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Bone > Dougherty Part 2 > Flashcards

Dougherty Part 2 Flashcards

1
Q

what is rickets

A

child vitamin D deficiency

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2
Q

osteomalacia is what

A

adult vitamin D deficiency

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3
Q

hyperparathyroidism is due to what

A

PTH excess

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4
Q

renal osteodystrophy is due to what

A

chronic renal disease

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5
Q

primary hyperparathyroidsim is most commonly from what

A

an adenoma

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6
Q

in hyperparathyroidism what is the osteoclast and osteoblast activity

A

increased activity in both OC>OB

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7
Q

secondary hyperparathyroidism is often due to what

A

hypocalcemia

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8
Q

what is part of the skeleton is affected in hyperparathyroidism

A

entire skeleton

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9
Q

what is seen in osteitis fibrosa cystica

A

subperiosteal resorption thins cortices
loss of lamina dura around the teeth
X-ray: bone loss radial aspect of middle phalanges of index and middle finger/ osteopenia

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10
Q

what is a brown tumor

A

bone replaced by fibrovascular tissue
microfractures result in hemorrhage and healing
granulation tissue and hemosiderin

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11
Q

what bone disease is caused by hyperparathyroidism

A

osteitis fibrosa cystica

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12
Q

brown tumors are seen in what

A

hyperparathyroidism (osteitis fibrosa cystica)

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13
Q

in renal osteodystrophy what is the osteoclast and osteoblastic activity

A

increased or decreased

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14
Q

in renal osteodystophy what is going on

A

hyperparathyroidism
decreased vitamin D conversion to 1,25-OH2VitD3
metabolic acidosis (increase release of calcium)

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15
Q

mosaic pattern of lamellar bone (jigsaw puzzle-like cement lines) is seen in what

A

paget disease (osteosclerotic

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16
Q

what are the stages of paget disease

A

osteolytic stage- loss of bone mass
mixed stage- osteolytic and osteoblastic
osteosclerotic stage- coarse thick irregular trabecular

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17
Q

v-shaped “blade of grass” lesion is characteristic of what

A

lytic pause of page’s disease

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18
Q

chalk stick-type fracture is seen in what

A

paget disease

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19
Q

what are calcium and phosphate levels in paget disease

A

normal

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20
Q

in paget disease what are alkaline phosphate levels

A

high

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21
Q

what benign tumors are associate with paget disease

A

giant cell tumor
giant cell reparative granuloma
extraosseous hematopoeisis

22
Q

what malignant tumors are associate with paget disease

A

osteosarcoma

fibrosarcoma

23
Q

how does one treat paget disease

A

calcitonin and biphosphonates

24
Q

what is a soft tissue callus (procallus)

A

hematoma fibrin creates framework
influx inflammation, fibroblasts, and capillaries
osteoprogenitor cells activated
no rigidity, easily disrupted

25
Q

boney callus is what

A

woven bone is made
+/- cartilage for enchondral ossification
over time remodels to bear full weight

26
Q

when is the maximum girth of a callus

A

3 weeks

27
Q

what are some complications with fractures

A

misaligned bone
infected, displaced or devitalized bone leads to deformity
pseudoarthrosis: nonunion

28
Q

what is the most common cause of osteonecrosis

A

corticosteroids

29
Q

what is osteonecrosis

A

infarction of bone and marrow

dead bone/fat is replaced by calcium soaps

30
Q

what are some of the most common causes of avascular necrosis

A 
corticosterioids
infection
dysbarsim (bends)
pregnancy
sickle cell disease and other anemias
31
Q

avascular necrosis due to subchondral infarct can be easily recognized in a photograph by what

A

crack in the bone

32
Q

avascular necrosis due to a medullary infarct casuses what

A

geographic necrosis
small silent and stable
large painful (dysbarism, sickle cell)

33
Q

avascular necrosis due to subchondral infarct causes what

A

chronic pain
wedge-shaped subchondral bone (often crack beneath preserved cartilage, overlying cartilage nurtured by synovial fluid)
secondary collapse lead to osteoarthritis

34
Q

what is osteomyelitis

A

inflammation almost always from infection

35
Q

how do bacteria reach the bone in osteomyelitis

A

hematogenous (most common in children)
direct extension
implantation

36
Q

what is the classic x-ray seen in osteomyelitis

A

lytic bone lesion with surrounding sclerosis

37
Q

what is the most common cause of pyogenic osteomyelitis

A

staph aureus

38
Q

what causes pyogenic osteomyelitis in people with GU infection and IV drug users

A

E Coli
pseudomonas
klebsiella

39
Q

pyogenic osteomyelitis in infants is commonly caused by what

A

H. flu

Group B strep

40
Q

what location is influenced by blood supply in pyogenic osteomyelitis of a neonate

A

metaphysis and or epiphysis (can spread into join through articular surface or adjacent structures)

41
Q

what location is influenced by blood supply in pyogenic osteomyelitis of a children

A

metaphysis (subperiosteal abscess)

42
Q

what location is influenced by blood supply in pyogenic osteomyelitis of an adult

A

epiphysis and subchondral bone

43
Q

what is sequestrum and when is it seen

A

dead piece of bone

pyogenic osteomyelitis

44
Q

what is involucrum and when is it seen

A

reactive surrounding bone

pyogenic osteomyelitis

45
Q

what is sclerosing osteomyelitis of Garre

A

in jaw with extensive new bone formation

46
Q

what are complications of chronic osteomyelitis

A

pathologic fracture

sarcoma

47
Q

how does osteomyelitis present

A

acutely sick to unexplained fever
local pain
draining sinus (can develop squamous cell carcinoma)

48
Q

what is potts disease

A

TB osteomyelitis of the lumbar/thoracic spine

break through discs to other vertebrae (scoliosis and kyphosis)

49
Q

most common TB osteomyelitis

A

potts disease

50
Q

what causes syphilis of the bone

A

T pallidum and T pertenue (yaws)

51
Q

what is seen in acquired syphilis of the bone

A

involves bone in tertiary phase
SADDLE NOSE
palate
skull

Bone (19 decks)

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