Bone Pathology And Soft Tissue Pathology

Question 1

What are the regions in the long bone

Answer 1

Epiphysis

Diaphysis

Question 2

What is the epiphysis

Answer 2

Ends of the bone

Question 3

What is the diaphysis

Answer 3

Shaft of the bone

Question 4

What does an osteon unit have

Answer 4

Haverian canal

Question 5

What are the haversian canal linked by

Answer 5

Volksmann canal

Question 6

What are the 3 main functions of the bone

Answer 6

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

Question 7

What is bone composed of

Answer 7

Water
Anorganic part
Organic part

Question 8

What is the anorganic part

Answer 8

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

Question 9

What is the organic part

Answer 9

Collagen fibres

Proteoglycans

Question 10

What cells are involved in bone remodelling

Answer 10

Osteoprogenitor cells
Osteoblasts
Osteocytes
Osteoclasts

Question 11

What cells does osteoprogenitor cells give rise to

Answer 11

Osteoblast and osteoclasts

Question 12

What are osteocytes

Answer 12

Inactive form of osteoblasts

Question 13

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

Answer 13

Compact and cancellous

Question 14

What is woven bone

Answer 14

Physiological bone in fertile development

Question 15

When we see woven bone in adults is that normal

Answer 15

No it is pathological

Question 16

What is achondroplasia

Answer 16

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

Question 17

What happens when you block chrondrocyte proliferation in long bones

Answer 17

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

Question 18

What is brittle bone disease (osteogenesis imperfecta)

Answer 18

Autosomal dominant genetic disorder that affects type 1 collagen synthesis

Question 19

Which cell decreases in activtiy in brittle bone disese

Answer 19

Osteoblast

Question 20

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

Answer 20

Skin
Joints
Sclera

Question 21

What is osteopetrosis (marble bone disease)

Answer 21

Autosomal recessive disorder

Question 22

What occurs in osteopetrosis

Answer 22

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

Question 23

Which hormones are involved in regulating bone homeostasis

Answer 23

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

Question 24

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

Answer 24

Decreased or increased bone mass

Question 25

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

Answer 25

Osteoporosis

Question 26

What is primary osteoporosis due to

Answer 26

Post menopausal | Senile

Question 27

What is secondary osteoporosis due to

Answer 27

Hyperparathyroidism Hypothyroidism Multiple myeloma Drugs: corticosteroids, anticoagulants, chemotherapy

Question 28

How can vitamin d deficiency alao cause osteoporosis

Answer 28

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

Question 29

What happens to the osteoblast activity in osteoporosis

Answer 29

Decreases

Question 30

What is osteomalacia

Answer 30

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

Question 31

Who does osteomalacia occur in

Answer 31

Adults

Question 32

What is rickets

Answer 32

Osteomalacia occuring in children

Question 33

What are the clinical features of rickets

Answer 33

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

Question 34

What can hyperparathyroidism be

Answer 34

Primary | Secondary

Question 35

What is primary hyperparathyroidism

Answer 35

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

Question 36

What is secondary hyperparathyroidism

Answer 36

Compensatory overactive parathyroid glands due to chronic renal failure

Question 37

What role does pth have

Answer 37

Calcium homeostasis

Question 38

What will hyperparathyroidism lead to

Answer 38

Osteoporosis of bone

Question 39

What cells does PTH activate in the bone

Answer 39

Osteoclast

Question 40

What is pagets disease

Answer 40

Disease of osteoclast dysfunction

Question 41

What are the phases of pagets disease

Answer 41

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

Question 42

What is osteomyelitis

Answer 42

Infectious process of the bone

Question 43

Wat is the route of entry of infection

Answer 43

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

Question 44

What are the features of ostemyelitis

Answer 44

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

Question 45

What is potts disease

Answer 45

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

Question 46

What is the prefix for benign bone tumours

Answer 46

-oma

Question 47

What is the prefix for malignant bone tumours

Answer 47

-sarcoma

Question 48

What is a primary bone tumour in the osteocytes

Answer 48

Osteosarcoma

Question 49

What is a primary bone tumour in the cartilage

Answer 49

Chondrosarcoma

Question 50

What is osteoid osteoma

Answer 50

Benign tumour

Question 51

Where does osteoid osteoma occur

Answer 51

Intracortical of long bones, small bone and vertebra

Question 52

What are the symptoms of osteoid osteoma

Answer 52

Nocturnal pain relieved by aspirin and NSAIDs

Question 53

What is echondroma

Answer 53

Benign cartilagenous tumour

Question 54

What are the common sites of echondroma

Answer 54

Small bones of hands and feet

Question 55

What are the background diseases that can occur in echondroma

Answer 55

Maffucis syndrome | Olliers disease

Question 56

What is the treatment of echondroma

Answer 56

excision of the tumour

Question 57

What is giant cell tumour of the bone

Answer 57

Locally agressive neoplasmis composed of neoplastic opiod mononuclear cells

Question 58

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

Answer 58

End of long bone (epiphyseal)

Question 59

What is the treatment of giant cell tumour of the bone

Answer 59

Denosumab

Question 60

What is the action of denosumab

Answer 60

Blocks osteoclast acitvity and stops osteolytic part of tumour manifestation

Question 61

What is high grade osteosarcoma

Answer 61

Malignant tumour that produces osteoid from tumour cells

Question 62

What is the characteristic finding of osteosarcoma

Answer 62

Codmans trianlge

Question 63

What is ewing sarcoma

Answer 63

Common bone sarcoma in children

Question 64

Symptoms of ewing sarcoma

Answer 64

Fever Weightloss Leukocytosis Mimicks osteomyelitis

Question 65

What are the common cancers that can metastase to bone

Answer 65

``` Breast Prostate Lung Thryoid Kidney Neuroendocrne Colorectal Squamous cell carcinoma ```