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NMSP - Exam 2 > Bones - Acquired Disorders > Flashcards

Bones - Acquired Disorders Flashcards

1
Q

Osteopenia

A

Decreased bone mass

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2
Q

With Osteopenia, how many SD’s below the mean must be present?

A

1-2.5 SD below mean

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3
Q

Osteoporosis

A

Very decreased bone mass with fracture risk

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4
Q

With Osteoporosis, how many SD’s below the mean must be present?

A

More than 2.5 SD below the mean

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5
Q

What are the signs of Osteoporosis?

A

Vertebral compression fractures or atraumatic fractures

Loss of height

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6
Q

What are the signs of Osteoporosis?

A

Vertebral compression fractures or atraumatic fractures

Loss of height

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7
Q

The magnitude of bone deficits that accumulate each year of life are determined by?

A

Hereditary factors

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8
Q

What treatment can often increase bone loss?

A

Breast cancer treatment (tamoxifen)

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9
Q

What are some risk factors for Osteoporosis?

A

Caucasian
Low calcium
High phosphorus
Smoke exposure

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10
Q

Age-related Osteoporosis

A

Decreased capacity to make bone (low turnover variant)

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11
Q

Decreased physical activity correlates with?

A

Increased rate of bone loss

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12
Q

Between load magnitude and load cycles, which physical activity is better for decreasing rate of bone loss?

A

Load magnitude – resistance exercises are better

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13
Q

Adolescent girls have insufficient ____ intake during growth that causes a decreased peak bone mass to be achieved

A

Insufficient calcium intake

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14
Q

Hormones can play a major role in the pathogenesis of Osteoporosis. Especially when?

A

Post-menopause = accelerated bone loss

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15
Q

_____ Estrogen can cause Osteoporosis

A

DECREASED

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16
Q

Decreased Estrogen causes _____ resorption&raquo_space; formation

A

Increased resorption (high turnover variant)

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17
Q

Decreased Estrogen can also activate what things to cause bone resorption?

A

RANKL
Cytokines
==> (+) osteoclasts

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18
Q

How does Osteoporosis look on histo?

A

NORMAL – just decreased bone in quantity

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19
Q

Post-menopausal Osteoporosis involves increased Osteoclast activity. What changes can be seen on the bone?

A

Trabeculae thinned and loss of the horizontal trabeculae

– microfractures and vertebral collapse

20
Q

Post-menopausal Osteoporosis involves thinned trabeculae. Senile Osteoporosis involves thinned ____

A

Thinned cortex = senile

21
Q

What causes Rickets and Osteomalacia?

A

Vitamin D Deficiency –> impairs mineralization

22
Q

What causes Rickets and Osteomalacia?

A

Vitamin D Deficiency –> impairs mineralization

23
Q

Rickets occurs in ____ and interferes with bone deposition where?

A

Kids - interferes with deposition of bone at growth plate

24
Q

What are the signs of Rickets?

A

Frontal bossing of head
Rachitic Rosary of ribs
Bowed legs
Pigeon breast deformity of chest

25
Q

A kid presents with frontal bossing, bowed legs, rachitic rosary of the ribs and pigeon chest. What do they have?

A

Rickets

26
Q

Osteomalacia occurs in?

A

Adults

– prone to fractures

27
Q

Hyperparathyroidism involves Increased PTH which = ___

A

Increased PTH = Increased Calcium

28
Q

Describe the cascade seen with Hyperparathyroidism

A
  • PTH increases RANKL to (+) osteoclasts
  • Calcium is resorbed by renal tubules
  • Urinary excretion of phosphates
  • Increased vitamin D synthesis increases RANKL
29
Q

Hyperparathyroidism involves ___ bone mass along with fractures, deformities, etc.

A

Decreased bone mass

30
Q

What 3 things can be seen morphologically with untreated Hyperparathyroidism?

A
  1. Osteoporosis
  2. Brown tumor - secondary hemorrhage mass lesion
  3. Von Recklinghausen - clasts tunnel to form “railroad tracks”
31
Q

Renal Osteodystrophy

A

Skeletal changes that occur with chronic renal disease

32
Q

What molecule is increased in the blood with Renal Osteodystrophy?

A

Hyperphosphatemia

33
Q

Paget Disease

A

INCREASED bone mass – disorganized

34
Q

With disease involves increased bone mass?

A

Paget Disease

35
Q

Paget Disease usually affects 1 or multiple bones?

A

Multiple

36
Q

What bones are usually involved with Paget Disease?

A

Axial skeleton

Femur

37
Q

Some cases of Paget disease are asscociated with mutations in what gene?

A

SQSTM1

38
Q

How does the bone look with Paget Disease?

A

Mosaic pattern of lamellar bone

== jigsaw appearance with prominent cement lines

39
Q

How does the bone look with Paget Disease?

A

Mosaic pattern of lamellar bone

== jigsaw appearance with prominent cement lines

40
Q

What are the 3 stages of Paget Disease?

A
  1. Osteolytic = Osteoclasts with 100 nuclei
  2. Mixed = clasts and blasts
  3. Burned out quiescent osteosclerotic = Osteoblasts
41
Q

What are the 3 stages of Paget Disease?

A
  1. Osteolytic = Osteoclasts with 100 nuclei
  2. Mixed = clasts and blasts
  3. Burned out quiescent osteosclerotic = Osteoblasts
42
Q

What types of fractures are seen with Paget Disease?

A

Chalk stick fractures of long bones

Spinal compression fractures

43
Q

With Paget Disease, the leg bones will ____. What types of fractures are seen too?

A

Legs will bow

  • Chalk stick fractures of long bones
  • Spinal compression fractures
44
Q

How will the skin feel over the affected bone and why with Paget Disease?

A

Warm due to hypervascularity

45
Q

Hypervascularity of the affected bones with Paget Disease can result in?

A

AV shunt ==> High output Heart Failure

46
Q

What will be elevated with Paget Disease?

A

Alk Phosphatase

47
Q

What are 2 treatment options for Paget Disease

A

Calcitonin

Bisphosphonates

NMSP - Exam 2 (29 decks)

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