Bones, joints, & soft tissue (slides 1-65) Flashcards
smooth muscle tumors particularly affect what demographic
women of child bearing age
what is osteomyelitis
infection of bone marrow
true or false; blood is connective tissue
true
What is dysostosis
development anomaly of bone
- abnormal mesenchymal migration
- defective ossification of fetal cartilage
What is aplasia
absent or incomplete development of organ tissues/system
true or false; dysostosis (development anomaly of bone) is associated with aplasia
true
What is dysplasia? What is it associated with?
Mutations interfere with growth
Associated with dwarfism
True or false; Dysplasia (mutations interfering with growth) can cause dwarfism via bone or cartilage mutations
true
bone-osteodysplasia
cartilage- chondrodysplasia
What is Sprengel’s deformity? What is it associated with?
Undescended scapula
Klippel-Feil syndrome (form of dysostosis)
What is Klippel-Feil syndrome
An idiopathic congenital fusion (any 2 cervical vertebrae) form of dysostosis
-Sprengel’s deformity - undescended scapula
What is the MC congenital malformation of the limbs?
Syndactyly (fusion of digits)
Autosomal dominant disorders typically effect what?
structural proteins
Autosomal recessive disorders typically effect what?
Enzymatic proteins
What is another name for osteogenesis imperfecta
brittle bone disease
osteogenesis imperfecta (brittle bone disease) causes mutations of what structural protein
collagen type 1
autosomal dominant
What disease causes bluish discoloration of sclera
Osteogenesis imperfecta (brittle bone disease)
What are the types of osteogenesis imperfecta (brittle bone disease)
Type 1 - normal lifespan
Type 2 - lethal in utero (cerebral hemorrhage)
Both involve type 1 collagen mutations
True or false; osteogenesis imperfecta is a contraindication to extremity adjusting
true (brittle bone disease)
What is the MC form of dwarfism
Achondroplasia
True or false; achondroplasia (MC form of dwarfism) is caused by the FBFR3 gene mutation
true
What disease is commonly associated with bullet vertebrae, scoliosis, and spinal stenosis
achondroplasia
What is thanatophoric dwarfism?
fatal form of achondroplasia
What does osteopetrosis cause in osteoclast activity
decreases osteoclast-mediated bone reabsorption
True or false; osteopetrosis causes “stone-like” bones making them harder but not stronger (increasing risk of fractures)
true
True or false; osteoporosis is commonly associated with hepatoslenomegaly
false; common in osteopetrosis (due to increased blood production because medullary cavity of bone is being filled with bone cells)
Along with Gaucher disease what pathology can cause erlenmeyer flask deformity
osteopetrosis
What is the most important form of osteopenia
osteoporosis
What is osteopenia
the subtle reduction of bone mineral density - (not full blown osteoporosis)
What is the MC type of osteoporosis
Senile, post-menopausal
What are some examples of secondary causes of osteoperosis
hyperparathyroidism
Nutrient deficiency
drug exposure - alcohol, smoking
How could hyperparathyroidism cause osteoporosis
As PTH goes up so dose calcium - this calcium comes from bone
True or false; osteoporosis MC impacts trabecular (spongy) bone
true
What are the 2 MC areas you’ll find osteoporosis
Vertebral body (old people shrinking) Femoral neck (fractured hip)
When does loss of bone density begin?
mid 20s (.05% per year)
True or false; senile or post-menopausal osteoporosis is caused by decreased growth factors and decreased osteoblast activity
true
What is Dowager’s hump? What are some complications of it?
Vertebral compression (kyphosis) due to senile osteoporosis
Can lead to issues with pneumonia
Why is it that a femoral neck fracture often leads to death in the next year
Due to immobilization - collection of blood clots in lower extremity - pulmonary embolism
True or false; osteoporosis can be diagnosed following an X-ray
False; you can see the effects of osteoporosis (loss of bone density) but patient would need to complete a T-score exam or DEXA scan
Regular exercise prior to age 30, dietary calcium and Vitamin D supplementation, bisphosphates consumption are all preventative measures for what disease?
Osteoporosis
What disease is associated with a lytic phase - mixed lytic and blastic phase - exhaustion of cellular activity causing a “shaggy” bone appearance
paget disease
What is paget’s disease?
Excessive bone formation - disorganized - “shaggy” bone appearance - excessive osteoclastic activity
True or false; 70-90% of Paget disease causes pain and discomfort
false; 70-90% of cases are asymptomatic
If a patient with Paget’s disease did show pain symptoms where is the MC area?
Bone pain in neck and back
80% of cases of Paget’s disease involve what part of skeleton?
axial skeleton or femur
At what age is Paget disease MC diagnosed
70
The Mosaic pattern or “jigsaw puzzle” appearance in histological sections of bone is associated with what disease
paget disease
The “ivory vertebra sign” is associated with what disease?
paget disease
What is the difference between rickets and osteomalacia
Rickets - vitamin D deficiency in children
Osteomalacia - vitamin D deficiency in adults - associated with hyperparathyroidism
What are the 2 types of hyperparathyroidism
Primary- autonomous PTH production
Secondary- renal failure - mild
What is the most common form of non-malignant cause of hypercalcemia
Hyperparathyroidism
True or false; >50% of hyperparathyroidism is asymptomatic
true (MC in women)
A “salt and pepper skull” on X-ray and a brown “tumor” (not actual neoplasm - replaced bone with loose connective tissue) are signs of what?
Hyperparathyroidism
True or false; complete fractures are MC in children
false; Incomplete are most common in children
infections are most common in what kind of fracture?
compound
True or false; subchondral areas including: hip, knee, shoulder, wrist, and ankle are all areas especially susceptible to avascular necrosis
true (especially rounded areas)
What is osteomyelitis? Is acute or chronic more common?
Bone-marrow inflammation
Chronic is MC
What is the MC mode of infection in osteomyelitis (bone marrow inflammation)
Hematogenous (sepsis)
What is the MC cause of pyogenic infections in Osteomyelitis (bone marrow infection)
Staph aureus (E. coli & Group B stept - neonates) (Salmonella - sickle cell disease)
Why would a patient with Sickle cell disease be very susceptible to a Salmonella infection
Sickle cell disease causes spleen to be over-worked and spleen protects us from salmonella infections
What is the name for the reactive woven bone surrounding infected bone in pyogenic osteomyelitis
involucrum
What is the name of the dead bone at the site of infection in pyogenic osteomyelitis
sequestrum
What is the name for the ruptured periosteum leads to an abscess in the surrounding soft tissue in a pyogenic osteomyelitis infection
Draining sinus
Tuberculous osteomyelitis is MC spread how?
Hematogenous spread
Pott disease is common which kind of osteomyelitis
Tuberculous osteomyelitis
True or false; primary bone tumors are more common than secondary
false; secondary are more common (spread from somewhere else)
What does pyrexia mean? What about cachexia?
Pyrexia - fever
Cachexia - wasting syndrome
Osteosaroma, chondrosarcoma, and ewing sarcoma are all examples of what?
Primary bone cancers
True or false; benign bone tumors are MC than malignant
true
What is the MC bone tumor
osteochondroma
True or false; RB or TP53 gene mutations are associated with bone tumors
true
True or false; bone tumors MC develop early and are malignant and painful
False; develop early BUT are benign and asymptomatic
Where are osteosarcomas most commonly found
> 50% at knee
Osteoma are MC where? What are they?
MC on head
Completely benign, non-invasive superficial mass
What is the main location difference between osteoid osteoma and osteoblastoma
Osteoid osteoma - smaller and on proximal femur
Osteoblastoma - larger usually found on vertebrae
Osteoid osteoma are associated with what kind of pain? What relieves it?
Well-localized nocturnal pain, aspirin relieves (smaller tumor)
Osteoblastomas are associated with what kind of pain? Does aspirin relieve it?
Larger tumor - mild/poorly-localized pain - unrelieved by aspirin
