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MSK II > Bone, Joints, and Soft tissue tumors > Flashcards

Bone, Joints, and Soft tissue tumors Flashcards

1
Q

osteoblasts

A

on surface of matrix

synthesize, transport, and assemble matrix and regulate mineralization

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2
Q

osteocytes

A

interconnected by intricate network of dendritic cytoplasmic processes via tunnels (canaliculi)
help control Ca and Phos levels and mechanotransduction

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3
Q

osteoclasts

A

specialized multinucleated macros derived from circulating monocytes
bone resorption

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4
Q

brachydactyly

A

HOXD13 TF

short terminal phalanges of first digits

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5
Q

achondroplasia

A

FGFR3

short stature, rhizomelic shortening of limbs, frontal bossing, midface deficiency

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6
Q

osteogenesis imperfecta

A

COL1A1 and COL1A2

bone fragility

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7
Q

osteogenesis imperfecta

A

blue sclera d/t missing collagen can see vv
type 1 most relevant
bc type II not compatible with life and III and IV rare

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8
Q

clinical features of osteogenesis imperfecta

A 
blue sclera
fractures
normal stature
no dentin
hearing impariment
joint laxity
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9
Q

osteopetrosis

A

aka marble bone disease, albers-schonberg disease

impaired formation/fnx of osteoclasts

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10
Q

osteopetrosis morphology

A

bones lack medullary canal and ends of long bones bulbous

neural foramina small and compress exiting nn

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11
Q

buzz words osteopetrosis

A

erlenmeyer flash shaped long bones

missing epiphyses

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12
Q

severe infantile osteopetrosis

A 
AR
evident in utero or soon after birth
fractures
anemia
hydrocephaly
postpartum mortality
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13
Q

osteopetrosis if survive into infancy

A

CN defects
infections d/t leukopenia
extramedullary hematopoiesis -> hepatosplenomegaly

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14
Q

mild AD form of osteopetrosis

A

may not be detected until adolescence or adulthood
discovered d/t multiple fractures
may have mild CN deficits and anemia

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15
Q

dysplasia

A

in bone just meets disorganization and tissue in the wrong places, not preCA

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16
Q

osteopenia

A

decreased bone mass

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17
Q

osteoporosis

A

osteopenia severe enough to increase risk of fracture

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18
Q

what is the most common cause of iatrogenic osteoporosis

A

over Tx of hypothyroidism

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19
Q

what CA is known to cause osteoporosis

A

MM

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20
Q

what endocrine disorders can cause osteoporosis

A 
addisons
DMI
hyperparathyroid 
hyper/hypothyroid
pituitary tumors
neoplasia
carcinomatosis
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21
Q

what are the most common forms of osteoporosis

A

senile

postmenopausal

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22
Q

clinical osteoporosis

A

depend on involved bones

vertebral fractures that frequently occur in T and L are painful with height loss and lumbar lordosis and kyphoscoliosis

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23
Q

complications of fractures

A

PE

pneumonia

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24
Q

pagets disease

A

aka osteitis deformans

disorder of increased, but disordered structurally unsound bone mass

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25
Q

hallmark of pagets

A

mosaic pattern of lamellar bone, seen in sclerotic phase

prominent cement lines

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26
Q

pagets clinical

A

extremely variable
most cases discovered incidentally on xray
axial skeleton or proximal femur in 80%
pain dt microfractures
many have elevated AlkPhos, but nomral Ca and Phos

27
Q

monostotic pagets

A

15%

the rest polyostotic

28
Q

leonstiasis ossea

A

lion face
pagets disease
enlargement of craniofacial skeleton
can get so heavy its hard for person to hold head errect

29
Q

benign lesions associated with pagets

A

giant cell tumor
giant cell reparative granuloma
extra-osseous masses of hematopoietic tissue

30
Q

most dreaded complication of pagets

A

osteosarcoma

31
Q

buzz word pagets

A

saber bone

32
Q

rickets and osteomalacia

A

vit D deficiency/abnormal metabolism
rickets-kids
osteomalacia-adults

33
Q

hyperparathyroidism

A

increased RANKL expression on osteoblasts
increased resorption of Ca by renal tubules
increased urinary excretion of phosphates
increased synthesis o factive bit D

34
Q

what is most common cuase of hyperparathyroidism

A

parathyroid adenoma, usually asymptomatic

35
Q

brown tumor

A

d/t hemorrhage into cartilage, not real tumor

can occur hyperparathyroidism

36
Q

renal osteodystrophy

A

skeletal changes that occur in chronic renal disease, including those associated with dialysis

37
Q

simple fracture

A

the overlying skin is intact

38
Q

compound fracture

A

bone communicates with skin surface

39
Q

comminuted fracture

A

bone is fragmented

40
Q

displaced fracutes

A

ends of bone not aligned

41
Q

stress fracture

A

slowly developing fracture d/t repetitive load

42
Q

greenstick fracture

A

extending only partially thru bone

young children

43
Q

what can cause iatrogenic fracutes

A

corticosteroids

avascular necorsis

44
Q

causes of osteomyelitis

A

hematogeneous spread
extension from contiguous site
direct implantation (surgery)

45
Q

what is most common cause of osteomyelitis

A

S. aureus

if pt has sickle cell prob salmonella

46
Q

sequestrium

A

dead bone d/t osteomyelitis

47
Q

involucrum

A

newly deposited bone forms a shell of living tissue around infected bone

48
Q

brodie abscess

A

small interosseous abscess that frequently involves Cx and is walled off by reactive bone

49
Q

osteomyelitis clinical

A

sometimes manifests as acute systemic illness w/malaise, fever, chills, leukocytes, and marked pain over region
can also be subtle with only unexplained fever or pain

50
Q

Dx of osteomyelitis

A

xray of lytic lesions with zone of sclerosis
blood cultures may be + or -
Bx to ID pathogen

51
Q

Dx bone tumors

A

Bx

benign greatly outnumber malignant

52
Q

benign bone tumors

A

usually in first 3 decades of life, if older more likely malignant

53
Q

most common bone CA

A

osteosarcoma
chondrosarcoma
Ewing sarcoma

54
Q

what tumor arises in epiphysis

A

giant cell

55
Q

what tumor arises in diaphysis

A

Ewing sarcoma

56
Q

osteoid osteoma vs osteoblastoma

A

osteoid osteoma- typical presentation in pain in heel with tumor 2cm in vertebral TP

57
Q

osteosarcoma

A

malignant
cancerous cells produce osteoid matrix or mineralized bone
75% are in pts <20
smaller peak in older adults

58
Q

risk factors for osteosarcoma

A

pagets
bone infarcts
radiation

59
Q

osteosarcoma stats

A 
M>W
usually arise in metaphyseal region of long bones 
50% at knee area
painful progressively enlarging masses
fracture may be 1st symptom
60
Q

osteosarcoma x-ray

A

large destructive mixed lytic and blastic mass w/infiltrative margins
frequently breaks thru Cx and lifts periosteum
triangular shadow -> CODMANS TRIANGLE indicative of aggressive tumor

61
Q

where do osteosarcomas metastasize too

A

lungs

62
Q

young person distal lytic lesion near knee should think?

A

osteosarcoma

63
Q

older person central pelvic lesion

A

chrondrosarcoma

64
Q

osteosarcoma clinical

A

if there are no mets- Tx with neoadjuvant chemo followed by surgery
if mets poor prognosis

MSK II (19 decks)

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