Bone Pathology And Soft Tissue Pathology Flashcards

1
Q

What are the regions in the long bone

A

Epiphysis

Diaphysis

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2
Q

What is the epiphysis

A

Ends of the bone

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3
Q

What is the diaphysis

A

Shaft of the bone

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4
Q

What does an osteon unit have

A

Haverian canal

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5
Q

What are the haversian canal linked by

A

Volksmann canal

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6
Q

What are the 3 main functions of the bone

A

Mechanical: function for muscles
Endocrine regulation
Haemopoiesis (red bone marrow)

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7
Q

What is bone composed of

A

Water
Anorganic part
Organic part

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8
Q

What is the anorganic part

A

Calcium in the form of hydroxyapatite crystals
Inorganic salts
Fluorids
Trace elements

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9
Q

What is the organic part

A

Collagen fibres

Proteoglycans

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10
Q

What cells are involved in bone remodelling

A

Osteoprogenitor cells
Osteoblasts
Osteocytes
Osteoclasts

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11
Q

What cells does osteoprogenitor cells give rise to

A

Osteoblast and osteoclasts

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12
Q

What are osteocytes

A

Inactive form of osteoblasts

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13
Q

What are the types of bone that belong to the lamellar bone

A

Compact and cancellous

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14
Q

What is woven bone

A

Physiological bone in fertile development

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15
Q

When we see woven bone in adults is that normal

A

No it is pathological

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16
Q

What is achondroplasia

A

Autosomal dominant bone disease caused by FGFR3 mutation that inhibits chondrocyte proliferation

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17
Q

What happens when you block chrondrocyte proliferation in long bones

A

The epihyseal plate chrondrocyte proliferation decreases so you have shortening of the the long bones

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18
Q

What is brittle bone disease (osteogenesis imperfecta)

A

Autosomal dominant genetic disorder that affects type 1 collagen synthesis

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19
Q

Which cell decreases in activtiy in brittle bone disese

A

Osteoblast

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20
Q

What other parts of the body does the collagen disorder synthesis affect

A

Skin
Joints
Sclera

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21
Q

What is osteopetrosis (marble bone disease)

A

Autosomal recessive disorder

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22
Q

What occurs in osteopetrosis

A
  1. Carbonic anhydrase 2 deficiency (enzymes required for acidification and excretion of hydrogen ions)
  2. Acidification is required for a space that osteoclast sit in called howship lucunae
  3. There is therefore reduced osteoblast bone resorption
  4. This causes a systemic sclerosis
  5. Bone becomes prone to fracture
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23
Q

Which hormones are involved in regulating bone homeostasis

A
Parathormone (PTH)
Calcitonin
STH
Oestrogen and androgen
Steroid hormone
Vitamin d and c
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24
Q

What happens to the boen when there is a disrupted hormonal homeostasis

A

Decreased or increased bone mass

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25
Q

What is a common disease of the bone that is associated with decreased bone mass

A

Osteoporosis

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26
Q

What is primary osteoporosis due to

A

Post menopausal

Senile

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27
Q

What is secondary osteoporosis due to

A

Hyperparathyroidism
Hypothyroidism
Multiple myeloma
Drugs: corticosteroids, anticoagulants, chemotherapy

28
Q

How can vitamin d deficiency alao cause osteoporosis

A

Vitamin d deficiency leads to poor bone mineralisation this mobilises calcium and phosphoate ions from the bone leading to osteoporosis

29
Q

What happens to the osteoblast activity in osteoporosis

A

Decreases

30
Q

What is osteomalacia

A

Poor calcification that causes a delay of bone mineralisation usually due to vitamin d deficiency

31
Q

Who does osteomalacia occur in

A

Adults

32
Q

What is rickets

A

Osteomalacia occuring in children

33
Q

What are the clinical features of rickets

A
Wide sutures in head
Delayed closure of frontanelles 
Bowing of legs 
Pectus carinatum 
Swelling in wrist and ankle
34
Q

What can hyperparathyroidism be

A

Primary

Secondary

35
Q

What is primary hyperparathyroidism

A

Tumour (adenoma or carcinoma) or hyperplasia of the parathyroid gland

36
Q

What is secondary hyperparathyroidism

A

Compensatory overactive parathyroid glands due to chronic renal failure

37
Q

What role does pth have

A

Calcium homeostasis

38
Q

What will hyperparathyroidism lead to

A

Osteoporosis of bone

39
Q

What cells does PTH activate in the bone

A

Osteoclast

40
Q

What is pagets disease

A

Disease of osteoclast dysfunction

41
Q

What are the phases of pagets disease

A
  1. Osteolytic phase: increased osteoclast activity
  2. Mixed phase: bone tries to compensate to osteoblast activity is on
  3. Osteosclerotic phase
42
Q

What is osteomyelitis

A

Infectious process of the bone

43
Q

Wat is the route of entry of infection

A
  • Contigous spread of adjoining soft tissue infection
  • Direct inoculation secondary to trauma or surgery
  • Haemtegenous bacterial emboli lodging in the bone
44
Q

What are the features of ostemyelitis

A

Pain
Fever
Incresed WBC
Edema, erythema and tenderness of site of infections

45
Q

What is potts disease

A

A type of osteomyelitis and is tuberuculosis of the spine due to haematogenous spread

46
Q

What is the prefix for benign bone tumours

A

-oma

47
Q

What is the prefix for malignant bone tumours

A

-sarcoma

48
Q

What is a primary bone tumour in the osteocytes

A

Osteosarcoma

49
Q

What is a primary bone tumour in the cartilage

A

Chondrosarcoma

50
Q

What is osteoid osteoma

A

Benign tumour

51
Q

Where does osteoid osteoma occur

A

Intracortical of long bones, small bone and vertebra

52
Q

What are the symptoms of osteoid osteoma

A

Nocturnal pain relieved by aspirin and NSAIDs

53
Q

What is echondroma

A

Benign cartilagenous tumour

54
Q

What are the common sites of echondroma

A

Small bones of hands and feet

55
Q

What are the background diseases that can occur in echondroma

A

Maffucis syndrome

Olliers disease

56
Q

What is the treatment of echondroma

A

excision of the tumour

57
Q

What is giant cell tumour of the bone

A

Locally agressive neoplasmis composed of neoplastic opiod mononuclear cells

58
Q

What is the common site for giant cell tumour of the bone

A

End of long bone (epiphyseal)

59
Q

What is the treatment of giant cell tumour of the bone

A

Denosumab

60
Q

What is the action of denosumab

A

Blocks osteoclast acitvity and stops osteolytic part of tumour manifestation

61
Q

What is high grade osteosarcoma

A

Malignant tumour that produces osteoid from tumour cells

62
Q

What is the characteristic finding of osteosarcoma

A

Codmans trianlge

63
Q

What is ewing sarcoma

A

Common bone sarcoma in children

64
Q

Symptoms of ewing sarcoma

A

Fever
Weightloss
Leukocytosis
Mimicks osteomyelitis

65
Q

What are the common cancers that can metastase to bone

A
Breast
Prostate
Lung
Thryoid 
Kidney 
Neuroendocrne
Colorectal 
Squamous cell carcinoma