Bones, Joints, and Soft Tissue Flashcards
___ bone cell involved in bone remodeling by coordinating osteoblast and osteocyte activity in response to different stimuli
osteocyte
most common skeletal dysplasia
achondroplasia
most common lethal form of dwarfism
thantophoric dysplasia
most common inherited disorder of connective tissue
osteogenesis imperfecta
most lethal type of osteogenesis imperfecta
Type II (usually autosomal recessive)
Albers-Schonberg disease is also known as
Osteopetrosus
[diagnose]
absent medullary canal, erlenmeyer flask deformity, renal tubular acidosis, diffuse symmetric skeletal sclerosis
osteopetrosis
decreased bone mass is called
osteopenia
severe osteopenia is called
osteoporosis
[diagnose: osteopenia]
cancellous part of the vertebral bodies have a thin trabecular plates and vertebral collapse
postmenopausal osteopenia
[diagnose: osteopenia]
cortical part is affected, widened haversian system
if severe, cancellous like appearance
senile osteopenia
osteoporosis in menopause is associated with increased ____ and decreased ___ activities
Decreased serum estrogen,
Increased IL1, IL6, TNF, RANK, RANKL, Osteoclast activity
osteoporosis in aging is associated with decreased ___
decreased
- replicative activity of osteoprogenitor cells
- osteoblast activity
- matrix-bound growth factor activity
- physical activity
[diagnose]
elderly, axial skeleton, proximal femur, bone pain due to microfacture
histo: increased but disordered and structurally unsound bone mass
“jigsaw puzzle”
can cause high output failure
paget disease
Osteitis deformans
[diagnose]
decreased mineral content of bone due to abnormal mineralization
rickets and osteomalacia
__
rail-road track like appreance
dissecting osteitis
[diagnose: renal ostodystrophy]
decrease BMP-7
Acidosis
increased RANKL
osteopenia
[diagnose: renal ostodystrophy]
Acidosis decreased 1,25 OH2 vitamin D Decreased calcium increased PO4 hyperparathyroidism
osteomalacia
___ increases PO4, decreases klotho
FGF-23
procallus bone is formed ___ week post injury
1 week
___ disease
avascular necrosis of ossification centers in children
legg-calve-perthes disease
most common etiologic agent in osteomyelitis
Pyogenic Osteomyelitis
most common etiologic agent in osteomyelitis in IV drug user
E. coli
pseudomonas
klebsiella
most common etiologic agent in osteomyelitis in neonates
H. influenza
GBS
most common etiologic agent in osteomyelitis in patients with sickle cel disease
salmonella
most common location of osteomyelitis in neonates
metaphyses and epiphyses
most common location of osteomyelitis in children
metaphyseal
most common location of osteomyelitis in adults
epiphyses and subchondral region
___ refers to small intraosseous abscess in osteomyelitis
Brodie abscess
___ refers to newly developed sleeve of bone around dead bone in osteomyelitis
involucrum
___ refers to dead bone in osteomyelitis
sequestrum
[diagnosis]
subperiosteal draining sinus, sequestrum, involucrum, brodie abscess
osteomyelitis
location of periosteal bone deposition in saber shin
anterior and medial surface of tibia
most common primary tumors excluding hematologic is
osteosarcoma
[diagnosis]
bone-forming, benign
<2cm
appendicular skeleton (common in femur and tibia)
marked reactive bone formation, relieved by NSAIDs
haphazardly interconnecting trabeculae of woven bone WITH osteoblastic rimming, no atypia
Osteoid sarcoma
[diagnosis]
bone-forming, benign
>2cm
common in axial skeleton (usually in vertebral column, less pronounced reactive bone formation, not relieved by NSAIDs
haphazardly interconnecting trabeculae of woven bone WITH osteoblastic rimming, no atypia
osteoblastoma
[diagnosis]
<20 years old, then older adults (bimodal)
bone pain, mass
metaphysis of long bone
periosteal lifting (codman triangle), infiltrative borders (sunburst appearance), lytic and blastic leasion
histo: lace-like pattern
osteosarcoma
[diagnosis]
adolescent
bone pain, mass
metaphysis of long bone
periosteal lifting (codman triangle), infiltrative borders (sunburst appearance), lytic and blastic leasion
histo: lace-like pattern
abundant malignant cartilage
chondroblastic osteosarcoma
[diagnosis]
late adolescent/early adulthood, metaphysis of long bone
hyaline cartilage (hyaline cap); covered peripherally by perichondrium; has underlying bone and marrow
osteochondroma
[diagnosis]
20-50 years old
solitary lesion in metaphysis of hand and foot bones
cytologically benign chondrocytes
chondroma
most common intraosseus cartilage tumor
enchondroma
___ syndrome
Chondroma + spindle cell hemangioma
Ollier and Maffucci syndrome
second most common malignant matrix-producing tumor of the bone
chondrosarcoma
[diagnosis]
> 40 year old, axial skeleton involved, anaplastic chondrocytes with varying cellularity, mitosis and atypia
chrondrosarcoma
second most common group of bone sarcoma in children
ewing sarcoma
t(11;22) fusion gene
ewing sarocma
[diagnosis]
child, painful enlarging mass with systemic symptoms
diaphysis of ling bone, flat bone of pelvis; onion skin-like deposition of reactive bone
ewing sarcoma
[diagnosis]
homer-wright rosettes, small, round blue cells in scant fibrous stroma
ewing sarcoma
[diagnosis]
20-40 years old,
solitary
seen in the epiphyses of long bones around the knee
histo: mononuclear cells with osteoclast-like giant cells
HIGH LEVELS OF RANKL activity
Giant cell tumor (osteoclastoma)
[diagnosis]
curvilinear trabeculae of woven bone without osteoblastic rimming
“chinese character” appearance of bony trabecuale
Fibrous dysplasia
___- syndrome
Fibrous dysplasia
Polyostotic FD
Cafe-au lait spots
precoccious puberty
McCune-Albright Syndrome
most common skeletal malignancy
metastasis
most common CA that metastasize to the bone in adults
prostate, breast, kidney, lung
most common CA that metastasize to the bone in children
neuroblastoma, wilms tumor, osteosarcoma, ewing sarcoma, rhabdomyosarcoma
blastic form of bone metastasis is seen in ___
prostate CA
kidney, lung, GIT, and melanoma can form ___ type of bone lesion once it metastasize
lytic form
most common form of arthritis
osteoarthritis
[diagnosis]
proliferation of chrondrocytes, joint mice, eburnation (ivory-like), osteophytes
Osteoarthritis
[diagnosis]
Bouchard nodes, Heberden nodes, 1st CMCJ, 1st MTPJ are affected
joint deformity without fusion
osteoarthritis
Bouchard nodes refer to what joint
PIP
Heberden nodes refer to what joint
DIP
Genetic component of RA
HLA-DRB1
Central cytokine in pathogenesis of RA
TNF
pannus is the site of ___ activity
osteoclast
[diagnose]
synovial cell hyperplasia, dense lymphoplasmacytic infiltrates, angiogenesis, fibropurulent exudates,
osseous ankylosis
RA
cause of pseudogout
calcium pyrophosphate
cut off value for hyperuricemia
> 6.8 mg/dL
[diagnosis]
needle shaped, negatively bifringent
gout
monosodium urate
[diagnosis]
rhomboid-shaped, positively birefringent
calcium pyrophosphate
pseudogout
pathognomonic hallmark of gout
tophi in various sites
most common soft tissue tumor of adulthood
lipoma
lipoma in the deep soft tissue and retroperitoneum is ___ (malignant/benign)
can be malignant
most common soft tissue sarcoma of childhood and adolescence
embryonal
___ is the immunostain for rhabdomyoblastic differentiation
myogenin
[diagnosis]
eosinophilic, tadpole cells, numerous filaments
rhabdomyoblast
rhabdomyosarcoma
most common neoplasm in women
leiomyomas
[diagnosis]
seen in deep tissues of extremities and retroperitoneum
eosinophilic spindle cells with atypia; prominent necrosis and frequent mitosis
SMA stain used differentiate
Leiomyosarcoma
