bones and joints patholgy/disease

Question 1

normal bone

Answer 1

• outer solid cortical bone
• inner trabecular (spongy) bone
• outside surface periosteum
• inner space (medullar) contains fat or haemopoietic marrow

Question 2

functions of bone

Answer 2

mechanical
mineral homeostasis(Calcium)
houses haemopoeitic system

Question 3

bone disease types

Answer 3

1) infections
2) tumours
3) trauma/degeneration
4) also specific dearrangmenst of bones specialised processed and functions

Question 4

bone matrix formation diseases

Answer 4

osteogenesis imperfecta
due to mutation in type 1 collagen
can also affect ear/eye/teeth/skin

Question 5

cartilage matrix formation fisroders

Answer 5

achondroplasia

• failure of cartilage maturation at the growth plate (of long bones)
• caused by mutation of fibroblast growth receptor 3 which causes it to be continually activated (it is a negative regulator of bone growth)
• failure of proper remodelling

Question 6

disease of mienralisation

Answer 6

osteomalacia/rickets

osteoporosis

Question 7

osteomalacia

Answer 7

defiicey in Vit D/calcium
can be dietary or metabolic
failure of mineralise - cartilage overgrowth, failure of longitudinal growth

causes fragility

Question 8

rickets

Answer 8

rickets in growing skeleton
due to failure of mineralisation of growth plate cartilage – growth plate cartilage functions in quiesant and hypertrophic zone, as it mineralises gets resorbed and replaced by bone, but the final stage fails in rickets

Question 9

osteoporsis

Answer 9

increase in porosity of bone due to reduction bone mass (gaps in trabecular bone increase)

hormones, lifestyle, activity, genetic, nutrition

Question 10

complications of osteoporosis

Answer 10

fragility fractues
kyphosis (dowagers hump, as spinous processes stronger tan vertebral bodies)
loss of height

Question 11

treatment of osteoporosis

Answer 11

inhibit bone resorption (bisphosphonates)

increase bone formation? experiments

Question 12

disorders of abnormal turnover

Answer 12

pages disease
deformity of individual bones
increase in resorption and poor controlled bone formation
can develop sarcoma 
no cure

Question 13

bone infections

Answer 13

osteomyelitis
complicate of compound fractres
necrosis bone fragmetns

Question 14

common organisms causing osteomyelitis

Answer 14

staph aureus

M tuberculosis

Question 15

bone tumours

Answer 15

most are metastases

top 3 - lung breast prostate

Question 16

primary bone tumours can be

Answer 16

chondrogenic
osteogenic
other (e.g. non matrix forming)

Question 17

chondrogenic bengin tumoir

Answer 17

1) osteochrondroma
- from the growth plate, buds out forming a tumour typically long bones
2) chrondroma
- forms inside bones, typically in small bones

more benign than malignant

Question 18

malignant chrondrogenic tumoir

Answer 18

1) chondrosarcoma
- resistant to radio therapy
- need to be surgical removal, difficult
- pelvis or proximal femur

Question 19

osteogenic tumours benign

Answer 19

fewer benign

1) osteoid osteoma
- any site
- small tumours in cortex
2) osteoblastoma
- larger tumours

Question 20

malignant osteogenic tumoirs

Answer 20

osteosarcoma

most common in distal femur

Question 21

which bone tumours affect younger pt more

Answer 21

osteosarcoma

ewings sarcoma

Question 22

types of joint diseases

Answer 22

1) infections
2) crystal arthropathies
3) chronic inflammatory arthritis
4) osteoarthritis/osteoarthrosis
5) tumours

Question 23

joint infections

Answer 23

septic arthritus
usually staph aureus
Iv Ab with /without draiange

Question 24

crystal arthropathies

Answer 24

gout

psudogout

Question 25

gout

Answer 25

urate crystals secondary to raised serum uric acid

treated with drugs to lower serum rate

Question 26

psuedogout

Answer 26

deposition of calcium pyrophosphate crystals
age related
treated symptimatically

Question 27

chronic infalmamtory arthritis

Answer 27

generally autoimmune

rheumatoid most common

Question 28

rheumatoid arthritis and tx

Answer 28

systemic inflmamtory disorder
progressive destruction synovitis
joint deformity

tx - anti TNF

Question 29

osteoarthrisis/throsis

Answer 29

degenerativ disase
erosion of cartialge
minimal inflammation
predisposed by previous joint failure

Question 30

treatment of osteoathritis

Answer 30

cannot cure

end stage treated by arthroplasty