Day 11 - Ms2 Quiz Flashcards
Lab values: Paget’s disease
Elevates Alk Phos; Otherwise, normal PT, serum phosphate, Ca
Lab values: Osteomalacia & Rickets
Vit D def; Serum Ca low, High PTH, Low Phosphate; Alk Phos normal or elevated
Lab values: Chronic kidney disease
Also Vit D def (but kidneys unable to respond to PTH); Serum Ca low, High PTH, High Phosphate; Alk Phos normal or elevated
Lab values: Osteoporosis & Osteopetrosis
All normal - Ca, PTH, Phosphate, Alk Phos
Lab values: Primary hyperparathyroidism
Elevated PTH, High serum Ca, Low Phosphate, Increase Alk Phos
Lab values: Hypoparathyroidism
Low PTH, Low serum Ca, High Phosphate, Normal Alk Phos
Lab values: Pseudohypoparathyroidism
End receptors not respond to PTH (i.e., high PTH but looks like hypoparathyroidism); High PTH, Low serum Ca, High Phosphate, Normal Alk Phos
3 Studies can be used to make dx osteoarthritis
MRI, Bone scan, Tagged WBC scan
Dx by joints involved: DIP & PIP
Osteoarthritis
Dx by joints involved: PIP, MCP, NOT DIP
Rheumatoid arthritis
Dx by joints involved: Isolated MCP with squared off bone ends and hook-like osteophytes of metaphalengeals
Hemochromatosis
Most common causes of bony metastasis
Breast, Lung, Prostate, RCC, Thyroid, Lymphoma
Classic radiograph of osteosarcoma
Sunburst appearance +/- Codman triangle
Classic radiograph of Ewing sarcoma
Codman triangle and/or onion-skinning (periosteal reactions)
Tx Lyme disease
Early disease: Doxycycline, Amoxicillin, or Cefuroxime; Late disease: Ceftriaxone
Tx RMSF
Doxycycline or Chloramphenicol
Meds tx acute gout
NSAIDs (especially Indomethacin), Colchicine, Steroids; NOT probenecid or allopurinol (these are used for chronic gout)
Tx pseudogout
NSAIDs or Colchicine
Tx osteoporosis
Ca, Vit D, exercise; Stopping steroid; Estrogen, testosterone replacement; Bisphosphonates; Pulsatile PTH (teriparatide)
Endocrine causes of osteoporosis
Hypogonadism, Cushing syndrome, Hyperthyroidism, Hyperparathyroidism
Knee x-ray shows calcifications of meniscus
Pseudogout
Hats no longer fit, deafness
Paget’s disease or Osteopetrosis
Needle-shaped negatively birefringent crystals
Gout
Bone pain, tenderness w/ elevated CRP & ESR
Most commonly due to Osteomyelitis
Low trauma fractures
Osteogenesis imperfecta
Narrowing of marrow cavity, resulting in low H & H
Osteopetrosis
55 yo F trips and sustains distal radius fracture
Colles fracture (osteoporosis may be cause)
Empiric tx septic arthritis
Presume S. aureus, start IV vancomycin; If N. gonorrhea, ceftriaxone with 10 days of doxycycline
