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Human Disease and Therapeutics > Bone/Joint and Muscle Pathology > Flashcards

Bone/Joint and Muscle Pathology Flashcards

1
Q

Characteristics of bone

how much calcium is stored in them? they are the primary site of ____? influenced by what hormones?

A
  • store 99% of the body’s calcium
  • in adults, they are the primary site of hematopoiesis
  • constantly remodeling under the influence of parathyroid hormone, vitamin D, and calcitonin
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2
Q

Description of medullary bone, cortical bone, periosteum, and woven bone.

A
  • medullary bone: resists compression forces
  • cortical bone: thick and resists bending forces
  • periosteum: tough fibrous membrane that covers bone surfaces except at the joints; well-innervated and painful if injured
  • woven bone: immature
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3
Q

osteogenesis imperfecta

A
  • disease of abnormal bone matrix
  • deficient or defective type 1 collagen –> too little bone
  • generalized osteopenia (multiple fractures and bone deformities)
  • malformed teeth (dentin deficiency)
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4
Q

achondroplastic dwarfism

A
  • reduced function of epiphyseal growth plates (mostly affects long bones)
  • has normal intelligence and normal life span
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5
Q

osteopetrosis

A
  • defective osteoclasts
  • bone is brittle and too dense
  • can cause cranial nerve palsies
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6
Q

osteomalacia

A
  • softening of the bone due to Vitamin D deficiency or kidney failure
  • delayed eruption of teeth
  • defects in dentin and enamel
  • adult form of Ricketts
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7
Q

Albers-Schonberg disease

A
  • impaired osteoclasts
  • reduces bone resorption
  • associated with anemia, bone fractures, blindness, deafness
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8
Q

osteitis deformans

A
  • mixed stages of osteolysis and osteogenesis
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9
Q

acquired bone diseases

A

Scurvy (Vit. C deficiency)
Ricketts (osteomalacia in adults)
- Vit. D deficiency
- due to GI malabsorption syndrome or lack of sunlight
exposure
- lack of normal mineralization (usually kidney related)
Osteoporosis
- common in elderly women after menopause
Hyperparathyroidism
- constantly releasing Ca2+
- adenoma in parathyroid can be a cause

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10
Q

Causes of osteoporosis

A
  • genetic: age, low estrogen, fair hair and skin, tall and thin
  • behavior: inactivity, smoking/alcohol, malnutrition, medication (chronic corticosteroids)
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11
Q

incidence/burden of osteoporosis in the US

A
  • 10 million people in the US, mostly women
  • 1/3 women over 50 yrs have at least one osteoporotic hip fracture
  • most hip fractures in women over 70 yrs (increases the likelihood of death in the next year…mechanism not understood)
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12
Q

disorders of bone instability

A
  • kyphosis - abnormal forward curvature of spine

- scoliosis - abnormal lateral curvature of spine

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13
Q

types of fractrues

A
  • complete
  • closed (overlying tissue intact)
  • compound (bone pieces in the skin)
  • comminuted (bone splintered or crushed)
  • displaced (fractured bone not aligned)
  • pathological (associated with cancers)
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14
Q

osteomyelitis (and causes)

A
  • inflammation of the bone/marrow
    CAUSES:
  • blood-born or direct inoculation
  • trauma from compound fractures
  • pyogenic infections (staph aureus, salmonella)
  • granulomatous (TB or fungal; “Pott Disease” when associated with TB and in the spine)
  • diabetes (poor circulation in the extremities; if chronic, can form a drainage site and can even become osteosarcoma)
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15
Q

characteristics of oasteoarthritis

A
  • degenerative joint disease
  • loss of articular cartilage with secondary changes in bone
  • presents to some degree is most persons older than 65 yrs; symptoms worsen with excessive use
  • wear and tear (most common type of joint pain)
  • no inflammatory changes
  • boney swellings called “Heberden nodes”
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16
Q

characteristics of rheumatoid arthritis

A
  • more systemic and bilateral
  • joint swelling, pain, and tenderness
  • extreme distortions of joints and surrounding bone (deforming and debilitating)
  • may have systemic symptoms of fever, weakness, and malaise
  • other areas also affected: ulcers, pulmonary nodules and fibrosis, carditis and pericarditis, vasculitis
  • most have circulating anti-cyclic citullinated peptides (anti-CCP)…used a a lab test
17
Q

incidence of rheumatoid arthritis

A
  • autoimmune (1% prevalence; most common form of autoimmune disease)
  • most common in caucasians; uncommon in asians
  • onset age: 25-50 yrs
  • 75% female
  • can have juvenile RA
18
Q

Other types of inflammatory arthritis

A
  • psoriatic arthritis
  • other autoimmune diseases (lupus, scleroderma)
  • post-infectious (rheumatic fever)
  • infectious (staph/strep, TB)
  • gout (crystallized uric acid)
  • lyme disease (tick-based spirochete; if not treated can lead to arthritis and neuro consequences)
19
Q

Gout (characteristics and causes)

A
  • primary cause: reduced renal excretion or purine
  • primary treatment: allopurinol - decreases synthesis of purines
  • symptoms: hot, swollen, pain in joints; progressive joint destruction –> gouty tophi (crystallized aggregates of uric acid)
  • pseudo-gout: crystal deposits of calcium pyrophosphate
  • treat with: colchicine, allopurinol, or indomethacin
20
Q

ganglion cysts

A
  • a cyst resulting from connective tissue around joints; often painful
21
Q

Marfan syndrome

A
  • hereditary connective tissue disease caused by a mutant fibrillin gene
  • symptoms: spider-like fingers, tall growth, necrosis of the aorta
22
Q

Malignant carcinomas spread to the bone most likely from to come from…

A

lungs, prostate, breast, thyroid, and kidneys

23
Q

Tumors most likely seen in maxilla or mandible

A
  • osteomas (immature bone)
  • giant cell tumor (benign, but aggressive; mandible)
  • fibrous dysplasia (not malignant, benign, medullary bone does not properly mature, often in jaws)
  • osteosarcoma (adolescents or older patients)
  • ewing sarcoma (10-20 yrs old, 2nd most frequent sarcoma after osteosarcoma)
24
Q

incidence of osteosarcomas in US

A

8,000/yr

25
Q

osteosarcoma

A
  • malignant
  • most frequent bone malignancy
  • adolescents or geriatric patients most likely
  • usually in long bones or sometimes mandible
26
Q

osteochondrosarcoma

A
  • malignancy of cartilage
27
Q

incidence of soft tissue tumors in the US

A

12,000/yr

28
Q

types of soft tissue tumors

A
  • lipomas (very common, don’t usually require treatment
  • liposarcoma (malignant)
  • fibrous tumors (usually reactive)
  • fibrosarcoma (malignant neoplasm of fibroblasts)
  • rhabdomyosarcoma (skeletal muscle tumor, frequently in head and neck region; rare)
  • leiomyoma (smooth muscle tumor, benign)
  • leiomyosarcoma (malignant smooth muscle tumor, deep soft tissue)
29
Q

muscular dystophy

A
  • most common = Duchenne Muscular Dystonia
  • symptoms: progressive weakness of voluntary muscles and breakdown of muscle tissue; can occur anytime/anywhere; represents a group of genetic diseases
30
Q

congenital myopathies

A
  • present with congenital hypotonia and weakness
31
Q

rhabdomyolysis

A
  • diffuse destruction of skeletal muscle
  • acute: muscles are tender and swollen
  • may develop with flu episode
  • can be caused by some drugs such as “statins”
32
Q

denervation diseases

A
  • ALS or polio

- typically result in muscle degeneration

33
Q

Myasthenia gravis

A
  • inflammatory myopathy
  • symptoms: weakness in skeletal muscles responsible for breathing and mobility; worsens with activity and improves with rest; often includes other skeletal muscles such as for eyelids, facial movement, chewing, swallowing, and talking
  • cause: auto-antibodies kill ACh receptors (thymus may contribute to formation); not inherited
34
Q

treatment of myasthenia gravis

A
  • acetylcholinesterase inhibitors (pyridostigmine)
  • immunosuppressants (prednisone, rituximab)
  • prognosis usually good with proper treatment

Human Disease and Therapeutics (11 decks)

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