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D&T1 Exam II > Bones I > Flashcards

Bones I Flashcards

1
Q

RANK pathway (2):

A
  • RANKL on osteoblast and marrow stromal cells

- RANK receptor on osteoclast precursor allows osteoclast generation and survival

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2
Q

M-CSF Pathway (2):

A
  • M-CSF secreted by osteoblast

- M-CSF receptor allows osteoclast generation and survival

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3
Q

WNT/Beta-catenin pathway (3):

A
  • WNT from marrow stromal cells
  • LRP5 and LRP6 osteoblast receptor bind WNT protein
  • Secrete OPG which blocks RANK
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4
Q

Bone composition (2):

A
  • Calcium hydroxyapatite (mineral portion)

- Organic matrix mostly type 1 collagen

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5
Q

Osteopontin:

A

Unique to bone, levels parallel osteoblast activity

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6
Q

Alkaline phosphatase:

A

From osteoblasts, also in liver and placenta

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7
Q

Woven bone (4):

A
  • Random collagen deposition
  • Rapid bone growth
  • Resists forces all directions
  • Always pathologic in an adult
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8
Q

Lamellar bone (3):

A
  • Ordered collagen deposition
  • Replaces woven bone
  • Stronger than woven bone
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9
Q

Epiphysis:

A

Distal to growth plate.

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10
Q

Metaphysis:

A

Beneath growth plate

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11
Q

Diaphysis:

A

Center of bone

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12
Q

Dysostosis:

A
  • Local* problems in migration of mesenchyme and their condensation.
    • Eg. polydactyly/brachydactyly
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13
Q

Dysplasia:

A

Global defect in regulation of skeletal organogenesis

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14
Q

Cleidocranial dysplasia (6):

A
  • Autosomal dominant
  • RUNX2 transcription factor defect
  • Short stature
  • Abnormal clavicles
  • Supernumerary teeth
  • Wormian bone
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15
Q

Achondroplasia (4):

A
  • Growth plate defect from paracrine cell defect
  • Reduced chondrocyte proliferation in growth plate
  • FGFR3 point mutation –> gain of function
  • Autosomal dominant
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16
Q

Achondroplasia appearance (5):

A
  • Short stature
  • Short proximal limbs
  • Normal trunk length
  • Enlarged head with bulging forehead
  • Depression of root of nose
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17
Q

Thanatophoric dwarfism (6):

A
  • Most common lethal dwarfism
  • Cloverleaf skull
  • More severe FGFR3 gain of function mutation
  • Micromelic short bowed limbs
  • Small underdeveloped chest with bell-shaped abdomen
  • Diminished chondrocyte proliferation
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18
Q

LRP5 - Gain of function:

A

Cannot upregulate osteoclasts

- Autosomal dominant osteopetrosis type 1

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19
Q

Osteoprorosis pseudoglioma syndrome (3):

A
  • Inactive LRP5
  • Skeletal fragility
  • Loss of vision
20
Q

Osteopetrosis (5):

A
  • Diffuse systemic bone sclerosis
  • Bone deposition replaces medullary cavity
  • Bulbous long bones
  • Narrow neural foramina
  • Brittle bones
21
Q

Osteopetrosis is due to:

A

Reduced osteoclast bone resorption

- Cannot acidify pit

22
Q

Autosomal dominant benign osteopetrosis (6):

A
  • Adolescent or adulthood
  • Multiple fractures
  • Mild anemia
  • Hepatosplenomegaly
  • Mild cranial nerve defects
  • Can be treated with bone marrow transplant
23
Q

Osteogenesis imperfecta (4):

A
  • Group of type 1 collagen diseases
  • Affects other areas rich in type 1 collagen
  • Autosomal dominant
  • Fragility vs. child abuse
24
Q

Osteogenesis imperfecta type 1 (5):

A
  • Normal stature with less fractures after puberty
  • Blue sclerae from translucency of sclera
  • Dentinogenesis imperfecta from dentin defect
  • Hearing loss
  • Joint laxity
25
Q

Mucopolysaccharidoses (3):

A
  • Defect in enzymes degrading dermatan sulfate, heparan sulfate and keratan sulfate
  • Abnormalities of hyaline cartilage
  • Malformed bones
26
Q

Osteoporosis:

A

Increased bone porosity and decreased mass

27
Q

Aging causes of osteoporosis (4):

A
  • Decreased replicative activity of osteoprogenitor cells
  • Decreased synthetic activity of osteoblasts
  • Decreased biologic activity of matrix-bound growth factors
  • Reduced physical activity
28
Q

Menopausal causes of osteoporosis (4):

A
  • Decreased serum estrogen
  • Increased cytokines
  • Increased expression of RANK, RANKL
  • Increased osteoclast activity
29
Q

Low turnover variant of osteoporosis:

A

Senile osteoporosis

30
Q

High turnover variant of osteoporosis:

A

Post-menopausal osteoporosis

31
Q

Secondary osteoporosis (3):

A
  • Hyperparathyroidism
  • Corticosteroids
  • Immobilization
32
Q

Brown tumor (3):

A
  • Bone loss due to hyperparathyroidism replaced by fibrovascular tissue
  • Microfractures result in hemorrhage and healing
  • Granulation tissue and hemosiderin
33
Q

Paget disease of bone stages (3):

A
  • Osteolytic stage: osteoclast activity
    • V-shaped lesion
  • Mixed stage: osteolytic and osteoblastic
  • Osteosclerotic stage: Mosaic pattern of lamellar bone due to osteoblasts
34
Q

Paget disease labs (2):

A
  • Increased alkaline phosphatase

- Normal calcium and PO4

35
Q

Paget disease: bone overgrowth can lead to (4):

A
  • Cranial nerve palsy
  • Heavy skull
  • Severe secondary osteoarthritis
  • Chalk stick-type fracture
36
Q

Fracture - soft tissue callus (4):

A
  • Hematoma fibrin creates framework
  • Influx inflammation, fibroblasts and capillaries
  • Osteoprogenitor cells activated
  • No rigidity, easily disrupted
37
Q

Fracture - boney callus (4):

A
  • Woven bone
  • +/- cartilage for enchondral ossification
  • Maximum girth of callus 3 wks
  • Over time remodels to bear full weight
38
Q

Osteonecrosis (3):

A

Avascular necrosis

  • Infarction of bone and marrow
  • Corticosteroids most common cause
  • Dead bone/fat replaced by Ca++ salts
39
Q

Causes of avascular necrosis (6):

A
  • Idiopathic
  • Corticosteroids
  • Infection
  • Dysbarism
  • Pregnancy
  • Sickle cell disease
40
Q

Subchondral infarct (2):

A
  • Chronic pain

- Wedge-shaped subchondral bone

41
Q

Osteomyelitis:

A

Bone inflammation almost always from infection

42
Q

Location of pyogenic osteomyelitis by age (3):

A
  • Neonate: metaphysis and/or epiphysis
  • Children: metaphysis
  • Adult: epiphyses and subchondral bone
43
Q

Sequestrum:

A

Dead piece of bone

44
Q

Brodie Abscess:

A

Small intraosseous abscess often in the cortex walled off by reactive bone

45
Q

Involucrum:

A

Reactive surrounding bone

46
Q

Potts disease:

A

TB infection of spine

D&T1 Exam II (18 decks)

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