Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pathophysiology > Bone Pathologies > Flashcards

Bone Pathologies Flashcards

1
Q

What are the most common congenital bone pathologies?

A

1.) failure of the development of the bone-absence of clavicle, or distal thumb phalange connected to metacarpal bone (example). 2.) Supernumerary bones- cervical or lumbar ribs (unpleasant symptoms in extremities, decreases flexibility), extra digits, 3.) Fusion of adjacent bones- syndactyly (mom can drink too much and give syndactyly or a recessive gene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can occur in achondroplastic bones?

A

morphologic abnormalities in epiphyseal plates of long bones- dwarfism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Symptoms of primordial people?

A

Smallest people on earth! Can be only 31 cm=adult. Can be from a recessive gene, brains can be different in structure- no corpus callosum, average intelligence, small lower jaw, higher risk of brain aneurysm (berry aneurysm)- can die young

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common lethal form of dwarfism?

A

Thanatophoric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What occurs in thanatophoric dysplasia?

A

small chest cavities cause respiratory insufficiency-lungs don’t have space to expand, they die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What occurs in osteogenesis imperfecta?

A

brittle bone syndrome- synthesis of collagen type 1 is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What occurs in subtype 1 of osteogenesis imperfecta?

A

AUTOSOMAL DOMINANT- normal stature, fragile bones, joint laxity, blue sclera, hearing impairment (bony labyrinth in middle ear is abnormal which changes conduction of sound)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What occurs in subtype 2 of osteogenesis imperfecta?

A

AUTOSOMAL RECESSIVE- most lethal- pre-natally or shortly after birth, blue sclera- NOT COMPATIBLE WITH LIFE!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What occurs in subtype 3 of osteogenesis imperfecta?

A

AUTOSOMAL DOMINANT- multiple fractures, short stature and growth retardation, progressive kyphoscoliosis- MOST PROBLEMATIC FOR PEOPLE WHO SURVIVE THROUGH OSTEOGENESIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What occurs in subtype 4 of osteogenesis imperfecta?

A

AUTOSOMAL DOMINANT-short statures, moderate skeletal fragility,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which pathology has increased porosity of the bone with resultant increased fragility?

A

osteoporosis- senile is the most common form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do women have osteoporosis at an older age?

A

decrease in estrogen after menopause, increase in IL-1, IL-6, TNF levels, increased levels of RANK, RANKL, increased osteoclast activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does osteoporosis occur in aging (not because of post-menopausal occurrences)

A

decreased replicative activity of osteoprogenitor cells, decreased synthetic activity of osteoblasts, decreased biological activity of matrix bound growth factors, reduced physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why do you see osteoporosis develop in women before men?

A

Estrogen drops in women before testosterone drops in men. Men can get osteoporosis when their testosterone drops, usually later in life than women do.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are other reasons for osteoporosis?

A

increased cortisol, hyperthyroidism, calcium deficiency, and significant inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is caused by osteitis fibrosa cystica?

A

primary or secondary hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the symptoms of osteitis fibrosa cystica?

A

osteolytic lesions, “brow tumor” of the bone: cystic spaces, lined by multinucleated osetoclasts, filled with vascular stroma, brown in color due to hemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What could osteitis fibrosis cystica mimic?

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is usually wrong with elderly people’s diet that results in oseoporosis?

A

They do no eat enough protein (they do not have the appetite for it) or they do not absorb enough. Problems with absorption could be that they do not have enough digestive enzymes for protein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What labs are commonly seen in OFC?

A

high PTH, high Ca, low P, high serum alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What presents in osteomalacia?

A

vitamin D deficiency in adults, defective calcification of osteoid matrix, diffuse radiolucency, it can mimic osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What presents in rickets?

A

vitamin D deficiency in children, decreased calcification AND excess accumulation of osteoid, thickening of epiphyseal growth plates, craniotabes=thinning and softening of occipital and parietal bones, delayed closing of fontanelles, pigeon breast (protrusion of the sternum), rachitic rosary: thickened costochondral junctions causing string of beads appearance, harrison groove= depression along the line of diaphragm insertion, bowed legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Osteitis deformans presents with what? What bones are most likely affected?

A

abnormal bone structure, most commonly affecting the spine, pelvis, skull, femur, tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Physiologically, what happens in osteitis deformans- paget’s disease?

A

increased osteblastic AND osteoclastic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which viruses cause osteitis deformans-paget's disease?
Intranuclear inclusions of measles, paramyxovirus, respiratory syncytial virus
26
Who typically presents with paget's disease?
elderly
27
Can paget's disease involve only one bone? (mono-ostotic)
yes
28
What do the labs look like in someone with paget's disease?
increased alkaline phosphatase, normal calcium and phosphate
29
What are the three major phases of paget's disease?
1.)osteolytic phase- increased relative activity of osteoclasts, resorption of the bone is prominent, 2.) Mixed osteilytic-osteblastic phase- New bone formation, onset of characteristic mosaic pattern, 3.) Thick trabeculae, Prominent mosaic pattern, overall bone density increased
30
Which disease has failure of osteoclastic activity (bone density increases)?
osteopetrosis "stone bone", known as marble bone disease or albers-schonberg disease (building bone w/o breaking down)
31
What are symptoms of osteopetrosis?
despite increased bone density, fragility of bones is increased as well, anemia due to suffocation of bone marrow, impingement of neural foramina (blindness, deafness due to nerve damage)
32
What are the differences between the autosomal recessive and dominant forms of osteopetrosis?
autosomal recessive is usually deadly in neonatal period, dominant is less severe- asymptomatic or scoliosis and stunted growth occurs in dominant
33
Calcium levels are normal in what pathologies?
osteoporosis, osteitis deformans, osteopetrosis
34
Calcium levels are decreased in what pathologies?
osteomalacia, rickets (or they could be normal in rickets)
35
calcium levels are increased in which pathology?
osteitis fibrosa cystica
36
phosphorous levels are normal in which pathologies?
osteoporosis, osteitis deformans, osteopetrosis
37
phosphorous levels are decreased in which pathologies?
osteomalacia, rickets, osteoitis fibrosa cystica
38
Alk-phos levels are variable in which pathologies?
osteoporosis, osteomalacia, osteitis deformans
39
Alk-phos levels are elevated in which pathologies?
rickets, osteoitis fibrosa cystica, osteopetrosis
40
PTH levels are elevated in which pathologies?
osteomalacia, rickets, osteitis fibrosa cystica
41
PTH levels are normal in which pathologies?
osteoporosis, osteitis deformans, osteopetrosis
42
How does osteoporosis present on a DEXA scan?
decreased bone density
43
How does osteomalacia present?
low vitamin D, soft bones
44
How does rickets present?
low 25-OH-vitamin D, soft bones
45
How does osteitis fibrosa cystica present?
brown tumors, cystic lesions
46
how does osteitis deformans present?
abnormal "mosaic" architecture of the bone
47
How does osteopetrosis present?
thick "marble" bones, increased # of fractures
48
Which bone pathology is deficient in vitamin C?
scurvy
49
How does scurvy present?
impaired formation of osteoid matrix, subperiosteal hemorrhage (painful!), osteoporosis, especially in metaphyseal areas, non-replacement with metaphyseal cartilage with bone
50
What occurs in fibrous dysplasia?
replacement of the bone with fibrous tissue- but the etiology is unknown
51
What are the three major types of fibrous dysplasia?
monostotic- often asymptomatic, but may result in sudden fracture. polystotic- associated with severe deformities. McCune-Albright syndrome- precocious puberty in girls, cafe-au lait spots, short stature
52
Why does avascular necrosis occur?
death to the bone due to decreased blood supply- there are various theories but there is no solid etiology
53
What are the risk factors for avascular necrosis?
Meds: chemo, steroids, or any condition that decreases perfusion (HTN, atherosclerosis), any condition that increases embolism formation (sickle cell, infection), trauma
54
When does avascular necrosis affect teenagers and children?
Legg-Calve-Perthes syndrome - affects capital femoral epiphyses Osgood-Shlatter syndrome – affects tibial tubercle Kuhler bone disease – affects navicular bone of the foot
55
How are children affected by osteomyelitis?
due to hematogenous spread of infection from some place else- staph A, E coli, group B beta hemolytic strep, salmonella with kids w/ sickle cell
56
How are adults affected by osteomyelitis?
Usually, complication from a fracture or surgery, IV drug users get pseudomonas (haha STAPH A actually) bone infections
57
How does osteomyelitis affect ALL age groups?
Most likely affected sites: distal femur, proximal tibia, proximal humerus Fever, pain, malaise In acute stage, may be resolved by antibiotic If untreated, may progress to ischemic necrosis of the bone (sequestrum) and marrow Subperiosteal dissection may burst and create sinuses draining through the skin A sleeve of new bone (involucrum) may form around necrotic bone
58
What is the most common benign tumor of the bone?
osteochondroma-exostosis
59
How does osteochondroma present?
``` Bone growth with cartilage covering Affects men under 25yo (most likely) Most likely to affect metaphysis Can occur in rare familial disease called multiple familial osteochondromatosis Multiple lesions Malignant transformation possible ```
60
How does a bone giant cell tumor present?
oval or spindle shaped cells mixed with multinucleated giant cells, most likely to affect epiphysis, 50% affect the knee, SOAP BUBBLE APPEARANCE ON XRAY- BUZZ WORDDDDD***
61
What is the most common primary malignant tumor for bone?
osteosarcoma
62
How does osteosarcoma present?
Occurs in the metaphysis of long bones Proximal tibia, distal femur, about the knee Pain and swelling, CAN METASTASIZE TO LUNG, LIVER AND BRAIN Occasionally, pathologic fracture Characteristic X-ray appearances: Codman triangle: lifting of the periosteum by the tumor Sunburst appearance – spikes along the pattern of growth***** BOTH BUZZ WORDSSS CODMAN AND SUNBURST
63
What are the risk factors for osteosarcoma?
ionizing radiation, bone infarcts, trauma
64
How does chondrosarcoma present?
``` Cartilaginous tumor May arise from multiple ostreochondromas or multiple enchondromas Prefers: Pelvis Spine Scapula May arise in: Proximal humerus Proximal femur Proximal tibia ```
65
In what pathology do you see "small blue cells"?
ewing sarcoma-extremely anaplastic
66
How does chondrosarcoma present?
``` Occurs most often in Long bones Ribs Pelvis Scapula Peak incidence: boys younger than 15 ```
67
How aggressive is chondrosarcoma?
very aggressive, but it responds well to chemo
68
In early stages, what pathology does chondrosarcoma mimic?
osteomyelitis with systemic symptoms
69
How does osteochondroma present?
Cartilage-capped subperiosteal bony projection from bone surface, distal femur- proximal tibia, males < 25 years old
70
How does a giant cell tumor present?
Multinucleated giant cells and fibrous stroma, Epiphyses of the long bones, distal femur, proximal tibia, Females 20yo-40yo
71
How does enchondroma present?
Intramedullary cartilagenous growth, bones of the hands and feet, no gender or age preference,
72
How does endosarcoma present?
osteoid and bone presenting neoplasm, distal femur, proximal tibia, around the knee, males 10-20 years old
73
How does chondrosarcoma present?
cartilagenous tumor, pelvis, femur, proximal tibia, ribs, vertebrae, males 30-60 years old
74
How does ewing sarcoma present?
undifferentiated small blue cells, lone bones, pelvis, scapula, ribs males <15 years old
75
What does rheumatoid arthritis affect?
joints
76
Which gender gets rheumatoid arthritis more commonly?
women
77
What is the etiology of rheumatoid arthritis?
Most likely autoimmune, Characterized by the presence of RF, rheumatoid factor, and IgM antibody with Anti-IgG activity, More likely in people with HLA-DR4
78
Physiologically, what presents with rheumatoid arthritis?
Synovitis, edema, inflammatory infiltrate with neutrophils that are followed by lymphocytes, Hyperplasia and hypertrophy of synovial lining cells, Granulation tissue extends over articular cartilage, Erosion and cyst formation in subchondral bone, scarring, contractures and deformities, may present with sub cutaneous nodules
79
What are the symptoms of rheumatoid arthritis?
``` Joint swelling and stiffness that lasts more than 30min in the morning or a period of inactivity, Fatigue, malaise, Polyarticular symmetric joint, involvement, Chronic changes include: Boutonniere’s deformity, Ulnar deviation of MCP joints, Swan-neck deformity of PIP and DIP joints ```
80
How is seronegative arthritis different from rheumatoid arthritis?
seronegative arthritis is negative for RF and is associated with HLA-B27
81
What are the symptoms of seronegative arthritis?
Ankylosing spondilitis-Affects spine and sacroiliac joints, “Bamboo” spine with lacy osteophytic projections, Reiter’s syndrome-Urethritis, conjunctivitis and arthritis,“can’t see, can’t pee, can’t dance with thee”, associated with STDs or intestinal infections, psoriartic arthritis
82
What occurs in osteoarthritis?
Non-inflammatory joint degeneration, Cartilage degeneration with new bone deposition Eburnation – polished, ivory appearance of the bone Cystic changes in subchondral bone, Increased density of the bone, Osteophytes – bone spurs Joint mice – broken off osteophytes in the synovial fluid, heberden nodes-affect DIP, bouchard nodes-affect PIP
83
How does gout present?
Deposition of urate crystals in the tissues, especially in the joints, Intensely inflammatory, IgG opsonizes crystals, Phagocytosis by neutrophils follows, Released proteolytic enzymes, create more damage and inflammation, Affect MTP joint of the great toe, but can affect any joint, Alcohol and large meals precipitate it, May be secondary to malignancy leading to significant cell turnover- leukiemias, multuple myeloma
84
Infective arthritis- what bacteria is the most common form of bacterial arthritis?
gonorrhea
85
Where does infective arthritis usually present?
single joint involvement, most likely, knee, wrist or arm or small joints of the hand
86
What presents in Lyme disease?
Polyarticular involvement, Knee and other large joints, like elbow, Characterized by significant joint effusion with fluid that is Negative for RF – not supportive of RA, shows no bacterial growth, lyme is fastidious, moderate neutrophilia, re-occurence of effusion within weeks of draining

Pathophysiology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions