Bone disease Flashcards
Osteoporosis:
Trabecular (spongy) bone loss
and interconnection
Despite normal serum Ca2+ and phos
Osteoporosis:
type I
Post menopausal:
increased bone resorption due to low estrogen
Femoral neck fracture,
distal radius fracture
Osteoporosis:
type II
Senile osteoporosis:
affect men and women > 70 years of age
Prophylaxis: weight bearing exercise and Ca2+/vit D
Tx: SERM or calcitonin;
bisphosphonate or pulsatile PTH for severe cases
Cortisol contraindicated
Osteopetrosis
marble bone disease
Defective osteoclast
Thickened, dense bone prone to fracture
Bone fills marrow space: pancytopenia, extramedullar hematopoesis.
Mutation: carbonic anhydrase II
Xray; bone in bone appearance
Tx: bone marrow transplant potentially curative
Osteomalacia and rickets
Vit D deficiency
Hyperactivity of osteoblasts, so increase alk phos
osteoblasts require alkaline environment
Paget’s disease of bone
Localized disorder of remodeling
increased osteoblast and osteoclast activity
Increased hat size, or hearing loss (auditory foramen narrowing)
Serum Ca2+, phos, PTH all normal, but elevated ALP
Mosaic (woven) bone pattern.
Long bone chalk stick fracture
Increased blood flow from AV shunt may cause high output heart failure
Increased risk of osteosarcoma
Polyostotic fibrous dysplasia
Bone replaced by fibroblasts, collagen, irregular bone trabeculae
McCune Albright syndrome:
form of polyostotic fibrous dysplasia characterized by unilateral bone lesions associated with endocrine abnormalities (precocious puberty and cafe-au-leit spots)
Osteonecrosis (avascular necrosis)
Infarction
Pain associated with activity
Caused by trauma, steroid, alcoholism, sickle
Most common is femoral head
Infectious arthritis
S aureus, Streptococcus, N gonorrhea
Gonococcal arthritis: migratory arthritis with an asymmetric pattern.
Triad: Synovitis, tenosynovitis (hand), dermatitis (pustules)
“STD”
