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D2 Fall > Gen Path Exam 4 - Musculoskeletal Pathology > Flashcards

Gen Path Exam 4 - Musculoskeletal Pathology Flashcards

1
Q

What are the components of bone?

A

35% organic osteoid
65% hydroxyapatite (inorganic)

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2
Q

What is found in organic osteoid?

A

Type I collagen
Glycosaminoglycans

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3
Q

Which component of bone is responsible for rigidity and hardness?

A

Hydroxyapatite

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4
Q

What are the 2 types of bone?

A

Woven
Lamellar

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5
Q

Which type of bone is rapidly produced and has less structural integrity?

A

Woven

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6
Q

Which type of bone is involved in fetal development and fracture repair?

A

Woven

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7
Q

Which type of bone is slowly produced and has more structural strength?

A

Lamellar

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8
Q

Which type of bone has parallel collagen fibers?

A

Lamellar

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9
Q

Which cell type?

Located on surface of bone matrix

A

Osteoblasts

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10
Q

Which cell type?

Synthesize, transport, assemble bone matrix

A

Osteoblasts

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11
Q

Which cell type?

Located within bone

A

Osteocytes

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12
Q

Which cell type?

Interconnected by cytoplasmic processes through canaliculi

A

Osteocytes

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13
Q

Which cell type?

Controls Ca2+ and phosphate levels

A

Osteocytes

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14
Q

Which cell type?

Detects mechanical forces

A

Osteocytes

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15
Q

Which cell type?

Located on bone surface

A

Osteoclasts

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16
Q

Which cell type?

Specialized multinucleated macrophages

A

Osteoclasts

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17
Q

Which cell type?

Responsible for bone resorption

A

Osteoclasts

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18
Q

Which cell type?

Secrete acid and neutral proteases (MMPs) to resorb bone

A

Osteoclasts

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19
Q

Constant, regulated process of bone turnover

A

Remodeling

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20
Q

What is remodeling of bone regulated by?

A

Cytokines
Cell-cell interactions

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21
Q

What are the 4 specific things that regulate remodeling of bone?

A

RANK receptors
RANK ligand (RANKL)
RANK-RANKL binding
Osteoprotegerin (OPG)

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22
Q

Which part of regulating remodeling of bone?

On osteoclast precursors

A

RANK receptors

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23
Q

Which part of regulating remodeling of bone?

On osteoblasts

A

RANKL

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24
Q

Which part of regulating remodeling of bone?

Stimulates differentiation into osteoclasts, leads to increased bone resorption

A

RANK-RANKL binding

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25
Q

Which part of regulating remodeling of bone?

Made by osteoblasts

A

Osteoprotegerin (OPG)

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26
Q

Which part of regulating remodeling of bone?

Blocks RANK interaction with RANKL

A

Osteoprotegerin (OPG)

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27
Q

Which part of regulating remodeling of bone?

Prevents osteoclast differentiation, decreases bone resorption

A

Osteoprotegerin (OPG)

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28
Q

What category of disease?

Osteoporosis

A

Metabolic

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29
Q

Which disease?

Decreased bone density and increased fracture risk

A

Osteoporosis

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30
Q

Which disease?

Decreased bone density

A

Osteopenia

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31
Q

What are the 5 most common causes of osteoporosis?

A

Increased age
Postmenopause
Sedentary lifestyle
Medications
Endocrine disorders

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32
Q

Which disease?

Affects older adults and postmenopausal women

A

Osteoporosis

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33
Q

Which disease has the following clinical presentation?

Vertebral fractures (loss of height)
Fractures of femoral neck, pelvis, spine

A

Osteoporosis

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34
Q

In osteoporosis, fractures of femoral neck, pelvis, and spine lead to what 2 things?

A

Embolism
Pneumonia

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35
Q

Which disease?

Not detected in plain radiographs until 30-40% of bone is lost

A

Osteoporosis

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36
Q

Which disease?

Dual energy X-Ray absorptiometry (DEXA scan)

A

Osteoporosis

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37
Q

Which disease has the following tx methods?

Exercise (load magnitude/resistance training)
Ca2+ and Vitamin D
Drugs that decrease bone resorption

A

Osteoporosis

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38
Q

Which drug is used to treat osteoporosis because it inhibits osteoclast-mediated bone resorption?

A

Bisphosphonates

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39
Q

Which category of disease?

Gout

A

Metabolic

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40
Q

Which disease?

Caused by hyperuricemia -> leads to deposition of urate crystals in joins -> stimulates inflammatory response

A

Gout

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41
Q

Which disease has the following risk factors?

Age
Genetics
Alcohol
Obesity
Drugs that reduce excretion of urate

A

Gout

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42
Q

Which disease has the following clinical presentation?

Asymptomatic hyperuricemia
Acute arthritis
Period of resolution, then repeated attacks

A

Gout

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43
Q

Which clinical presentation of Gout?

Can be present for years before symptoms appear

A

Asymptomatic hyperuricemia

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44
Q

Which clinical presentation of Gout?

Sudden onset excruciating localized joint pain; often affects joint of 1st toe

A

Acute arthritis

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45
Q

Which disease is diagnosed by the following?

Elevated uric acid
Synovial fluid shows urate crystals

A

Gout

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46
Q

Which disease has the following tx methods?

Lifestyle modification
NSAIDs
Meds to lower urate levels

A

Gout

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47
Q

Which category of disease?

Osteoarthritis

A

Injury

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48
Q

Which disease?

Caused by degeneration of cartilage

A

Osteoarthritis

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49
Q

Which disease?

Most common disease of joints

A

Osteoarthritis

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50
Q

Which disease has the following risk factors?

Age
Joint overuse
Prior injury

A

Osteoarthritis

51
Q

Which disease?

Affects adults > 50 yrs old

A

Osteoarthritis

52
Q

Which disease has the following clinical presentation?

Joint pain, worsens with use
Morning stiffness
Crepitus (grinding of joint)
Reduced range of motion

A

Osteoarthritis

53
Q

Which disease?

Diagnosed by radiographs

A

Osteoarthritis

54
Q

Which disease has the following tx methods?

Management of pain w/ NSAIDs, corticosteroids, activity modification, surgery

A

Osteoarthritis

55
Q

Which disease has the following tx methods?

Physical therapy
Weight management

A

Osteoarthritis

56
Q

Which disease?

Currently, there is no way to prevent or stop progression

A

Osteoarthritis

57
Q

Which is the most common demographic for osteoporosis?

Men over 30
Postmenopausal women
Adolescents
Athletes under 30

A

Postmenopausal women

58
Q

Which category of disease?

Osteomyelitis

A

Infection

59
Q

Which disease?

Caused by inflammation of bone

A

Osteomyelitis

60
Q

Which disease?

Almost always secondary to infection

A

Osteomyelitis

61
Q

What is the most common bacteria in Osteomyelitis?

A

Staph aureus

62
Q

Which disease?

Affects immunocompromised, diabetics, trauma

A

Osteomyelitis

63
Q

Which disease has the following clinical presentation?

Localized pain, swelling, fever, erythema

A

Osteomyelitis

64
Q

Which disease?

If chronic, can show abscess formation

A

Osteomyelitis

65
Q

Which disease?

Diagnosed by imaging or biopsy

A

Osteomyelitis

66
Q

Which disease?

Imaging shows patchy, ragged, ill-defined radiolucency

A

Osteomyelitis

67
Q

Which disease has the following tx methods?

Resolve source of infection
Surgical debridement (removal of necrotic bone)
ABs

A

Osteomyelitis

68
Q

Gout is primarily caused by an excess of which substance?

A

Uric acid

69
Q

Which category of disease?

Osteoma

A

Neoplasm

70
Q

Which disease?

Caused by benign tumor of bone

A

Osteoma

71
Q

Which disease?

Multiple are seen in pts with Gardner syndrome

A

Osteoma

72
Q

Which disease has the following clinical presentation?

Primary involves craniofacial bones
Arise on bone surface or within medullary bone

A

Osteoma

73
Q

Which disease?

Diagnosed by circumscribed, sclerotic mass on X-Ray or biopsy

A

Osteoma

74
Q

Which diseases?

Tx is excision

A

Osteoma
Osteoid osteoma
Osteoblastoma

75
Q

Which category of disease?

Osteoid osteoma

A

Neoplasm

76
Q

Which diseases?

Benign tumor of bone arising from osteoblasts

A

Osteoid osteoma
Osteoblastoma

77
Q

Which disease?

Peaks in 2nd and 3rd decades of life

A

Osteoid osteoma

78
Q

Which disease has the following clinical presentation?

Bony tumor < 2 cm
Painful (usually nocturnal), relieved by NSAIDs

A

Osteoid osteoma

79
Q

Which diseases?

Diagnosed by radiograph or biopsy

A

Osteoid osteoma
Osteoblastoma

80
Q

Which disease?

Radiograph will show non-expansile, well circumscribed radiolucency w/ thick reactive sclerosis

A

Osteoid osteoma

81
Q

Which disease?

Radiograph may show central radiopaque nidus (target-like)

(ON EXAM)

A

Osteoid osteoma

82
Q

Which disease?

Usually occurs before age 30

A

Osteoblastoma

83
Q

Which disease has the following clinical presentation?

Bony tumor > 2 cm
Painful, but not relieved by NSAIDs

A

Osteoblastoma

84
Q

Which disease?

Radiograph will show expansile radiolucency with patchy or diffuse mineralization

A

Osteoblastoma

85
Q

Which category of disease?

Osteosarcoma

A

Neoplasm

86
Q

Which disease?

Malignant tumor that produces bone

A

Osteosarcoma

87
Q

Which disease?

A risk factor is radiation exposure

A

Osteosarcoma

88
Q

Which disease?

75% under 20 yrs old
2nd peak in older adults

A

Osteosarcoma

89
Q

Which disease has the following clinical presentation?

Painful, enlarging mass
May be discovered due to pathologic fracture
Codman triangle

A

Osteosarcoma

90
Q

Tumor breaks through cortex of bone and lifts periosteum, resulting in reactive subperiosteal formation

A

Codman triangle

91
Q

Which diseases?

Diagnosed by biopsy

A

Osteosarcoma
Chondrosarcoma

92
Q

Which disease has the following tx methods?

Combo of surgery, chemo, radiation

A

Osteosarcoma

93
Q

Which category of disease?

Chondrosarcoma

A

Neoplasm

94
Q

Which disease?

Malignant tumor that produces cartilage

A

Chondrosarcoma

95
Q

Which disease?

Affects adults > 40 yrs old

A

Chondrosarcoma

96
Q

Which disease has the following clinical presentation?

Painful, enlarging mass
Predilection for axial skeleton (pelvis, shoulder, ribs)

A

Chondrosarcoma

97
Q

Which disease has the following tx method?

Wide surgical excision w/ chemo if necessary

A

Chondrosarcoma

98
Q

Which age group is most commonly affected by osteosarcoma?

Elderly
Infants
Adolescents and young adults
Middle aged adults

A

Adolescents and young adults

99
Q

Which disease?

Called “brittle bone disease”

A

Osteogenesis imperfecta

100
Q

Which category of disease?

Osteogenesis imperfecta

A

Developmental

101
Q

Which disease?

Autosomal dominant inheritance

A

Osteogenesis imperfecta

102
Q

Which disease?

Caused by mutations in type 1 collagen genes

A

Osteogenesis imperfecta

103
Q

What are the type 1 collagen genes that are affected in Osteogenesis imperfecta?

A

COLA1A1
COLA1A2

104
Q

Which disease?

Caused by inadequate bone formation

A

Osteogenesis imperfecta

105
Q

Which disease?

Leads to weak bones that break easily

A

Osteogenesis imperfecta

106
Q

Which disease?

Present from birth

A

Osteogenesis imperfecta

107
Q

Which disease has the following clinical presentation?

Multiple bone fractures
Hearing loss
Blue sclerae
Opalescent teeth

A

Osteogenesis imperfecta

108
Q

Which disease?

Opalescent teeth are clinically and radiographically identical to dentinogenesis imperfecta

A

Osteogenesis imperfecta

109
Q

Which diseases?

Diagnosed by genetic testing

A

Osteogenesis imperfecta
Osteopetrosis

110
Q

Which disease has the following tx methods?

Management of fractured bones
Antiresorptive meds

A

Osteogenesis imperfecta

111
Q

Which antiresorptive medications are used to treat Osteogenesis imperfecta?

A

Bisphosphonates

112
Q

Which category of disease?

Osteopetrosis

A

Developmental

113
Q

Which disease?

Autosomal dominant or recessive inheritance

A

Osteopetrosis

114
Q

Which disease?

Caused by impaired formation of osteoclasts, leading to bone deposition without resorption

A

Osteopetrosis

115
Q

Which disease?

Results in dense, but brittle bones

A

Osteopetrosis

116
Q

Which disease?

Bone remodeling cannot occur normally

A

Osteopetrosis

117
Q

Which disease?

Affects broad range of people

A

Osteopetrosis

118
Q

Which disease has the following clinical presentation?

Obliterated marrow space
Extramedullary hematopoiesis
Compressed cranial nerves
Dense, opaque, solid bones on X-Ray
Osteomyelitis
Bone fractures

A

Osteopetrosis

119
Q

In Osteopetrosis, what is obliterated marrow space associated with?

A

Leukopenia

120
Q

In Osteopetrosis, what is extramedullary hematopoiesis associated with?

A

Hepatosplenomegaly

121
Q

In Osteopetrosis, what is are compressed cranial nerves associated with?

A

Deafness and blindness

122
Q

Which disease has the follwoing tx methods?

Manage symptoms
Preventative oral healthcare

A

Osteopetrosis

123
Q

The hallmark clinical feature of osteogenesis imperfecta is:

Muscle weakness
Fragile bones w/ frequent fractures
Joint stiffness
Enlarged bones

A

Fragile bones w/ frequent fractures

D2 Fall (37 decks)

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