Lecture 8- Musculoskeletal pathology Flashcards
… aka “brittle bone disease, these are a group of hereditary bone disorders with abnormal synthesis of type 1 collagen
osteogenesis Imperfecta (OI)
… and … may be seen as components of OI
blue sclera
opalescent teeth (dentinogenesis imperfecta-like)
most OI’s are autosomal…
dominant
…. aka “marble bone disease” is a group of rare hereditary bone disorders with defective bone remodeling (osteoclast dysfxn)
osteopertosis
affected bone of osteopetrosis is … but structurally … and…
dense
unsound
weak
patients with osteopetrosis are prone to .. and …
fractures
infections (osteomyelitis)
in osteopetrosis, compression of … can lead to …
cranial foramina
blindness, deafness
in osteopetrosis, bone can replace … and lead to …
marrow stem cells
pancytopenia (anemia, thrombocytopenia, leukopenia)
… is an increased porosity of the skeleton resulting from reduced bone mass and leading to bone fragility
osteoporosis
most common form of acquired, metabolic bone disease?
osteoporosis
… million people in the US have osteoporosis and … million have osteopenia
10
44
postmenopausal women are at the greatest risk for osteoporosis because it is associated with…
reduced estrogen
most common sites of osteoporosis?
vertebral bodies, pelvis, femoral neck and other weight bearing bones
osteoporosis may lead to … and subsequent…
kyphoscoliosis
reduced respiratory fxn
dx for osteoporosis
dual X-ray absorptiometry (DEXA scan)
tx for osteoporosis
diet/exercise
calcium with vit D supp
bisphosphonates
hormone replace. therapy
monoclonal Ab (denosumab, Prolia)
prognosis for osteoporosis
guarded
…. disease is an abnormal dense bone formation which is structurally weak and prone to fracture. usuall affects multiple bones (85% polyostitic) and affects adults over the age of 40
paget disease
etiology of paget disease?
unknown but paramyxovirus infection suspected
T/F most cases of paget disease are asymptomatic
true, may be detected on routine radiographs or blood studies
what symptoms could you see in paget disease
bone enlargement
bowing of leg bones
cranial nerve compression
pain
fractures
a very distinct feature that you could see from paget disease is …. which is termed a “lion face” characterized by overgrowth of facial and cranial bones and a slight increased risk (1% lifetime) for development of sarcomas (particularly osteosarcoma)
leontiasis ossea
paget disease happens in these 3 phases:
- osteoclactis activity , hypervascularity, bone loss
- osteoclastic and osteoblastic proliferation
- late osteosclerotic phase
what is the bone called in paget disease due to its histologic appearance
mosaic
tx for paget disease
calcitonin, bisphosphonates
analgesic for bone pain
… is the inappropriate secretion of PTH
hyperparathyroidism
Primary hyperparathyroidism is due to … , … or … and is more … but less…
parathyroid hyperplasia, adenoma, carcinoma
more severe
less common
Secondary hyperparathyroidism leads to poor … and altered ….
commom complication of ESRD or vit. D deficiency
calcium retention
vit. D metabolism
PTH actions
osteoclastic activation
increased calcium absorption by the kidneys
increased vit. D syn (kidneys) promoting calcium absorption from gut
ALL increase serum calcium
… is infection of bone and marrow and are usually bacterial
osteomyelitis
bacteria can colonize in bone one of 3 ways:
hematogenous spread (staph)
contiguous infection (odontogenic)
implantation following fracture of surgery
T/F osteomyelitis is usually asymptomatic
false. associated with pain/tenderness, possible overlying erythema or swelling
tx for osetomyelitis
drainage
antibiotics
surgical debridement
