Bone Pathology Flashcards

1
Q
  • Hematogenous spread by bacteremia from trivial causes
  • Causes worm eaten lytic lesions showing necrotic resorbing bone masses used as a scaffold by osteoblasts to form new bone
    • Marrow spaces replaced by pus
A

Osteomyelitis

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2
Q
  • Type 1 collagen is defective with inadequate bone formation resulting in thin cortices and trabeculae
  • Mistaken for child abuse
  • Autosomal Dominant
  • Feature: dentinogenesis imperfecta and blue sclera
A

Osteogenesis Imperfecta

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3
Q
  • Osteoclasts lack the ability to remodel bone, causing obliteration of marrow space
  • Marrow crowded out, causing myelophthisic anemia and extramedullary hematopoiesis with hepatosplenomegaly
  • Deafness and Blindness due to constricted nerve ostea
  • Dense bone easily infected causing osteomyelitis
  • Autosomal Dominant most common and compatible with survival
  • Autosomal Recessive causes death by anemia
A

Osteopetrosis - Marble Bone Ds

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4
Q

Explain how Estrogen is protective in Osteoporosis of Post-Menopausal Women.

A
  • Counter acts cytokines (IL-1, 6, TNF) by monocytes that cause resorption by:
    • Augmenting RANK receptor
    • Recruiting osteoclasts
  • Stimulates OPG (inhibits osteoclasts)
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5
Q
  • Spontaneous wedge shaped infact of medullary subchondral bone mostly in the head of femur
A

Aseptic (Avascular) Necrosis

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6
Q
  • Increased remodleing not in response to physiological demands
  • Increased thickness of architecturally weak bone
  • Disease of Elderly
  • Cause - paramyxovirus
  • Cotton wool appearance in skull
  • Increase in skull (hat) size
  • Maxillary expansion
  • Complication of High CO Failure
  • Dx - elevated alkaline phosphatase
A

Paget Disease - Osteitis Deformans

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7
Q
  • Develpmental bone disease of continued production of immature bone matrix
  • A switch for bone growth is turned on
    • Non-heritable somatic mutation
    • Continual production of cAMP (causes bone matrix formation)
  • Severity depends on how early in embryogenesis the mutation occurs
  • Begins in childhood, stopping after growth spurt
  • Chinese Character Lettering - trabeculae form without regard to physiologic demands
  • Woven bone matrix forms metaplastically from stroma, without osteoblastic rimming
A

Fibrous Dysplasia

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8
Q

What is the worst form of Fibrous Dysplasia?

A

Albright Sx - severe polyostotic (many bones affected) fibrous dysplasia + precocious puberty in females; mutation occurs in the embryo

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9
Q
  • X-linked Dominant
  • Kidney can’t resorb phosphate (it is excreted in urine)
  • Short stature
  • Elongated pulp horns stretch all the way to the DEJ, resulting in exposure upon tx
A

Vitamin D Resistant Rickets - Hypophosphatemia

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10
Q
  • Deficiency of tissue alkaline phosphatase
  • Hammared copper skull appearance
  • Wide pulp canals
  • Early deciduous tooth loss due to lack of cementum
  • Dx Tests:
    • urinary phosphoethanolamine
    • Low serum alkaline phosphatase
A

Hypophosphatasia

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11
Q
  • Adenoma secreting PTH, causing hypercalcemia
  • Ca is leached out of the bone into the blood, leaving rarefied bone or giant cell lesions composed of osteoclasts (brown tumor)
  • High serum Ca –> Metastic calcification with:
    • depostion in kidneys, pancreatic ducts
    • causes gastrin secretion (peptic ulcers)
A

Primary Hyperparathyroidism

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12
Q
  • Compensatory PTH release triggered by low serum Ca, usually due to phosphate retention seen in kidney failure
A

Secondary Hyperparathyroidism

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13
Q
  • Benign neoplasm of bone
  • Tumor composed of mature bone
  • Projects as a slow growing bony mass
  • Multiple osteomas of facial and jaw bones signal Gardner Sx
A

Osteoma

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14
Q
  • Small tumor, not clinically noted
  • Long bones, rarely jaws
  • Sever pain at night - relieved by aspirn
    • Pain produced by prostaglandin E produced by osteoblasts
  • Men age 10-20
  • Histology shows osteoblasts producing bone
A

Osteoid Osteoma

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15
Q
  • Large tumor
  • Most cases in spine; some in jaws
  • Dull Pain - not relieved by aspirin
  • Men age 10-20
  • Histology shows osteoblasts producing bone
A

Osteoblastoma

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16
Q
  • Malignant neoplasm of bone
  • 2nd decade
  • Genetic mutation of RB gene
  • Knee most common site
  • Sunburst appearance on x-ray due to reactive periosteal bone formation
  • Spreads through blood to lungs
A

Osteosarcoma

17
Q
  • Men > 40
  • Central portion of the body; axial skeleton
  • Mesenchymal Variant - occurs in JAWS in YOUNG people and is very aggressive
A

Chondrosarcoma

18
Q
  • Malignant neoplasm of plasma
  • Most common primary tumor of bone
A

Multiple Myeloma

19
Q
  • Malignant neoplasm of precursors of neuroblasts
  • Chromosomal translocations produce oncoproteins that stimulate cell growth
  • Small round cell tumor of medullary portion of bone, particularly in white male chlidren
  • Most in leg bones and pelvis
  • Grow rapidly
  • X-ray - lytic lesion; cortex shows onion skinning of bone due to periosteal attempt to keep up with tumor growth
A

Ewing Sarcoma

20
Q
  • Neoplasm of macrophages and osteoclasts
  • Around knee joint; young to midle aged adults; NEVER IN JAWS
  • Composed of sheets of mononuclear round cells (MACs) and Giant cells (osteoclasts)
    • Resemles brown tumor
A

Giant Cell Tumor

21
Q

Metastic cancers show up on X-rays as moth eaten lytic radiolucencys except prostate, which causes …

A

osteoblastic radiopaque metastases

22
Q

What is Osteoarthritis of the distal phalanges of women known as?

A

Heberden nodes

23
Q

Most common sarcoma of childhood, most in HandN, and GU system

A

Rhabdomyosarcoma (SKM)

24
Q

More common in women (uterus), skin, retroperitoneum

A

Leiomyosarcoma (SM)

25
Q

Most common sarcoma in adults, most in retroperitoneum

A

Liposarcoma (fat)