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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
hallmark of pagets
mosaic pattern of lamellar bone, seen in sclerotic phase | prominent cement lines
26
pagets clinical
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
monostotic pagets
15% | the rest polyostotic
28
leonstiasis ossea
lion face pagets disease enlargement of craniofacial skeleton can get so heavy its hard for person to hold head errect
29
benign lesions associated with pagets
giant cell tumor giant cell reparative granuloma extra-osseous masses of hematopoietic tissue
30
most dreaded complication of pagets
osteosarcoma
31
buzz word pagets
saber bone
32
rickets and osteomalacia
vit D deficiency/abnormal metabolism rickets-kids osteomalacia-adults
33
hyperparathyroidism
increased RANKL expression on osteoblasts increased resorption of Ca by renal tubules increased urinary excretion of phosphates increased synthesis o factive bit D
34
what is most common cuase of hyperparathyroidism
parathyroid adenoma, usually asymptomatic
35
brown tumor
d/t hemorrhage into cartilage, not real tumor | can occur hyperparathyroidism
36
renal osteodystrophy
skeletal changes that occur in chronic renal disease, including those associated with dialysis
37
simple fracture
the overlying skin is intact
38
compound fracture
bone communicates with skin surface
39
comminuted fracture
bone is fragmented
40
displaced fracutes
ends of bone not aligned
41
stress fracture
slowly developing fracture d/t repetitive load
42
greenstick fracture
extending only partially thru bone | young children
43
what can cause iatrogenic fracutes
corticosteroids | avascular necorsis
44
causes of osteomyelitis
hematogeneous spread extension from contiguous site direct implantation (surgery)
45
what is most common cause of osteomyelitis
S. aureus | if pt has sickle cell prob salmonella
46
sequestrium
dead bone d/t osteomyelitis
47
involucrum
newly deposited bone forms a shell of living tissue around infected bone
48
brodie abscess
small interosseous abscess that frequently involves Cx and is walled off by reactive bone
49
osteomyelitis clinical
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
Dx of osteomyelitis
xray of lytic lesions with zone of sclerosis blood cultures may be + or - Bx to ID pathogen
51
Dx bone tumors
Bx | benign greatly outnumber malignant
52
benign bone tumors
usually in first 3 decades of life, if older more likely malignant
53
most common bone CA
osteosarcoma chondrosarcoma Ewing sarcoma
54
what tumor arises in epiphysis
giant cell
55
what tumor arises in diaphysis
Ewing sarcoma
56
osteoid osteoma vs osteoblastoma
osteoid osteoma- typical presentation in pain in heel with tumor 2cm in vertebral TP
57
osteosarcoma
malignant cancerous cells produce osteoid matrix or mineralized bone 75% are in pts <20 smaller peak in older adults
58
risk factors for osteosarcoma
pagets bone infarcts radiation
59
osteosarcoma stats
``` M>W usually arise in metaphyseal region of long bones 50% at knee area painful progressively enlarging masses fracture may be 1st symptom ```
60
osteosarcoma x-ray
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
where do osteosarcomas metastasize too
lungs
62
young person distal lytic lesion near knee should think?
osteosarcoma
63
older person central pelvic lesion
chrondrosarcoma
64
osteosarcoma clinical
if there are no mets- Tx with neoadjuvant chemo followed by surgery if mets poor prognosis

MSK II (19 decks)

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