Gen Path Exam 4 - Musculoskeletal Pathology Flashcards
1
Q
What are the components of bone?
A
35% organic osteoid
65% hydroxyapatite (inorganic)
2
Q
What is found in organic osteoid?
A
Type I collagen
Glycosaminoglycans
3
Q
Which component of bone is responsible for rigidity and hardness?
A
Hydroxyapatite
4
Q
What are the 2 types of bone?
A
Woven
Lamellar
5
Q
Which type of bone is rapidly produced and has less structural integrity?
A
Woven
6
Q
Which type of bone is involved in fetal development and fracture repair?
A
Woven
7
Q
Which type of bone is slowly produced and has more structural strength?
A
Lamellar
8
Q
Which type of bone has parallel collagen fibers?
A
Lamellar
9
Q
Which cell type?
Located on surface of bone matrix
A
Osteoblasts
10
Q
Which cell type?
Synthesize, transport, assemble bone matrix
A
Osteoblasts
11
Q
Which cell type?
Located within bone
A
Osteocytes
12
Q
Which cell type?
Interconnected by cytoplasmic processes through canaliculi
A
Osteocytes
13
Q
Which cell type?
Controls Ca2+ and phosphate levels
A
Osteocytes
14
Q
Which cell type?
Detects mechanical forces
A
Osteocytes
15
Q
Which cell type?
Located on bone surface
A
Osteoclasts
16
Q
Which cell type?
Specialized multinucleated macrophages
A
Osteoclasts
17
Q
Which cell type?
Responsible for bone resorption
A
Osteoclasts
18
Q
Which cell type?
Secrete acid and neutral proteases (MMPs) to resorb bone
A
Osteoclasts
19
Q
Constant, regulated process of bone turnover
A
Remodeling
20
Q
What is remodeling of bone regulated by?
A
Cytokines
Cell-cell interactions
21
Q
What are the 4 specific things that regulate remodeling of bone?
A
RANK receptors
RANK ligand (RANKL)
RANK-RANKL binding
Osteoprotegerin (OPG)
22
Q
Which part of regulating remodeling of bone?
On osteoclast precursors
A
RANK receptors
23
Q
Which part of regulating remodeling of bone?
On osteoblasts
A
RANKL
24
Q
Which part of regulating remodeling of bone?
Stimulates differentiation into osteoclasts, leads to increased bone resorption
A
RANK-RANKL binding
25
Which part of regulating remodeling of bone?
Made by osteoblasts
Osteoprotegerin (OPG)
26
Which part of regulating remodeling of bone?
Blocks RANK interaction with RANKL
Osteoprotegerin (OPG)
27
Which part of regulating remodeling of bone?
Prevents osteoclast differentiation, decreases bone resorption
Osteoprotegerin (OPG)
28
What category of disease?
Osteoporosis
Metabolic
29
Which disease?
Decreased bone density and increased fracture risk
Osteoporosis
30
Which disease?
Decreased bone density
Osteopenia
31
What are the 5 most common causes of osteoporosis?
Increased age
Postmenopause
Sedentary lifestyle
Medications
Endocrine disorders
32
Which disease?
Affects older adults and postmenopausal women
Osteoporosis
33
Which disease has the following clinical presentation?
Vertebral fractures (loss of height)
Fractures of femoral neck, pelvis, spine
Osteoporosis
34
In osteoporosis, fractures of femoral neck, pelvis, and spine lead to what 2 things?
Embolism
Pneumonia
35
Which disease?
Not detected in plain radiographs until 30-40% of bone is lost
Osteoporosis
36
Which disease?
Dual energy X-Ray absorptiometry (DEXA scan)
Osteoporosis
37
Which disease has the following tx methods?
Exercise (load magnitude/resistance training)
Ca2+ and Vitamin D
Drugs that decrease bone resorption
Osteoporosis
38
Which drug is used to treat osteoporosis because it inhibits osteoclast-mediated bone resorption?
Bisphosphonates
39
Which category of disease?
Gout
Metabolic
40
Which disease?
Caused by hyperuricemia -> leads to deposition of urate crystals in joins -> stimulates inflammatory response
Gout
41
Which disease has the following risk factors?
Age
Genetics
Alcohol
Obesity
Drugs that reduce excretion of urate
Gout
42
Which disease has the following clinical presentation?
Asymptomatic hyperuricemia
Acute arthritis
Period of resolution, then repeated attacks
Gout
43
Which clinical presentation of Gout?
Can be present for years before symptoms appear
Asymptomatic hyperuricemia
44
Which clinical presentation of Gout?
Sudden onset excruciating localized joint pain; often affects joint of 1st toe
Acute arthritis
45
Which disease is diagnosed by the following?
Elevated uric acid
Synovial fluid shows urate crystals
Gout
46
Which disease has the following tx methods?
Lifestyle modification
NSAIDs
Meds to lower urate levels
Gout
47
Which category of disease?
Osteoarthritis
Injury
48
Which disease?
Caused by degeneration of cartilage
Osteoarthritis
49
Which disease?
Most common disease of joints
Osteoarthritis
50
Which disease has the following risk factors?
Age
Joint overuse
Prior injury
Osteoarthritis
51
Which disease?
Affects adults > 50 yrs old
Osteoarthritis
52
Which disease has the following clinical presentation?
Joint pain, worsens with use
Morning stiffness
Crepitus (grinding of joint)
Reduced range of motion
Osteoarthritis
53
Which disease?
Diagnosed by radiographs
Osteoarthritis
54
Which disease has the following tx methods?
Management of pain w/ NSAIDs, corticosteroids, activity modification, surgery
Osteoarthritis
55
Which disease has the following tx methods?
Physical therapy
Weight management
Osteoarthritis
56
Which disease?
Currently, there is no way to prevent or stop progression
Osteoarthritis
57
Which is the most common demographic for osteoporosis?
Men over 30
Postmenopausal women
Adolescents
Athletes under 30
Postmenopausal women
58
Which category of disease?
Osteomyelitis
Infection
59
Which disease?
Caused by inflammation of bone
Osteomyelitis
60
Which disease?
Almost always secondary to infection
Osteomyelitis
61
What is the most common bacteria in Osteomyelitis?
Staph aureus
62
Which disease?
Affects immunocompromised, diabetics, trauma
Osteomyelitis
63
Which disease has the following clinical presentation?
Localized pain, swelling, fever, erythema
Osteomyelitis
64
Which disease?
If chronic, can show abscess formation
Osteomyelitis
65
Which disease?
Imaging shows patchy, ragged, ill-defined radiolucency
Osteomyelitis
66
Which disease has the following tx methods?
Resolve source of infection
Surgical debridement (removal of necrotic bone)
ABs
Osteomyelitis
67
Gout is primarily caused by an excess of which substance?
Uric acid
68
Which category of disease?
Osteoma
Neoplasm
69
Which disease?
Caused by benign tumor of bone
Osteoma
70
Which disease?
Multiple are seen in pts with Gardner syndrome
Osteoma
71
Which disease has the following clinical presentation?
Primary involves craniofacial bones
Arise on bone surface or within medullary bone
Osteoma
72
Which disease?
Diagnosed by circumscribed, sclerotic mass on X-Ray or biopsy
Osteoma
73
Which diseases?
Tx is excision
Osteoma
Osteoid osteoma
Osteoblastoma
74
Which category of disease?
Osteoid osteoma
Neoplasm
75
Which diseases?
Benign tumor of bone arising from osteoblasts
Osteoid osteoma
Osteoblastoma
76
Which disease?
Peaks in 2nd and 3rd decades of life
Osteoid osteoma
77
Which disease has the following clinical presentation?
Bony tumor < 2 cm
Painful (usually nocturnal), relieved by NSAIDs
Osteoid osteoma
78
Which diseases?
Diagnosed by radiograph or biopsy
Osteoid osteoma
Osteoblastoma
Osteomyelitis
79
Which disease?
Radiograph will show non-expansile, well circumscribed radiolucency w/ thick reactive sclerosis
Osteoid osteoma
80
Which disease?
Radiograph may show central radiopaque nidus (target-like)
(ON EXAM)
Osteoid osteoma
81
Which disease?
Usually occurs before age 30
Osteoblastoma
82
Which disease has the following clinical presentation?
Bony tumor > 2 cm
Painful, but not relieved by NSAIDs
Osteoblastoma
83
Which disease?
Radiograph will show expansile radiolucency with patchy or diffuse mineralization
Osteoblastoma
84
Which category of disease?
Osteosarcoma
Neoplasm
85
Which disease?
Malignant tumor that produces bone
Osteosarcoma
86
Which disease?
A risk factor is radiation exposure
Osteosarcoma
87
Which disease?
75% under 20 yrs old
2nd peak in older adults
Osteosarcoma
88
Which disease has the following clinical presentation?
Painful, enlarging mass
May be discovered due to pathologic fracture
Codman triangle
Osteosarcoma
89
Tumor breaks through cortex of bone and lifts periosteum, resulting in reactive subperiosteal formation
Codman triangle
90
Which diseases?
Diagnosed by biopsy
Osteosarcoma
Chondrosarcoma
91
Which disease has the following tx methods?
Combo of surgery, chemo, radiation
Osteosarcoma
92
Which category of disease?
Chondrosarcoma
Neoplasm
93
Which disease?
Malignant tumor that produces cartilage
Chondrosarcoma
94
Which disease?
Affects adults > 40 yrs old
Chondrosarcoma
95
Which disease has the following clinical presentation?
Painful, enlarging mass
Predilection for axial skeleton (pelvis, shoulder, ribs)
Chondrosarcoma
96
Which disease has the following tx method?
Wide surgical excision w/ chemo if necessary
Chondrosarcoma
97
Which age group is most commonly affected by osteosarcoma?
Elderly
Infants
Adolescents and young adults
Middle aged adults
Adolescents and young adults
98
Which disease?
Called "brittle bone disease"
Osteogenesis imperfecta
99
Which category of disease?
Osteogenesis imperfecta
Developmental
100
Which disease?
Autosomal dominant inheritance
Osteogenesis imperfecta
101
Which disease?
Caused by mutations in type 1 collagen genes
Osteogenesis imperfecta
102
What are the type 1 collagen genes that are affected in Osteogenesis imperfecta?
COLA1A1
COLA1A2
103
Which disease?
Caused by inadequate bone formation
Osteogenesis imperfecta
104
Which disease?
Leads to weak bones that break easily
Osteogenesis imperfecta
105
Which disease?
Present from birth
Osteogenesis imperfecta
106
Which disease has the following clinical presentation?
Multiple bone fractures
Hearing loss
Blue sclerae
Opalescent teeth
Osteogenesis imperfecta
107
Which disease?
Opalescent teeth are clinically and radiographically identical to dentinogenesis imperfecta
Osteogenesis imperfecta
108
Which diseases?
Diagnosed by genetic testing
Osteogenesis imperfecta
Osteopetrosis
109
Which disease has the following tx methods?
Management of fractured bones
Antiresorptive meds
Osteogenesis imperfecta
110
Which antiresorptive medications are used to treat Osteogenesis imperfecta?
Bisphosphonates
111
Which category of disease?
Osteopetrosis
Developmental
112
Which disease?
Autosomal dominant or recessive inheritance
Osteopetrosis
113
Which disease?
Caused by impaired formation of osteoclasts, leading to bone deposition without resorption
Osteopetrosis
114
Which disease?
Results in dense, but brittle bones
Osteopetrosis
115
Which disease?
Bone remodeling cannot occur normally
Osteopetrosis
116
Which disease?
Affects broad range of people
Osteopetrosis
117
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
Osteopetrosis
118
In Osteopetrosis, what is obliterated marrow space associated with?
Leukopenia
119
In Osteopetrosis, what is extramedullary hematopoiesis associated with?
Hepatosplenomegaly
120
In Osteopetrosis, what are compressed cranial nerves associated with?
Deafness and blindness
121
Which disease has the follwoing tx methods?
Manage symptoms
Preventative oral healthcare
Osteopetrosis
122
The hallmark clinical feature of osteogenesis imperfecta is:
Muscle weakness
Fragile bones w/ frequent fractures
Joint stiffness
Enlarged bones
Fragile bones w/ frequent fractures
