Final: Musculoskeletal patho Flashcards
what does the musculoskeletal system provide for the body
form, stability, movement
every how many years is the complete human skeleton replaced?
every 10-12 years a completely new skeleton is formed
what is a group of hereditary bone diseases with abnormal synthesis of Type 1 collagen? aka? leads to what?
osteogenesis imperfecta which leads to skeletal fragility
aka brittle bone disease
most osteogenesis imperfecta disorders are inherited how?
if severe enough what may happen at birth?
what are two facial features that may be seen with OI?
most OI= autosomal DOMINANT
if severe enough death may occur from passage thru birth canal
BLUE SCLERA and opalescent teeth (similar to dentinogenesis imperfect) may be seen
whats the tx with OI?
whats the prognosis based on?
OI tx: minimize factors that causes fractures
prognosis: based on type of OI and expression of gene
what is clinically indistinguishable between Dentinogenesis Imperfecta and Osteogenesis Imperfecta?
Opalescent teeth
whats a group of rare hereditary disorders w defective bone remodeling (osteoclast dysfunction)?
what is the resulting bone in this disorder?
AKA?
osteopetrosis= dense bone that is structurally unsound and weak
Osteopetrosis aka marble bone disease
PTs with osteopetrosis are predisposed to what?
Pts with osteopetrosis are prone to fractures and infections like osteomyelitis
what is the only cure for osteopetrosis?
replacement of the marrow stem cells can lead to what?
what can occur in the head in PTs w osteopetrosis?
Osteopetrosis cure = bone marrow transplant
replacement of marrow stem cells can lead to anemia, thrombocytopenia, leukopenia
w osteopetrosis the cranial foramen can compress leading to blindness, deafness
what is the most common acquired, metabolic bone disease ? what does this disease cause?
osteoporosis= INC porosity of skeleton resulting from reduced bone mass, INC bone fragility e
who is at greatest risk for osteoporosis and what is this associated with? what percent sustain fractures by 65? by age 90?
postmenopausal women at greatest risk for osteoporosis associated with DEC estrogen
25% of women at age 65 have fractures bc of osteoporosis
50% of women at age 90 have fractures
what is basically the problem in osteoporosis?
osteoporosis is an imbalance between INC osteoclastic activity and an DEC in osteoblastic activity
what sites are most commonly affected by osteoporosis?
vertebral bodies, pelvis, femoral neck, other weight bearing bones
what may osteoporosis lead to?
osteoporosis may lead to kyphoscoliosis and reduced respiratory function
what affect more women osteoporosis fractures or the combo of heart attach + stroke + great cancer? how many people die within 1 year of sustaining a hip fracture bc of osteoporosis?
osteoporosis! 25% of people die within 1 year of hip fracture
how do you diagnose osteoporosis?
tx?
prognosis?
osteoporosis gold standard of diagnosis= dual X ray absorptiometry (dexa scan)
tx: diet, exercise, calcium and vit D, biphosphonates, hormone therapy, monoclonal ABs
prognosis: guarded
what disease usually affects adults older than 40 but has an unknown etiology that may be related to a paramyxovirus infection?
pagets disease of bone
Pagets disease of bone causes what?
what percent are polyostotic: affects multiple bones?
pages disease of the bone causes abnormal, dense bone formation which is structuraly weak and prone to fracture
85% are polyostotic
what are common signs of pagets disease that can be found on X-rays or blood tests even tho it may be asymptomatic
bone enlargement, fractures, pain, cranial nerve compression, bowing of leg bones
what are the 3 phases of Pagets disease? what is a common description of the bone in Pagets disease?
- osteolytic phase
- mixed phase
- osteosclerotic phase
Mosaic bone
Tx of Pagets?
Risks of Pagets outside of bone fractures?
Pagets tx: Calcitonin, bisphosphonates, analgesics for bone pain
slight 1% lifetime INC risk for sarcomas especially osteosarcoma
what is primary hyperparathyroidism? tx of primary?
primary is due to parathyroid hyperplasia, adenoma, carcinoma more severe but less common
primary Tx: remove affected gland or tumor
actions of PTH?
osteoclastic activation, INC Ca absorption by kidneys
INC Vit D synthesis by kidneys which promotes Ca absorption by gut
All these lead to INC serum Ca!!
what can hyperparathyroidism causes?
what is more severe but less common primary or secondary
“painful bones, renal stones, abdominal groans and psychic moans”
primary is more severe but less common
