Bone and Joint TEST #3 Flashcards
What percent of Ca2+ is stored in bones?
99%
In adults what is the primary site of hematopoeises?
-Bones
What three hormones influence the remodeling of bone?
- PTH
- Vitamin D
- Calcitonin
What type of bone resists compression forces?
-Medullary bone
What type of bone resists bending forces and is thick?
-Cortical bone
Periosteum is a tough fibrous membrane that covers bone surfaces except at what point?
-Joints
T/F The periosteum is well innervated and painful if injured
True
T/F Woven bone is mature
False
-It is immature
Osteogenesis imperfecta is deficient in what?
-Type I collagen that causes too little bone
What do you see with generalized osteopenia is osteogenesis imperfecta?
- Multiple fractures and bone deformities
- Malformed teeth because of a dentin deficiency
- Blue sclera
What is Acohndroplastic dwarf?
-Reduced function of epiphyseal growth plates
What bones does Achondroplastic dwarf affect mostly?
-Long bones
T/F A person with Achondroplastic dwarf syndrome has normal intelligence and normal ifespan
True
What bone disease has defective osteoclasts?
-Osteopetrosis
T/F In osteopetrosis the bone is brittle and not dense enough
False
-It is brittle and too dense
What nerve problem can osteopetrosis cause?
-Cranial nerve palsies
What is Osteomalacia?
-Softening bone due to Vit. D defiency or kidney failure
What bone disease do you see delayed eruption of teeth and defects in the dentin and enamel assocaited with a Vit. D. deficiency
Osteomalacia
What is Albers-Schonberg disease?
-Impaired osteoclasts that reduces bone resorption
What is albers-Schonberg disease associated with?
- Anemia
- Bone fractures
- Blindness
- Deafness
What is the cause of Osteitis deformans?
-Mixed stages of osteolysis and osteogenesis
What is adults ricketts called?
-Osteomalacia
What acquired diseases of the bone deal with vitamin D. defciency?
-Rickets
What causes Rickets syndrome?
- GI malabsorption syndrome
- Lack of sunlight exposure
What acquired diseases of the bone deal with Vit C deficiency?
-Scurvy
What are the different types of acquired diseases of the bone?
- Osteoporosis
- Osteomalacia (Rickets)
- Hyperparathyroidism
What are the genetic causes of Osteoporosis?
- Age
- Low estrogen
- Fair hair and skin
- Tall and thin
What are the behavior causes of Osteoporosis?
- Inactivity
- Smoking/alcohol
- Malnutrition
- Medication (chronic corticosteroids)
T/F 1/3 of women over 50 years old have at least one osteoporitic fracture
True
What is Kyphosis?
-Abnormal forward curvature of spine
What is Scoliosis?
-Abnormal lateral curvature of spine
What are the different types of bone fractures?
- Complete
- Closed
- Compound/open
- Comminuted
- Displaced
- Pathological
- Greenstick
What is a comminuted fracture?
-Bone splintered
What is a displaced fracture?
-Fractured bone not aligned
What is a pathological fracture?
-Fracture associated with cancers
What is a compound fracture?
-Bone pieces skin
What is osteomyelitis?
-Inflammation of bone/marrow
What is Granulomatous osteomyelitis called when associated with TB and in the spine?
-Pott disease
What is a greenstick fracture?
Bone cracks through only on side
What do you see a loss of in osteoarthritis?
-Articular cartilage with secondary changes in bone
What is the most common type of joint pain?
-Osteoarthritis
What are boney swelling in osteoarthritis known as?
-Heberden nodes
What is the most common form of autoimmune disease?
-Rheumatoid arthritis (1% prevalence)
T/F Rheumatoid arthritis is less systemic and unilateral
False
-More systemic and bilateral
Who is Rheumatoid arthritis more common in and uncommon in respectively?
- Caucasians
- Asians
What are the symptoms of Rheumatoid arthritis?
- Joint swelling
- Pain and tenderness
- Often cause extreme distortions of joints and surrounding bone
- Fever
- Weakness
- Malaise
What are some other areas that can be affected by RA?
- Ulcers
- Pulmonary nodules and fibrosis
- Carditis and pericarditis
- Vasculitis
What type of lab test can you do to determine RA?
-Anti CCP (cyclic citrillunated peptides)
What is the primary cause of Gout?
-Reduced renal excretion of purine (uric acid is break down product)
What is the primary treatment of gout?
-Allopurinol
What are the symptoms of Gout?
- Hot
- Swollen
- Pain in joints
What is pseudo gout?
-Crystal deposits of calcium pyrophosphate
Besides allopurinol what else can be used to treat Gout?
- Colchicine
- Allopurinol
- Indomethacin
What are Ganglion cysts?
-A cyst resulting from connective tissue around joints that is often painful
What is Marfan Syndrome>
-Hereditary connective tissue disease caused by a mutate fibrillin gene
What symptoms do you see with Marfan syndrome?
- Spider like fingers
- Tall growth
- Necrosis of aorta
what can cause hyperparathyroidism?
adenoma in the parathyroid
what does hyperparathyroidism cause that relates to bones?
constant release of Ca2+
how many people in the US have osteoporosis?
10 million, mostly women
most osteoporosis-related hip fractures in women occur at what age? what does a hip fracture increase the likelihood of?
- > 70
- increases the likelihood of death in the next year (mechanisms for this fatality are not fully understood)
what are some causes of osteomyelitis?
- trauma from compound fractures or surgery
- pyogenic infections (staph aureus or salmonella)
- granulomatous (TB or fungal)
- diabetes due to poor circulation in the extremities
what is the concern with osteomyelitis that results from diabetes?
it results from poor circulation in the extremeties, and if it is chronic, it can form a drainage site and can even become osteosarcoma
___ is a degenerative joint disease
osteoarthritis
osteoarthritis is present in some degree in most people greater than what age? what makes the symptoms worse?
> 65 years of age
-symptoms worsen with excessive use of joints (osteoarthritis is due to wear and tear)
are there inflammatory changes associated with osteoarthritis?
no, changes are degenerative
what is the age of onset of rheumatoid arthritis, and what % are female?
- 25-50 years old (can have juvenile RA)
- 75% female
what are some other inflammatory arthritites?
- psoriatic arthritis
- autoimmune - lupus erythematous, scleroderma
- postinfections - rheumatic fever
- infectious - staph/strep, TB
- gout
- lyme disease
if lyme disease goes untreated, what can result?
arthritis and neurologic consequences
what is gouty tophi?
crystalized aggregates of uric acid
malignant carcinomas that spread to bone most likely come from where?
lungs, prostate, breast, thyroid, and kidneys
what tumors are most likely to be seen in the maxilla or mandible?
- osteomas
- giant cell tumor
- fibrous dysplasia
- osteosarcoma
- ewing sarcoma
what tumor that is commonly seen in the jaws is made up of immature bone?
osteomas
what tumor that is commonly seen in the jaws is benign but aggressive?
giant cell tumor
is fibrous dysplasia malignant?
no
what tumor that is commonly seen in the jaws is most often seen in adolescents or older patients?
osteosarcoma
what is the most frequent sarcoma that is commonly seen in the jaws? what about the second most frequent?
1 - osteosarcoma
2 - ewing sarcoma
what age patient is ewing sarcoma common in?
10-20 years old
what location are osteosarcomas most common in?
long bones mostly, but sometimes in the mandible
what is a benign tumor of cartilage? is it seen in the mandible or maxilla?
- osteocondroma
- no
what is a malignancy of cartilage?
chondrosarcoma
what is benign medullary bone that does not properly mature, and is often in the jaws?
fibrous and fibro-osseous tumors
what are 6 types of soft tissue tumors?
- lipomas
- liposarcoma
- fibrous tumors
- fibrosarcoma
- rhabdomyosarcoma
- leiomyoma
- leiomyosarcoma
what is a malignant neoplasm of fibroblasts?
fibrosarcoma
what is a reactive tumor?
fibrous tumor (can be malignant or benign)
are lipomas common? do they require treatment?
- yes
- not usually
what area are rhabdomyosarcomas frequently found in? are they common?
- head and neck region
- they are rare
muscular dystrophy is most common in ___
duchenne muscular dystonia
what are the symptoms of muscular dystrophy?
- weakness of voluntary muscles
- breakdown of muscle tissue
when does muscular dystrophy typically present?
it can occur anytime and in any part of the body
muscular dystrophy represents a group of ___ diseases
genetic
congenital myopathies tend to present with ___ and ___
congenital hypotonia and weakness
___ is diffuse destruction of skeletal muscle
rhabdomyolysis
what are the symptoms of rhabdomyolysis?
- acute
- muscles are tender and swollen
what are two things that can cause rhabdomyolysis?
- may develop with a flu episode
- can be caused by some drugs, like statins
ALS and polio are considered ___ diseases that typically result in ___
- denervation
- typically result in muscle degeneration
myasthenia gravis is an ___ myopathy
inflammatory
what are the symptoms of myasthenia gravis?
- weakness in skeletal muscles responsible for breathing and mobility
- can include other skeletal muscles such as those for eyelids, facial movement, chewing, talking, and swallowing
what can worsen myasthenia gravis? what improves it?
- activity worsens it
- rest improves it
what causes myasthenia gravis? is it inherited?
- auto-antibodies kill ACh receptors (thymus may contribute to formation)
- not inherited
what is the treatment and prognosis of myasthenia gravis?
- acetylcholinesterase inhibitors - pyridostigmine
- immunosuppressants - prednisone and rituximab
- prognosis is typically good with proper treatment
