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Systems Pathology Exam One > Fractures And Associated Issues > Flashcards

Fractures And Associated Issues Flashcards

0
Q

What is another term for incomplete fractures?

A

Green stick fractures

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1
Q

Incomplete fractures are more common among what group of people?

A

Children

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2
Q

What is the term for an open fracture that ruptures the skin?

A

Compound fracture

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3
Q

What is a risk with compound fractures?

A

Infections

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4
Q

What is the type of fracture where the overlying tissue remains intact?

A

Closed fracture

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5
Q

What is the term for a fragmented or splintered fracture?

A

Comminuted

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6
Q

What type of fracture has a distal segment that is malaligned?

A

Displaced fracture

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7
Q

What is another name for a displaced fracture?

A

Nightstick fracture

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8
Q

What are examples of things that can cause pathological fractures?

A

Bone cyst, tumor, brown tumor

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9
Q

What is a stress fracture?

A

Fractures that develop slowly over time due to repetitive injury

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10
Q

What is the most common location of stress fractures?

A

Lower legs and feet

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11
Q

At what time after a fracture is the bony callus revealed and casts are typically taken off?

A

6-8 weeks

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12
Q

Can stress fractures be visible on X-rays?

A

No; microfractures occur

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13
Q

What is another term for avascular necrosis (AVN)?

A

Osteonecrosis

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14
Q

What causes the bony necrosis with AVN?

A

Ischemia

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15
Q

What is the most common cause of AVN?

A

Vascular disruption via fracture

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16
Q

What makes AVN worse?

A

Time, physical activity, pathological fracture

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17
Q

What areas are largely affected by AVN?

A

Subchondral areas of hip, knee, shoulder, wrist, ankle (large round joints)

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18
Q

Possible collapse with AVN creates a risk for what condition?

A

Osteoarthritis

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19
Q

What is “creeping substitution” seen with AVN?

A

Eventual new bone growth can occur over the damaged area

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20
Q

What is the most common form of osteomyelitis?

A

Acute

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21
Q

What condition is known as “bone-marrow-inflammation”?

A

Osteomyelitis

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22
Q

What is specifically infected in osteomyelitis?

A

Bone marrow

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23
Q

What is the most common mode of infection with osteomyelitis?

A

Hematogenous (sepsis)

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24
Q

What destroys the bone in osteomyelitis?

A

Leukocytes

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25
Q

What are other modes of infection for osteomyelitis besides the most common one?

A

Adjacent infection or traumatic implantation

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26
Q

What are signs and symptoms of osteomyelitis?

A

Acute fever, intense malaise, throbbing pain

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27
Q

What is usually the bacterial cause of osteomyelitis?

A

Pyogenic bacteria

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28
Q

Can the single microbe be found as the cause of osteomyelitis all of the time?

A

No; 50% of the time we are unable to identify the agent

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29
Q

What is the most common pyogenic bacteria to cause osteomyelitis?

A

Staphylococcus aureus

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30
Q

What are the most common pyogenic bacteria to cause osteomyelitis in neonates?

A

E. coli and group B streptococci

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31
Q

What is the most common pyogenic bacteria to cause osteomyelitis in patients with sickle cell anemia?

A

Salmonella spp

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32
Q

How is osteomyelitis diagnosed?

A

Radiography, biopsy, blood culture

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33
Q

In pyogenic osteomyelitis, what is the reactive woven/lamellar bone that surrounds the infected bone called?

A

Involucrum

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34
Q

In pyogenic osteomyelitis, what is that dead bone seen at the site of infection?

A

Sequestrum

35
Q

In pyogenic osteomyelitis, what is the ruptured periosteum that leads to an abscess in the surrounding soft tissue?

A

Draining sinus

36
Q

What is another name for tuberculous osteomyelitis?

A

Skeletal TB

37
Q

Skeletal TB occurs in what percentage of overall TB cases?

A

3%

38
Q

Caseous granulomas are seen among which osseous condition?

A

Skeletal TB (tuberculous osteomyelitis)

39
Q

What is the most common form of spread in tuberculous osteomyelitis?

A

Hematogenous (other form would be lymphatics)

40
Q

What is Pott disease?

A

Tuberculous osteomyelitis that has ended up in the spinal column

41
Q

Which is more common: secondary or primary bone tumors?

A

Secondary

42
Q

What six factors indicate a larger risk of a bone tumor being the cause of low back pain?

A

50 years of age or older, history of cancer, unexplained weight loss, failure to improve after a month of conservative care, unrelieved with bed rest, and pain duration longer than one month

43
Q

What is fibrous dysplasia?

A

Arrested development of bone resulting in a benign lesion (failure of bone differentiation)

44
Q

McCune-Albright syndrome is part of what category of fibrous dysplasia?

A

Polystotic + café-au-lait spots & endocrinopathy

45
Q

What category of fibrous dysplasia is most commonly represented?

A

Monostotic (70%)

46
Q

What is the age range of monostotic fibrous dysplasia?

A

10-30

47
Q

What is the typical location of monostotic fibrous dysplasia?

A

Ribs, femur, tibia, jawbones, calvaria, humerus

48
Q

What category of fibrous dysplasia is asymptomatic and results in minimal bony distortion or enlargement?

A

Monostotic

49
Q

Does polystotic fibrous dysplasia have any endocrinopathy?

A

No

50
Q

When does polystotic fibrous dysplasia typically develop?

A

Late childhood and adolescence (earlier than monostotic)

51
Q

Craniofacial involvement is present in about half of the cases of which category of fibrous dysplasia?

A

Polystotic

52
Q

The “ground glass” appearance on X-ray is characteristic of what bone condition?

A

Fibrous dysplasia

53
Q

How can you distinguish Paget’s disease from fibrous dysplasia on X-ray?

A

Fibrous dysplasia tends to be focused on the proximal region of the bone, while Paget’s disease is throughout the entire bone

54
Q

What is the treatment for fibrous dysplasia?

A

Excision, othropedic hardware

55
Q

McCune-Albright syndrome is more common among what gender?

A

Females

56
Q

What types of endocrine hyperfunction is associated with McCune-Albright syndrome?

A

Hyperthyroidism, pituitary adenoma, and adrenal hyperplasia

57
Q

What usually prompts the evaluation leading to McCune-Albright syndrome?

A

Precocious puberty

58
Q

Are the skin and bony lesions of McCune-Albright Syndrome commonly unilateral or bilateral?

A

Unilateral

59
Q

What is PNET?

A

Primitive neuroectodermal tumor

60
Q

What causes Ewing sarcoma or PNET?

A

Translocations of genetic bits of information

61
Q

“Small round cell tumors of bone” is associated with what bone condition?

A

Ewing sarcoma or PNET

62
Q

What is the appearance of the cells involved with an Ewing sarcoma?

A

Highly primitive and undifferentiated

63
Q

What is the second most common pediatric bone cancer (#1 osteosarcoma)?

A

Ewing sarcoma

64
Q

What is the difference between Ewing sarcoma and PNET?

A

PNET has some neural differentiation while Ewing sarcoma is virtually completely undifferentiated

65
Q

What is the most common age range of Ewing sarcoma and PNET?

A

10-20

66
Q

What race is more likely to be affected by Ewing sarcoma or PNET?

A

Caucasians (9X)

67
Q

What gender is at a greater risk for Ewing sarcoma and PNET?

A

Males

68
Q

What is the most common location of bone for Ewing sarcoma or PNET?

A

Femur

69
Q

What effect does an Ewing sarcoma or PNET mimic?

A

That of infection: pyrexia, leukocytosis, increased erythrocyte sedimentation rate

70
Q

“Onion-skinning” appearance of the periosteum is associated with what bone condition?

A

Ewing sarcoma

71
Q

What percentage of patients with Ewing sarcoma or PNET end up with complete remission?

A

50%

72
Q

Ewing sarcoma can sometimes mimic what other bone condition?

A

Osteosarcoma

73
Q

Homer-Wright pseudo rosettes are associated with what bone condition?

A

PNET

74
Q

What is the age range for giant-cell tumors of bone (GCT)?

A

20-40

75
Q

What is the most common location for giant-cell tumors of bone?

A

Knee

76
Q

What type of bone condition produces arthritis like pain, is osteolytic, and is painful?

A

Giant-cell tumor of bone

77
Q

What is the most common location of metastasis for a giant-cell tumor of bone, although it rarely metastasizes?

A

Lungs

78
Q

The “soap bubble” appearance on X-ray is associated with which bone condition?

A

Giant-cell tumor of bone

79
Q

What types of cancer may spread to bone?

A

Any

80
Q

What is the metastatic pathway of sarcomas?

A

Hematogenous

81
Q

What is the metastatic pathway of carcinomas?

A

Lymphatic

82
Q

What is the most common type of secondary metastasis to bone?

A

Mixed- both osteoblastic and osteolytic

83
Q

What part of the skeleton is the most common location for secondary metastasis of bone?

A

Axial skeleton

84
Q

Why is the axial skeleton the most common location for secondary metastasis to bone?

A

Heavy bone marrow

85
Q

What are the most common forms of secondary metastasis to bone in adults?

A

Prostate (blastic), breast (lytic), lung

86
Q

What are the most common forms of secondary metastasis to bone in children?

A

Neuroblastoma, Wilm’s tumor, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma

Systems Pathology Exam One (7 decks)

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