cementum lesions

Answer 15

cementoblastoma - neoplasm attacjed to root, starts as radiolucency then calcifications

Question 16

Osteosarcoma

Answer 16

rare 30,s, mandible localised destruction and POOR PROGNOSIS