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DIT topics > bone formation + bone tumors + bone disorders > Flashcards

bone formation + bone tumors + bone disorders Flashcards

1
Q

bones of axial and limb skeletons are formed by

A

endochondrial ossification

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2
Q

bones of skull + facial bones are formed by

A

membranous ossification

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3
Q

bone made by osteoblasts and osteoclasts is first built on a cartilage frame made by chondrocytes in this type of bone formation

A

endochondrial ossification

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4
Q

no cartilage frame in this type of bone formation

A

membranous ossification

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5
Q

epiphyseal plates are an example of this type of bone formation

A

endochondrial ossification

new bone formation in growing long bones→ lengthen bones, once plates fuse, no more growth

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6
Q

sporadic mutation that causes a constitutively active fibroblast growth factor receptor (FGFR3) → inhibits chondrocyte proliferation for endochondrial ossification will cause

A

achondroplasia

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7
Q

risk factor for achondroplasia

A

advanced paternal age

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8
Q 
what condition is this:
proximal limbs shorter than distal limbs
limb length disproportionate to trunk length
large head relative to limbs
frontal bossing
bowed tibias
normal lifespan + fertility
AD mutation - 50% chance offspring will get if spouse has no mutation, 2/3 chance living offpsring will get if spouse is also affected
A

achondroplasia

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9
Q

benign primary bone tumor in patient 20-40 yo

A

osteoclastoma

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10
Q

benign primary bone tumor in male

A

osteochondroma

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11
Q

malignant primary bone tumor in male 10-20 yo

A

osteosarcoma

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12
Q

malignant primary bone tumor in boy

A

ewing sarcoma

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13
Q

xray appearance of osteoclastoma

A 
CLean = "soap bubbles" = 
lytic lesion (osteoclast break down bone matrix) = luscent
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14
Q

xray appearance of osteochondroma

A

CHondroma = CHunk of bone =

hamartoma (benign tumor of disorganized tissue in normal location) = bone spur with cartilaginous cap

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15
Q

xray appearance of osteosarcoma

A

SarComa =
Sunburst pattern
Codman’s triangle: elevation of periosteum

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16
Q

most common primary malignant bone tumor in children

A

osteosarcoma (not multiple myeloma - proliferation of plasma cells in bone marrow in elderly)

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17
Q

xray appearance of Ewing sarcoma

A

Wing =think Onion rings = “onion skin” (layers of new bone in periosteum)

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18
Q

t(11;22) translocation associated with what primary bone tumor

A

Ewing Sarcoma

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19
Q

primary malignant bone tumor that is aggressive + early mets but responds to chemo

A

Ewing Sarcoma

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20
Q

most common benign primary bone tumor

A

osteochondroma

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21
Q

primary bone tumors that are near the knee

A

osteoclastoma (benign)

osteosarcoma (malignant)

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22
Q

primary tumors with mets to bones

A 
Permanently Relocated Tumors Like Bones
think GU:
Prostate
Renal cell cancer
Testes, thyroid
Lung
Breast
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23
Q

metastatic tumor that causes lytic bone lesions (break down bone)

A

lung

breast (lytic or blastic)

24
Q

metastatic tumor that causes blastic bone lesions (build new bone, disordered, weak, fractures)

A

prostate

breast (lytic or blastic)

25
Q

is bone mets or primary bone tumor more common

A

bone mets

26
Q

presentation of bone mets

A

bone pain
epidural spinal cord compression causing neuro sx (BB dysfunction) due to vertebral body lesion
hypercalcemia (lytic lesion)

27
Q

bone disease caused by osteoblasts working too slowly allowing ↑ bone resorption by osteoclasts →↓ bone mass and Ca matrix →↑ risk of fracture

A

osteoporosis

28
Q

bone disease with normal Ca, phosphate, PTH, alk phos

A

osteoporosis

29
Q

bone disease common in postmenopausal women

A

osteoporosis

30
Q

complications of osteoporosis

A

vertebral crush fractures: may have acute back pain, loss of height, leads to kyphosis
low trauma fractures (falling to the ground): femoral neck fracture, distal radius fracture

31
Q

diagnosis of osteoporosis by

A

DEXA scan - bone mineral density test (T

32
Q

treatment of osteoporosis

A

stop smoking (↓ bone density), alcohol, high dose or chronic glucocorticoid steroid use, avoid PPIs (need acid to absorb Ca), H2 blockers
exercise - weight bearing (strain bones → stimulate osteoblasts)
vitamin D + vitamin C
bisphosphonates (inhibit osteoclast resorption,↓ fracture risk)
teriparatide (pulsatile PTH,↓ hip fracture risk)
OTHER tx:
post-menopausal conjugated estrogen (not used soley for osteoporosis due to SE of MI and CVA,↓ hip fracture risk)
if low T, give testosterone (build bones)
SERM (raloxifene) (reduce risk of breast cancer,↓ vertebral fracture risk)
calcitonin (inhibit osteoclast, not as effective as bisphosphonates, no ↓ fracture risk)
denosumab: RANK-L inhibitor (inhibit osteoclast)

33
Q

bone disease where osteoclasts work too slowly → no bone resorption → thick, dense, disorganized bone → ↑ risk of fracture

A

osteopetrosis

34
Q

bone disease caused by a mutation in the osteoclast carbonic anhydrase II → no bone resorption

A

osteopetrosis

35
Q

bone disease that may cause:
cranial nerve impingement
palsies due to narrowed foramina
pancytopenia (osteoblasts grow in BM)

A

osteopetrosis

36
Q

treatment of osteopetrosis

A

BMT: osteoclasts are derived from monocytes in BM

37
Q

xray appearance of osteopetrosis

A

bones flare at end, bone-in-bone apperance

38
Q

bone cell that build bone by secreting/laying down collagen and catalyzing the mineralization of the bone matrix

A

osteoblast

39
Q

when osteoblast is incorporated into the bone it is called an

A

osteocyte (in the lacune of bony matrix, contact with each other via canalliculi)

40
Q

mutlinucleated bone cell that originated from a monocyte/macrophage, and dissolves bone by secreting acid and collagenases for the goal of releasing Ca into serum or promote remodeling after a fracture

A

osteoclast

41
Q

bone disease in which osteoclasts break down bony matrix → activates osteoblasts to lay down new matrix
osteoclasts burnout due to excess activity → only osteoblasts are working → disorganized bony architecture

A

Paget disease of bone

42
Q

localized disorder of excess bone remodeling/ bone turnover →↑ alk phos (only lab abnormality)

A

Paget disease of bone

43
Q

bone disease with increased risk of osteosarcoma

A

Paget disease of bone

44
Q

alk phos is a marker

A 
bone formation (reflects osteoblast activity)
other types of alk phos: liver, billirubin
45
Q 
bone disease that can cause:
bone pain
bone deformaties
fractures
↑HAT SIZE (thicker bone)
hearing loss (narrowing of auditory foramen)
A

Page disease of bone

46
Q

bone disease in kids caused by vitamin D deficiency

A

rickets

47
Q

bone disease in adults caused by vitamin D deficiency

A

osteomalacia

48
Q

bone disease that causes soft bones that bow out

A

osteomalacia/rickets

49
Q

bone disease that causes defective mineralization and calcification of osteoid due to vitamin D deficiency →↓ serum Ca

A

osteomalacia/rickets

50
Q

what is the name for cystic bone spaces “brown tumors” lined by osteoclasts filled with fibrous stroma + blood

A

osteitis fibrosa cystica: a bony manifestation of a endocrine disorder

51
Q

causes of osteitis fibrosis cystica

A

1° hyperparathryoidism: high PTH → high Ca, low phosphate, high alk phos
type 1A pseudohypoparathyroidism = (Albright hereditary osteodystrophy): PTH resistance at renal tubules →no signal to ↑ Ca reabsorption → low serum Ca, high serum phosphate → low serum Ca is trigger to increase PTH
in both cases: high PTH → excess osteoclast activity → bone tumors, ↓bone mineral density

52
Q

bone disease in which bone is replaced by collagen + fibroblasts (more collagen than Ca) → irregular bony trabeculae

A

polyostotic fibrous dysplasia

53
Q

polyostotic fibrous dysplasia is part of this syndrome:

A

McCune Albright Syndrome:
precocious puberty
cafe au lait spots
fibrous dysplasia of bone

54
Q

treatment for osteomalacia/rickets

A

vitamin D - reversible!

55
Q

risk factors for osteoporosis

A 
old age
smoking
steroid use
chronic heparin use
white or asian race
thin build
lack of exercise
poor Ca/D intake
low T or low estrogen (menopause)

DIT topics (115 decks)

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