Bone and Joint TEST #3 Flashcards
1
Q
What percent of Ca2+ is stored in bones?
A
99%
2
Q
In adults what is the primary site of hematopoeises?
A
-Bones
3
Q
What three hormones influence the remodeling of bone?
A
- PTH
- Vitamin D
- Calcitonin
4
Q
What type of bone resists compression forces?
A
-Medullary bone
5
Q
What type of bone resists bending forces and is thick?
A
-Cortical bone
6
Q
Periosteum is a tough fibrous membrane that covers bone surfaces except at what point?
A
-Joints
7
Q
T/F The periosteum is well innervated and painful if injured
A
True
8
Q
T/F Woven bone is mature
A
False
-It is immature
9
Q
Osteogenesis imperfecta is deficient in what?
A
-Type I collagen that causes too little bone
10
Q
What do you see with generalized osteopenia is osteogenesis imperfecta?
A
- Multiple fractures and bone deformities
- Malformed teeth because of a dentin deficiency
- Blue sclera
11
Q
What is Acohndroplastic dwarf?
A
-Reduced function of epiphyseal growth plates
12
Q
What bones does Achondroplastic dwarf affect mostly?
A
-Long bones
13
Q
T/F A person with Achondroplastic dwarf syndrome has normal intelligence and normal ifespan
A
True
14
Q
What bone disease has defective osteoclasts?
A
-Osteopetrosis
15
Q
T/F In osteopetrosis the bone is brittle and not dense enough
A
False
-It is brittle and too dense
16
Q
What nerve problem can osteopetrosis cause?
A
-Cranial nerve palsies
17
Q
What is Osteomalacia?
A
-Softening bone due to Vit. D defiency or kidney failure
18
Q
What bone disease do you see delayed eruption of teeth and defects in the dentin and enamel assocaited with a Vit. D. deficiency
A
Osteomalacia
19
Q
What is Albers-Schonberg disease?
A
-Impaired osteoclasts that reduces bone resorption
20
Q
What is albers-Schonberg disease associated with?
A
- Anemia
- Bone fractures
- Blindness
- Deafness
21
Q
What is the cause of Osteitis deformans?
A
-Mixed stages of osteolysis and osteogenesis
22
Q
What is adults ricketts called?
A
-Osteomalacia
23
Q
What acquired diseases of the bone deal with vitamin D. defciency?
A
-Rickets
24
Q
What causes Rickets syndrome?
A
- GI malabsorption syndrome
- Lack of sunlight exposure
25
What acquired diseases of the bone deal with Vit C deficiency?
-Scurvy
26
What are the different types of acquired diseases of the bone?
- Osteoporosis
- Osteomalacia (Rickets)
- Hyperparathyroidism
27
What are the genetic causes of Osteoporosis?
- Age
- Low estrogen
- Fair hair and skin
- Tall and thin
28
What are the behavior causes of Osteoporosis?
- Inactivity
- Smoking/alcohol
- Malnutrition
- Medication (chronic corticosteroids)
29
T/F 1/3 of women over 50 years old have at least one osteoporitic fracture
True
30
What is Kyphosis?
-Abnormal forward curvature of spine
31
What is Scoliosis?
-Abnormal lateral curvature of spine
32
What are the different types of bone fractures?
- Complete
- Closed
- Compound/open
- Comminuted
- Displaced
- Pathological
- Greenstick
33
What is a comminuted fracture?
-Bone splintered
34
What is a displaced fracture?
-Fractured bone not aligned
35
What is a pathological fracture?
-Fracture associated with cancers
36
What is a compound fracture?
-Bone pieces skin
37
What is osteomyelitis?
-Inflammation of bone/marrow
38
What is Granulomatous osteomyelitis called when associated with TB and in the spine?
-Pott disease
39
What is a greenstick fracture?
Bone cracks through only on side
40
What do you see a loss of in osteoarthritis?
-Articular cartilage with secondary changes in bone
41
What is the most common type of joint pain?
-Osteoarthritis
42
What are boney swelling in osteoarthritis known as?
-Heberden nodes
43
What is the most common form of autoimmune disease?
-Rheumatoid arthritis (1% prevalence)
44
T/F Rheumatoid arthritis is less systemic and unilateral
False
| -More systemic and bilateral
45
Who is Rheumatoid arthritis more common in and uncommon in respectively?
- Caucasians
| - Asians
46
What are the symptoms of Rheumatoid arthritis?
- Joint swelling
- Pain and tenderness
- Often cause extreme distortions of joints and surrounding bone
- Fever
- Weakness
- Malaise
47
What are some other areas that can be affected by RA?
- Ulcers
- Pulmonary nodules and fibrosis
- Carditis and pericarditis
- Vasculitis
48
What type of lab test can you do to determine RA?
-Anti CCP (cyclic citrillunated peptides)
49
What is the primary cause of Gout?
-Reduced renal excretion of purine (uric acid is break down product)
50
What is the primary treatment of gout?
-Allopurinol
51
What are the symptoms of Gout?
- Hot
- Swollen
- Pain in joints
52
What is pseudo gout?
-Crystal deposits of calcium pyrophosphate
53
Besides allopurinol what else can be used to treat Gout?
- Colchicine
- Allopurinol
- Indomethacin
54
What are Ganglion cysts?
-A cyst resulting from connective tissue around joints that is often painful
55
What is Marfan Syndrome>
-Hereditary connective tissue disease caused by a mutate fibrillin gene
56
What symptoms do you see with Marfan syndrome?
- Spider like fingers
- Tall growth
- Necrosis of aorta
57
what can cause hyperparathyroidism?
adenoma in the parathyroid
58
what does hyperparathyroidism cause that relates to bones?
constant release of Ca2+
59
how many people in the US have osteoporosis?
10 million, mostly women
60
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)
61
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
62
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
63
___ is a degenerative joint disease
osteoarthritis
64
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)
65
are there inflammatory changes associated with osteoarthritis?
no, changes are degenerative
66
what is the age of onset of rheumatoid arthritis, and what % are female?
- 25-50 years old (can have juvenile RA)
| - 75% female
67
what are some other inflammatory arthritites?
- psoriatic arthritis
- autoimmune - lupus erythematous, scleroderma
- postinfections - rheumatic fever
- infectious - staph/strep, TB
- gout
- lyme disease
68
if lyme disease goes untreated, what can result?
arthritis and neurologic consequences
69
what is gouty tophi?
crystalized aggregates of uric acid
70
malignant carcinomas that spread to bone most likely come from where?
lungs, prostate, breast, thyroid, and kidneys
71
what tumors are most likely to be seen in the maxilla or mandible?
- osteomas
- giant cell tumor
- fibrous dysplasia
- osteosarcoma
- ewing sarcoma
72
what tumor that is commonly seen in the jaws is made up of immature bone?
osteomas
73
what tumor that is commonly seen in the jaws is benign but aggressive?
giant cell tumor
74
is fibrous dysplasia malignant?
no
75
what tumor that is commonly seen in the jaws is most often seen in adolescents or older patients?
osteosarcoma
76
what is the most frequent sarcoma that is commonly seen in the jaws? what about the second most frequent?
1 - osteosarcoma
| 2 - ewing sarcoma
77
what age patient is ewing sarcoma common in?
10-20 years old
78
what location are osteosarcomas most common in?
long bones mostly, but sometimes in the mandible
79
what is a benign tumor of cartilage? is it seen in the mandible or maxilla?
- osteocondroma
| - no
80
what is a malignancy of cartilage?
chondrosarcoma
81
what is benign medullary bone that does not properly mature, and is often in the jaws?
fibrous and fibro-osseous tumors
82
what are 6 types of soft tissue tumors?
- lipomas
- liposarcoma
- fibrous tumors
- fibrosarcoma
- rhabdomyosarcoma
- leiomyoma
- leiomyosarcoma
83
what is a malignant neoplasm of fibroblasts?
fibrosarcoma
84
what is a reactive tumor?
fibrous tumor (can be malignant or benign)
85
are lipomas common? do they require treatment?
- yes
| - not usually
86
what area are rhabdomyosarcomas frequently found in? are they common?
- head and neck region
| - they are rare
87
muscular dystrophy is most common in ___
duchenne muscular dystonia
88
what are the symptoms of muscular dystrophy?
- weakness of voluntary muscles
| - breakdown of muscle tissue
89
when does muscular dystrophy typically present?
it can occur anytime and in any part of the body
90
muscular dystrophy represents a group of ___ diseases
genetic
91
congenital myopathies tend to present with ___ and ___
congenital hypotonia and weakness
92
___ is diffuse destruction of skeletal muscle
rhabdomyolysis
93
what are the symptoms of rhabdomyolysis?
- acute
| - muscles are tender and swollen
94
what are two things that can cause rhabdomyolysis?
- may develop with a flu episode
| - can be caused by some drugs, like statins
95
ALS and polio are considered ___ diseases that typically result in ___
- denervation
| - typically result in muscle degeneration
96
myasthenia gravis is an ___ myopathy
inflammatory
97
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
98
what can worsen myasthenia gravis? what improves it?
- activity worsens it
| - rest improves it
99
what causes myasthenia gravis? is it inherited?
- auto-antibodies kill ACh receptors (thymus may contribute to formation)
- not inherited
100
what is the treatment and prognosis of myasthenia gravis?
- acetylcholinesterase inhibitors - pyridostigmine
- immunosuppressants - prednisone and rituximab
- prognosis is typically good with proper treatment
