Chapter 18 Flashcards

1
Q

one sentence summary of achondroplasia

A
  • Defect in proliferation of chondrocytes at the cartilage growth plate
  • Overexpression of FGFR3 inhibits growth.
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2
Q

why is there blue sclera in osteogenesis imperfecta?

A

Blue sclera- Thinning of scleral collagen reveals underlying choroidal vein

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3
Q

what is osteopetrosis? what is the enzyme defect?

A

Inherited defect of bone resorption resulting in abnormally thick, heavy bone that fractures easily –> Due to poor osteoclast function

Multiple genetic variants exist; carbonic anhydrase II mutation leads to loss of the acidic microenvironment required for bone resorption.

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4
Q

what are the complications of osteopetrosis?

A
  1. Bone fractures
  2. Anemia, thrombocytopenia, and leukopenia with extramedullary
    hematopoiesis- due to bony replacement of the marrow
  3. Vision and hearing impairment-due to impingement on cranial nerves
  4. Hydrocephalus-due to narrowing of the foramen magnum
  5. Renal tubular acidosis- seen with carbonic anhydrase II mutation
    i. Lack of carbonic anhydrase results in decreased tubular reabsorption of HCo,-, leading to metabolic acidosis.
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5
Q

What is the one sentence summary of osteomalacia/rickets?

A

Osteoblasts normally produce osteoid, which is then mineralized with calcium and phosphate to form bone.

Due to low levels of vitamin D,

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6
Q

lab values of osteomalacia/rickets?

A

Laboratory findings include decreased serum calcium and phosphate, increased PTH, and INCREASED alkaline phosphatase.

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7
Q

stages of pagets disease of bone

A

Three distinct stages are (l) osteoclastic, (2) mixed osteoblastic-osteoclastic, and (3)
osteoblastic.
1. End result is thick, sclerotic bone that fractures easily.
2. Biopsy reveals a mosaic pattern oflamellar bone (Fig. 18.2).

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8
Q

clinical features of pagets disease of bone

A

Clinical features

  1. Bone pain- due to microfractures
  2. Increasing hat size- Skull is commonly affected.
  3. Hearing loss-impingement on cranial nerve
  4. Lion-likefacies- involvementofcraniofacialbones
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9
Q

labs of pagets disease of bone

A

Isolated elevated alkaline phosphatase-most common cause of isolated elevated
alkaline phosphatase in patients> 40 years old

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10
Q

complications of pagets disease of bone

A

l. High-output cardiac failure-due to formation of AV shunts in bone 2. Osteosarcoma BECAUSE THERE ARE SOME MANY BLASTS REPLICATING AND LOOKY THERE A TUMOR OF THE BLASTS

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11
Q
Transient bacteremia (children) seeds metaphysis.
Open-wound bacteremia (adults) seeds epiphysis.
A

X

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12
Q

what are the histological features of OA?

A

Pathologic features include
l. Disruption of the cartilage that lines the articular surface (Fig. 18.7); fragments ofcartilage floating in the joint space are called ‘joint mice.’
2. Eburnation of the subchondral bone
3. Osteophy te formation (reactive bony outgrowths); classically arises in the DIP
(Heberden nodes) and PIP (Bouchard nodes) joints of the fingers

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13
Q

What part of the fingers can OA effect?

A

DIP and PIP
Osteophy te formation (reactive bony outgrowths); classically arises in the DIP
(Heberden nodes) and PIP (Bouchard nodes) joints of the fingers

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14
Q

what is the pathological hallmark of RA?

A

Hallmark is synovitis leading to formation of a pannus (inflamed granulation tissue).
2. Leads to destruction of cartilage and ankylosis (fusion) of the joint

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15
Q

what joints are affected in RA?

A

Symmetric involvement of PIP joints of the fingers (swan-neck deformity),
wrists (ulnar deviation), elbows, ankles, and knees is characteristic (Fig.
18.8); DIP is usually spared (unlike osteoarthritis).

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16
Q

What are the systemic sx of RA?

A

Fever, malaise, weight loss, and myalgias
3. Rheumatoid nodules- central zone of necrosis surrounded by epithelioid
histiocytes; arise in skin and visceral organs
4. Vasculitis- Multiple organs may be involved.
5. Baker cyst-swelling ofbursa behind the knee
6. Pleural effusions, lymphadenopathy, and interstitial lung fibrosis

17
Q

Lab results of RA

A

IgM autoantibody against Fe portion of IgG (rheumatoid factor); marker of tissue damage and disease activity
2. Neutrophils and high protein in synovial fluid

18
Q

sausage fingers/toe

A

psoriatic arthritis

19
Q

aortitis

A

Ankylosing spondylitis

20
Q

some cases of dermatomyositis are associated with

A

some cases are associated with carcinoma (e.g., gastric carcinoma) .

21
Q

histology on dermatomyositis vs polymyositis

A
Perimysial inflammation (CD4+T cells) with perifascicular atrophy on biopsy
(Fig. 18.10)

“peri = closer to skin”

Resembles dermatomyositis clinically, but skin is not involved; endomysial inflammation (CDS+T cells) with necrotic muscle fibers is seen on biopsy.

22
Q

do your bone tumor cards

A

thanks