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Endocrine- MHD > Bone Pathology I > Flashcards

Bone Pathology I Flashcards

1
Q

What type of tissue is bone?

A

Connective tissue

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2
Q

What is the inorganic component of bone?

A

Hydroxyapatite

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3
Q

What is the organic component of bone?

A

Cells, protein, type I collagen

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4
Q

What is unmineralized bone called?

A

Osteoid

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5
Q

What is endochondral bone formation and which bones are made this way?

A

Mineralized bone is laid on top of a cartilage matrix

Most bones (long bones) are formed this way

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6
Q

What is intramembranous bone formation and which bones are formed this way?

A

Formation of the bone without preexisting cartilage matrix. Bone formation occurs within membrane-like mesenchymal condensations

Flat bones (skull, rib cage, mandible) are made this way

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7
Q

Fractured bones repair themselves via what process?

A

Callus formation

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8
Q

What is a pathologic fracture?

A

Bone that breaks due to an underlying disease process (non-traumatic)

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9
Q

What is osteoporosis?

A

Absolute decrease in bone mass

Leads to increased risk of fracture

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10
Q

What causes localized osteoporosis?

A

Disuse

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11
Q

What are the two types of primary osteoporosis?

A

Post-menopausal

Senile (in men)

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12
Q

How does bone remodeling lead to osteoporosis?

A

As we age, osteoclast activity > osteoblast activity

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13
Q

What cells are responsible for activating osteoclasts?

A

Surface osteoblasts

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14
Q

RANK receptors are located on what type of cell?

A

Osteoclasts

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15
Q

RANK signaling activates what?

A

NFkappaB –> important for osteoclast generation and survival

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16
Q

RANK ligand is on which cell?

A

Osteoblasts

17
Q

What is the mechanism by which osteoblasts inhibit activation of osteoclasts?

A

Production of OPG

OPG binds to RANK ligand and inhibits interaction with the RANK receptor on osteclasts

18
Q

How are RANK and RANKL affected by menopause?

A

Increase expression of both RANK and RANKL in menopause contributes to osteoporosis (through increased activation of osteoclasts)

19
Q

Which bones are more inclined to fracture?

A

Vertebra, wrist, ribs, pelvis

20
Q

What is the etiology of rickets/osteomalacia?

A

Vitamin D deficiency –> bone mineralization defect and accumulation of osteoid (unmineralized bone)

21
Q

How does vitamin D affect calcium absorption?

A

Vitamin D increase calcium and phosphate absorption from the gut

22
Q

What is osteomalacia?

A

Lack of vitamin D in adults

Loss of bone density (osteopenia)–> fractures and microfractures, bone pain

23
Q

What happens to the bones of children with Ricketts?

A

The growth plate is not adequately mineralized –> osteoclasts do not absorb the growth plate cartilage and you end up with excess cartilage and lack of mineralized bones.

24
Q

How do joints of children with rickets appear?

A

Knobby/enlarged- due to lack of absorption of cartilage.

25
Q

What causes primary hyperparathyroidism?

A

Adenoma
Hyperplasia
Carcinoma

26
Q

What causes secondary hyperparathyroidism?

A

Prolonged hypocalcemia

27
Q

What is a brown tumor?

A

With hyperparathyroidism, increase Ca resorption from bone –> microfractures

Microfractures cause hemorrhage in the bone, which recruits macrophages and results in extensive repair with ingrowth of fibrous tissue

28
Q

Why is advanced hyperparathyroidism rarely seen these days?

A

Calcium levels are checked when you order an BMP

29
Q

What is Paget’s disease of the bone?

A

Disease caused by osteoclast dysfunction- excessive bone resorption followed by disorganized, excessive bone formation

30
Q

What is the pattern of bone seen in Paget’s disease of the bone?

A

“Mosaic pattern” of bone- with “cement lines” in between bones

31
Q

What is the risk associated with high vascularity of bones?

A

High output heart failure- shunting of blood to hypervascular areas

32
Q

What is the most dreaded complication of paget’s disease of the bone?

A

Osteosarcoma
Fibrosarcoma
5-10% of patients

33
Q

What is the treatment for Paget’s disease of the bone?

A

NSAIDS for pain

Inhibitors of osteoclast function (bisphosphonates, calcitonin)

34
Q

What blood serum finding may be seen in someone with Paget’s disease?

A

Elevated alkaline phosphatase

other causes- obstructive liver disease

Endocrine- MHD (17 decks)

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