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CMS > Bones and Joints > Flashcards

Bones and Joints Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

Describe the difference between cortical and cancellous bone

A

Cortical = compact bone, layers of concentric rings (osteons)
Cancellous = Spongy bone, interconnecting layers of rods and plates

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2
Q

what is the main protein that forms in lamellae

A

Type 1 collagen

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3
Q

Osteoblasts ____, osteoclasts ____

A

Osteoblasts synthesize bone, osteoclasts resorb bone

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4
Q

How does the parathyroid hormone influence bone?

A

Stimulates osteoclasts to resorb bone to increased serum calcium levels

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5
Q

How does Vitamin D influence bone?

A

synthesized in the skin and taken in from diet, Vit D promotes calcium absorption

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6
Q

What is calcitonin and what does it do?

A

Enzyme that acts as opposite to PTH, lowers blood calcium levels by promoting calcium deposition into bones

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7
Q

What are the stages of bone healing?

A

Cellular stage, vascular stage, primary callus, bony callus, mature callus
(Haematoma, granulation tissue, bony resorption, proliferation, reorganisation)

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8
Q

What is the cause of osteogenesis imperfecta?

A

Rare, autosomal dominant genetic condition

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9
Q

What does osteogenesis cause?

A

collagen defect that causes brittle bones
4 types that vary in severity (1 least severe, 2 kills you)

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10
Q

Symptoms of osteogenesis imperfecta?

A

Blue sclera
deafness
bruising easily
can have cardiac complications

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11
Q

What are some dental considerations of osteogenesis imperfecta?

A

XLA caution > massive fracture risk
GA risk > normally have cardiac issues

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12
Q

What is cleidocranial dysplasia

A

Rare, autosomal dominant genetic condition

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13
Q

What are the symptoms of cleidocranial dysplasia

A

absent or defective clavicle
broad, short skull
hypoplastic midface

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14
Q

What are dental considerations of cleidocranial dysplasia?

A
  • can cause mandibular protrusion CIII occlusion
  • can cause clefts, hypodontia, supernumeraries
  • abnormal root morphology
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15
Q

What is another name for Albers-Schonberg Disease?

A

Osteopetrosis

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16
Q

What does osteopetrosis cause?

A

Autosomal dominant condition
Causes defective osteoclasts, excessive bone density (opposite to osteoporosis)

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17
Q

What causes Rickets? (osteomalacia)

A

Lack of Vitamin D/calcium as a child

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18
Q

What is the treatment for osteomalacia (rickets)

A

Vitamin D supplements and dietary advice

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19
Q

What is osteoporosis?

A

A condition that causes diminished bone mass, low bone density

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20
Q

What are the symptoms for osteoporosis?

A

Back pain, reduced height, stooped posture, unexpected fractures

21
Q

How do you diagnose and manage osteoporosis?

A

DEXA scan > measures bone density
Managed with exercise, Ca and Vit D supplements, bisphosphonates

22
Q

What happens in fibrous dysplasia

A

Fibrous dysplasia = abnormal growth of fibrous tissues
chronic disorder, scar-like tissue grows in place of normal bone, weakening it over time

23
Q

What is the presentation of fibrous dysplasia?

A

ground-glass appearance on radiographs
ALP is raised, but Ca and K ions normal

24
Q

What is ALP?

A

Alkaline phosphatase
Enzyme found in osteoclasts

25
Q

What is Paget’s Disease?

A

Unknown aetiology, causes unbalanced bone remodelling
shows areas of mixed lysis and sclerosis

26
Q

Dental considerations of Paget’s Disease

A
  • Bisphosphonates are a common Tx
  • can get AV fistulas > cardiac failure
  • hypercementosis of teeth
  • bulging of maxilla
  • risk of excessive bleeding and osteomyelitis
27
Q

Calcitonin is released by the ____ when the ___ is ____

A

Thyroid gland, blood calcium levels are too high

28
Q

What is primary hyperparathyroidism

A

parathyroid adenoma, causing excessive release of PTH:
hypercalcemia, bone pain, peptic ulcers, pancreatitis

29
Q

What is secondary hyperparathyroidism?

A

a condition outside of the parathyroid gland causes parathyroid hyperplasia (chronically low vit D, kidney failure)

30
Q

How can a clinician differentiate primary and secondary hyperparathyroidism?

A

Primary = high Ca serum levels

31
Q

What is the aetiology of marfan’s syndrome?

A

Autosomal dominant, connective tissue disorder

32
Q

What happens in Marfan’s syndrome?

A

connective tissue disorder causing hyper-flexible joints, lax ligaments, hernias
mitral valve prolapse, cardiac issues

33
Q

What is Ehlers-Danlos Syndrome?

A

group of rare autosomal dominant disorders that impacts collagen formation

34
Q

Signs and symptoms of Ehler-Danlos Syndrome?

A

Hyperflexible skin, bruising, loose joints, recurrent spontaneous dislocations, poor healing

35
Q

Define osteoarthritis

A

Degeneration of the articular cartilage and proliferation of new bone
remodelling of joint contour

36
Q

Where are you likely to find a patient presenting with osteoarthritis?

A

Load-bearing joints (knees, hips)

37
Q

Tx for osteoarthritis

A

Analgesia, joint replacement, weight loss

38
Q

What is rheumatoid arthritis

A

Systemic Auto-immune disease causing symmetrical, destructive inflammation joints

39
Q

How does Rheumatoid arthritis affect the joints?

A

Causes inflammation of the Synovium (soft tissue inside/lining the joint space)

40
Q

How do you diagnose Rheumatoid arthritis?

A

Stiffness of the hands/feet, worse in morning
ulnar deviation makes hands point outward
5 cardinal inflammatory signs in joints
+ve testing for rheumatoid factor

41
Q

Management for Rheumatoid arthritis

A

NSAIDS
corticosteroids
DMARDS (Disease modifying anti-Rheumatic drugs)

42
Q

Dental consideration of rheumatoid arthritis

A

in hands -> OHI
often associated with Sjorgen’s syndrome
Medications: risk of bleeding/MRONJ

43
Q

What is ankylosing spondylitis

A

Form of chronic inflammatory arthritis, mostly in males, causes fusion of spinal vertebrae over time

44
Q

Treatment for ankylosing spondylitis

A

Physiotherapy, exercise, NSAIDS

45
Q

What is gout?

A

Form of chronic inflammatory arthritis

46
Q

What is the mechanism of gout?

A

Chronically high urate levels (from breakdown of purines, meat and seafood) forms crystals of monosodium urate which are deposited into the joints

47
Q

Clinical features of gout

A

-inflammatory arthritis
- inflammation of synovium membrane
- renal disease
- most common joints: joint on big toe, wrist, base of thumb

48
Q

Causes of gout

A

High uric acid (from breaking down purines found in red meat, seafood)
high BP
diabetes, obesity

49
Q

Tx for Gout

A

NSAIDs, Allopurinol

CMS (15 decks)

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