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Pathology III > BONES > Flashcards

BONES Flashcards

1
Q

what is epiphysis?

A

it is the part of the long bone that extends from subarticular bone plate to the base of growth plate

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2
Q

what is metaphysis and why is it important?

A

course cancellous bone
important in hematogenous infections, tumors, and skeletal malformation (arthritis)
*highly susepatable for infections

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3
Q

why does arthritis cause deformed joints?

A

because it occurs in the metaphysis ie the part of the bone that causes change

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4
Q

what is diaphysis?

A

body/shaft of the bone

zone between 2 metaphysis

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5
Q

what is the definition of woven bone?

A

haphazard organization of collagen fibers
seen in fetal developing skeleton and at growth plates
always abnormal in adults unless it is seen in fractures within the first few weeks of injury (before it becomes lamellar)

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6
Q

what is the definition of lamellar bone?

A

regular-parallels-alignment of collagen into sheets

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7
Q

what is a DEXA scan?

A

uses low xray waves to look at bone density

can also determine body fat

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8
Q

Normal DEXA scan values?

A

BMD no lower than 1 SD below the mean for young adult women

T>-1

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9
Q

What are the DEXA scan osteopenia (low bone mass) values?

A

BMD 1.0-2.5 SD below the mean for young adult women

T=-1 to -2.5

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10
Q

what is osteoporosis DEXA scan values?

A

BMD more than 2.5 SD below the young adult mean

T<-2.5

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11
Q

what are T scores based on?

A

standardized values of otherwise healthy 30 year old females

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12
Q

what is the Z score based on?

A

age and gender

does not always have a bell shaped curve for every age and gender so T scores are most generally used instead

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13
Q

where is the most sensitive place to scan for the DEXA?

A

the spine because of the abundance of cancellous bone, so osteoporotic changes are most conspicuous (seen the best)
can lead to kyphosis (dogwager’s hump)-because vertebral bodies get shorter

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14
Q

How sensitive is a DEXA scan?

A

it will miss 30% of individuals with osteoporosis

ie the DEXA with come back normal

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15
Q

who should get a DEXA?

A 
woman 65 or older
man age 70 or older
if you break a bone after age 50
women of menopausal age with risk factors
PM woman under 65 with risk factors
man age 50-59 with risk factors
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16
Q

what are other reasons to get a DEXA?

A

an x ray showing bone loss
back pain with possible break in spine
height loss of 1/2 in or more within 1 year
total height loss of 1 1/2 inches from your original height

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17
Q

NOF recommendations for Ca
adults under 50
adults over 50

A

1000 mg
1200 mg
with Vit D

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18
Q

NOF recommendations for Vit D
adults under 50
adults over 50

A

400-600 IU
800-1000 IU
* daily dose of sunlight at peak time from a minimum of 20 minutes

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19
Q

what are normal vit D levels?

A

75 nmol/L or higher

30 ng/ml or higher but less than 50 ng/ml

20
Q

what is deficient Vit D?

inadequate?

A

< 30 nmol/L (<12 ng/mL)

30-50 nmol/L (12-30 ng/mL)

21
Q

what is adequate Vit D?

Bad?

A

> or = 50 nmol/L (> or = 30 ng/ml)

125 nmol/L (>50 ng/ml)

22
Q

what is the bisphosphonates MOA and what are the four drugs?

A

inhibit osteoclasts

  • alendronate- take weekly
  • risedronate-take weekle
  • ibanddronate-take monthy
  • zoledronic acid-take every year
23
Q

MOA of forteo?

A

rPTH

intermittent exposure stimulates osteoblasts

24
Q

MOA for denosumab?

A

antibody to RANKL

25
Q

Vertebral osteomyelitis is associated with?

A 
septicemia
bacterial arthritis
pathologic fracture
SCC
amyloidosis
26
Q

Fibrous synarthrosis

A

syndesmosis-bones connected by fibrous tissue without cartilage
cranial sutures,tibiofubular syndesmoses

27
Q

cartilaginous synarthrosis

A

symphyses-joined by fibrocartilaginous tissue and firm ligaments (vertebral bodies)
synchondrosis-articular cartilage without synovium (1rst rib and sternum)

28
Q

cavitated joints

A

synovial (hole)

dense fibrous capsule reinforced buy ligaments and muscles

29
Q

uniaxial joint

A

movement around only one axis

hinge joint at elbow

30
Q

biaxial joint

A

movement around 2 axes

wrist and thumb

31
Q

polyaxial joints

A

movement in any axis

ball and socket

32
Q

plane joint

A

articular surfaces glide over on another

patella

33
Q

Tangential or gliding zone of the hyaline cartilage

A

closest to the articular surface

contains- chondrocytes and type II collagen

34
Q

Transitional zone of the hyaline cartilage

A

chondrocytes and hyaline cartilage present

35
Q

radial zone of hyaline cartilage

A

contains collagen fibers

36
Q

calcified zone of hyaline cartilage

A

calcified matrix

tidemark

37
Q

what is the tidemark?

A

it separates the radial from the calcified zone
cartilage cells regenerate here and migrate upward
chondroblasts arise in the tidemark and proliferate into chondrocytes (precursor cells are further down and they mature as they go up)

38
Q

what is the definition of eburnation?

A

conversion of bone into a hard ivory-like mass

it is in the subchondral area on the x-ray

39
Q

what is the definition of joint mice?

A

dislodged pieces of cartilage and subchondral bone in the joint
seen on x-ray, arthroscopy, or in surgery

40
Q

what is the definition of oseophytes?

A

bony outgrowths develop at a margins of articular surface
capped by fibrocartilage and hyaline cartilage that ossify
seen on x-ray on OA

41
Q

what is the clinical expression of PAIN, and limitation of motion?

A

Heberden nodes: osteophytes at a distal interphalangeal joints
(looks like swelling, but are really bony outgrowths)

42
Q

what is oligoarthritis? is it more common in adults and children?

A

rhumatoid arthrits <4 joints affected

more common in JIA

43
Q

In JIA what is affected more? larger joints or smaller joints?

A

larger joints:KNEES

44
Q

Pauci definition?

A

> 1 joint but < 5 joints

45
Q

reiter syndrome triad?

A

seronegative polyarthritis
conjunctivitis/uvitis
non specific urethritis (nongonococal) or cervicitis in females

Pathology III (3 decks)

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