Bone pathology

Question 1

main types of fractures

Answer 1

1. Simple - 6 weeks
2. Greenstick - usually occurs in child
3. Compound - open fracture. More chance of infection
4. Comminuted
5. Spiral
6. Pathologic

Question 2

Healing impairment of fractures

Answer 2

• Movement during repair phase
  
  • Interposed soft tissue
  • Gross misalignment
  • Infection
    Pre-existing bone disease

Question 3

factors that contribute to attaining peak bone mass.

Answer 3

Partially genetic
Nutrition
Physical activity

Question 4

risk factors for the development of osteoporosis

Answer 4

genetic factors, physical activity, nutrition, menopause, aging
Loss of bone mass
Not attaining full bone mass
Treated with gluccocorticoids

Question 5

tumours that occur in the skeletal system

Answer 5

Benign 
Osteoma 
Chondroma 
Fibroma 
Giant cell tumour

Malignant
Osteosarcoma
Chondrosarcoma
Ewing’s sarcoma

Secondary tumours
Trabecular
- Common site
Causes weakening and pain of bone

Question 6

how bone loss may be retarded/accelerated.

Answer 6

Menopause - loss of estrogenic activity

Sarcopeonia - skeletal muscle atrophy

Question 7

Gout risk factors

Answer 7

common systemic metabolic disorder often affecting the joints and soft tissue

Increases with age, rare in females before menopause
Indigenous population at greatest risk  Increased incidence due to age, obesity and consumption of alcohol and fructose-sweetened drinks

Question 8

Why are the bones frequently affected by metastatic cancer?

Answer 8

secondary more likely than primary

• large arterial blood supply
• growth factors

Question 9

What impact does renal failure have on the musculoskeletal system?

Answer 9

Osteomalacia
Lack of activation of vitamin D

Less absorption of dietary calcium

Serum level of calcium go down

Parathyroid is overactivated trying to get more calcium from bone and kidneys

Kidney no longer functioning
and not getting rid of phosphate

Calcium gets into urine, extra loss of calcium

Bone is calcified as parathyroid attempts to balance out calcium levels

Question 10

Rheumatoid arthritis cause

Answer 10

Chronic, Autoimmune 
	- Genetic predisposition 
	- Environmental influences
	- 1% population 
Females more than males
Chronic inflammation

Question 11

Pathologic fracture

Answer 11

occurs in bones already weakened by disease

caused by all bone disease

Question 12

Osteoarthritis causes

Answer 12

Wear and tear
Athlete
Heavy weight

Question 13

Osteoarthritis features

Answer 13

Irregular joint space
	Cartilage is worn down
	Underlying bone is exposed
	Cystic change 
	Osteophytes
	Pain, stiffness, swelling impaired movement
	Low levels of swelling
	“Swelling”:
	- Bony: hard due to osteophyte formation
	- Spongy: due to synovial thickening
Some soft tissue swelling

Question 14

Gout consequences

Answer 14

Hyperuricemia - deposition of urate crystals in tissues, inflammation of joints

Question 15

Paget’s disease

Answer 15

Common chronic disease of unknown aetiology
5-10% Caucasian population
Irregular restructuring of bone – thickening & deformities of bones
Complications: osteosarcoma, pathologic fracture

Question 16

Name 3 joint diseases

Answer 16

1. gout
2. Osteoarthritis
3. Rheumatoid arthritis

Question 17

Name 4 bone disease

Answer 17

1. Osteoporosis
2. Osteomalacia
3. Osteomyelitis
4. Paget’s disease

Question 18

Normal function of kidney regarding calcium

Answer 18

1. Regulate serum levels of calcium and phosphate

2. Activation of vitamin D

Question 19

Osteomyelitis

Answer 19

Inflammation of bone and marrow

- infection or aseptic

Question 20

Osteomalacia

Answer 20

Softening of bones caused as a result of vitamin D deficiency
rickets - osteomalacia in children

Question 21

Consequences of osteoporosis

Answer 21

• pathologic fractures
• reduced activity and independence
• impacts on drug prescription

Question 22

Risks caused by paget’s disease

Answer 22

• osteosarcoma

- pathologic fracture