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NBDE PART 1 MICRO/PATH > Micro/Path: Bone Disorders > Flashcards

Micro/Path: Bone Disorders Flashcards

1
Q

The most common bone lesion is a __

A

fracture

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2
Q

Healing of a fracture involves what 3 phases

A

Inflammatory phase
Reparative phase
Remodeling phase

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3
Q
  1. Which phase in the healing of a bone fracture does a BLOOD CLOT FORM
  2. Which phase does a CALLUS of CARTILAGE + CALLUS OF COMPACT BONE/BONY CALLUS FORM
  3. in the remodeling phase, the __ is revitalized
A
  1. inflammatory phase
  2. reparative phase
  3. cortex
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4
Q

Non union of fractures means that the fracture?

A

Failed to heal

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5
Q

There are 4 reasons for non union/failure of a bone fracture to heal. What are they?

A
  1. Infection
  2. Ischemia
  3. Excessive mobility
  4. Interposition of soft tissue-between the fractured ends
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6
Q
  1. bone fragments usually protrude in this kind of fracture

2. what is the most likely reason a compound fracture does not heal (non -union)

A
  1. compound fracture

2. infection

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7
Q

Pseudoarthrosis or pseudojoint may occur when a fracture fails to heal due to?

A

excessive mobility.
Pseudarthrosis = is a fracture that has not united in the stipulated time in which such fractures usually unite and has no chance of union without intervention.
There is movement of a bone at the location of a fracture resulting from inadequate healing of the fracture

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8
Q

fractures in which bones may fail to heal (non-union) due to ischemia? (3)

A

neck of femur (thigh bone), navicular bone of the wrist, and lower third of tibia (lower leg bone) b/c they are poorly vascularized = subject to coagulation necrosis after a fracture

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9
Q

___ is a pathological condition resulting from a disease, injury, therapy, or other trauma

A

sequela

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10
Q

____ is most often a sequel of fractured bones due to the mechanical disruption of bone marrow fat and by alterations in plasma lipids

A

fat embolism

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11
Q

Osteochondroma:

  1. benign/malignant tumor
  2. it is made of?
  3. found most frequently near the end of __ bones
  4. most common in patients aged _ -___
A
  1. benign
  2. bone and cartilage
  3. long bones
  4. 10-25years
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12
Q
  1. ___ = a group of disease that affects the growth plate during childhood, resulting in abnormal bone growth and deformity.
  2. affects different bones initially characterized by __ and __ followed by regeneration and ossification
A
  1. Osteochondroses

2. aseptic necrosis and degeneration

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13
Q
  1. osteochondro-ma =

2. osteochondro-ses =

A
  1. benign tumor of long bones made of cartilage and bone

2. group of diseases that affects the growth plate in CHILDHOOD

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14
Q

Osgood-Schlatter Disease - a type of osteochondroses

  1. _____of bone and cartilage at the ___
  2. usually develops b/w ages __ and more common in athletic boys/girls
  3. major symptoms
  4. usually involves the __ of the knee
A
  1. inflammation , top of the SHINBONE
  2. 10-15 athletic boys
  3. pain, swelling, tender knee.
  4. tibial tubercle (tibial tuberosity) of knee
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15
Q

Legg-Calve Perthes Disease- a type of osteochondroses 1. it is the destruction of the growth plate in the ___ caused by __

  1. develops between ages ___ and more common in boys/girls
  2. symptoms?
A
  1. neck of thigh bone (femur), poor blood supply to thighbone
  2. 5-10 years, boys
  3. hip pain and problems walking
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16
Q

___ is a bone condition that results from poor blood supply to an area of bone, causing LOCALIZED bone death.

A

Aseptic necrosis

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17
Q

Schuermann’s Disease: a type of osteochondroses

  1. a common condition in which changes in ___ cause ___
  2. Affects mostly boys/girls?
  3. symptoms?
A
  1. humpback (kyphosis) and backache due to changes in the vertebrae.
  2. boys
  3. rounded shoulders and PERSISTENT MILD BACKPAIN
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18
Q

Kohler’s bone disease - a type of osteochondroses:

  1. a rare form of __ of bone and cartilage
  2. it affects which bones
  3. usually affects g/b
  4. symptoms -
A
  1. inflammation (osteochondritis)
  2. small bones (navicular bones) in the foot
  3. boys
  4. swollen foot and limping
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19
Q

Identify the osteochondroses disease based on the symptoms:

  1. mild pain in back that is persistent, shoulders rounded, kyphosis
  2. swollen foot and limping
  3. hip pain and problems walking
  4. pain, swelling, and tenderness in shin

a. Osgood-schlatter disease
b. legg-calve perthes disease
c. scheuermann’s disease
d. kohler’s bone disease

A
  1. scheuremann’s disease (C)
  2. Kohler’s bone disease (D)
  3. Legg-Calve-Pertes disease (B)
  4. Osgood-schlatter disease (A)
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20
Q

Osteomalacia-

  1. is caused by __ deficiency in adults/youth?
  2. bones ___ b/c the bones contain osteoid tissue that failed to ___ due to lack of Vitamin __
  3. are all or some bones affected? where in the bone?
  4. Identified radiographically as?
  5. Characterized by gradual ___ of bones with ___ pain
A
  1. vitamin D, adults
  2. soften, calcify, D
  3. ALL bones affected at their epiphyseal growth plates.
  4. diffuse radiolucency that mimics osteoporosis
  5. softening and bending of bones with varying severity of pain.
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21
Q
  1. Osteomalacia often looks like what other disease on radiographs?
  2. What is the only way to differentiate bw the two
A
  1. Osteoporosis (diffuse radiolucency)

2. bone biopsy

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22
Q
  1. Osteomalacia is the ADULT form of ___
  2. OSteomalacia occurs more in W/M?
  3. T/F it may be asymptomatic until a fracture occurs
A
  1. Rickets
  2. WOMEN
  3. true
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23
Q
  1. Rickets is ___ in children that causes skeletal __
  2. it is usually accompanied by listlessness, irritability and general muscle weakness. In Rickets the bone becomes ___ because of failure of osteoid tissue to ___
A
  1. osteomalacia, deformities

2. bowed, calcify

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24
Q

TEETH IN CHILD WITH RICKET’S:

  1. Eruption is early/delayed
  2. occlusion?
  3. which dental tissues have developmental abnormalities?
  4. Is the caries rate affected?
A
  1. Eruption is delayed
  2. malocclusion
  3. dentin and enamel have abnormal development
  4. caries rate increases
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25
Q
  1. __________ - a bone infection usually caused by BACTERIA introduced by trauma/surgery/or nearby infection via bloodstream
  2. It is an acute/chronic pyogenic/non pyogenic infection of bone?
  3. which bacteria causes it
  4. common infection sites? (3)
  5. symptoms of?
A
  1. Osteoyelitis
  2. acute pyogenic
  3. Staphylococcus Aureus
  4. distal femur, proximal end of tibia, proximal end of humerus (upper arm bone)
  5. pain, redness, swelling, fever, malaise (feeling of general discomfort or uneasiness)
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26
Q
  1. ____ is a decrease in BONE MASS caused by impaired synthesis or increased resorption of bony matrix protein.
  2. It results in a predisposition to ___
  3. Common in what people and in what stage of life?
  4. treatment?
A
  1. Osteoporosis
  2. pathologic fractures
  3. thin, elderly white women, associated with postmenopausal bc estrogen deficiency, physical inactivity, hyperthyroidism, and calcium deficiency.
  4. estrogen therapy, calcium supplemets, vitamin D
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27
Q

____ = osteonecrosis

A

bone death

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28
Q
  1. OsteopeTrosis (NOT OSTEOPEROSIS) is aka (2)
  2. It is an uncommon__ bone disorder of marked ____ in density of bones, causing skeletal abnormalities
  3. begins at what age
  4. symptoms:
  5. What organs may enlarge?
  6. progressive __ and __ may occur
A
  1. marble bone disease, Albert-Schonberg Disease
  2. hereditary, increase
  3. infancy
  4. poor growth and poor weight gain (failure to thrive), easy bruising, abnormal bleeding, and anemia.
  5. Kidneys and liver may enlarge
  6. blindness and deafness
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29
Q
  1. neoplasm is a
A
  1. tumor = abnormal mass of tissue as a result of abnormal growth or division of cells
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30
Q

Metaplasia =

A

(Greek: “change in form”) is the reversible replacement of one differentiated cell type with another mature differentiated cell type
(conversion in cell type)

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31
Q

____(increase in the volume of cells)

A

Hypertrophy

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32
Q

___(reduced functionality of an organ, with decrease in the number or volume of cells)

A

Atrophy

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33
Q

___ (connective tissue growth)

A

Desmoplasia

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34
Q

___ (abnormal proliferation)

A

Neoplasia

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35
Q

___ (proliferation of cells)

A

Hyperplasia

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36
Q

____ (congenital below-average number of cells, especially when inadequate)

A

Hypoplasia

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37
Q

__ (organ or part of organ missing)

A

Aplasia

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38
Q

___ (structural differentation loss within cell or group of cells)

A

Anaplasia

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39
Q

NON-NEOPLASTIC BONE DISEASE

  1. Achondroplasia: one of the most common causes of
  2. It is genetically an x-linked/autosomal dominant/recessive disorder
  3. characterized by __ limbs with __ sized head and trunk
A
  1. Dwarfism
  2. autosomal dominant
  3. short limbs, normal sized head and trunk
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40
Q

NON-NEOPLASTIC BONE DISEASE

  1. Osteogenesis imperfect: a rare __ disorder that demonstrates the effect of inadequate osteoid production.
  2. bones are brittle/soft?
  3. OI results in skeletal fragility, __ skin, poor teeth.
  4. affect on eyes?
  5. affect on joints?
  6. the teeth are poor bc of malformation of ____
  7. patients have a history of multiple ___
A
  1. hereditary
  2. brittle
  3. thin
  4. thin sclera with a blue appearance
  5. Hypermobility of joints
  6. dentin (dentinogenesis imperfecta)
  7. multiple fractures
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41
Q

NON NEOPLASTIC BONE DISORDERS:

  1. Fibrous dysplasia is when normal bone is __
  2. there are 3 classifications depending on extensiveness of skeletal movement: name them
  3. if polyostotic AND endocrine disturbance it is called ___ syndrome
A
  1. replaced by fibrous tissue
  2. Monostotic: one bone
    Polyostotic: more than one bone
  3. Albright’s Syndrome
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42
Q

Osteoarthritis = aka (2)

A

degenerative arthritis

degenerative joint disease

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43
Q
  1. The most common joint disorder is

2. The most common bone lesion is

A
  1. osteoarthritis

2. fracture

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44
Q
  1. Osteochondroma
  2. Ostechondroses
  3. Ostemalacia
  4. Rickets
  5. Osteomyelitis
  6. Osteoperosis
  7. Osteornecrosis
  8. Osteropetrosis
  9. Osteoarthritis
A
  1. benign tumor of bone and cartilage (10-25yr athletic boys), long bone ends
  2. group of diseases that affects growth plate during CHILDHOOD = abnormal bone growth and deformity
  3. Vit D deficiency = adults bones failed to calcify. all bones
  4. Vit D def in kids. Same as osteomalacia but in kids, higher caries, dentin and enamel abnormal, delayed eruption of teeth, malocclusion
  5. Bone infection, staph aureus, distal femur, prox tibia, prox humerus. acute pyogenic
  6. loss of bone mass, assoc with menopause, age, hyperthyroid, inactivity
  7. bone death
  8. increase in bone density, begins in infancy, poor weight and development anemia, liver kidney enlarge, blind, deaf
  9. chronic joint disorder: degeneration of joint cartilage and adj bone
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45
Q
  1. Osteoarthritis: chronic/acute joint disorder
  2. ___ degeneration
  3. osteoarthritis is classified as primary when?
  4. It is classified as secondary when?
  5. Has a higher incidence in w/m over the age of
A
  1. chronic
  2. cartilage and adjacent bone degenerates -can cause pain and discomfort
  3. when cause is unknown
  4. when it is caused by another disease (ex Paget’s disease), or an infection, deformity, injury, or overused joint.
  5. women over 50
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46
Q

Osteoarthritis morphological changes:

  1. Eburnation of bone =
  2. Osteophyte
  3. Heberden’s nodes
  4. Bouchar’s nodes
  5. joints most often affected?
A
  1. polished ivory like appearance of bone
  2. bony spur formation that can fracture and float into the synovial fluid along with fragments of separated cartilage called JOINT MICE)
  3. osteophytes (bone spurs) found in DISTAL interphalangeal joints of fingers
  4. osteophytes (bone spurs) found in PROXIMAL interphalangeal joints of fingers
  5. intervertebral joints of the spine, phalangeal joints of fingers, knees, hips
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47
Q
  1. Rhueumatoid arthritis (RA) = a severely damaging form of arthritis affecting certain bones especially in the
  2. Begins at ___ age, but first symptoms occur
  3. w/m affected more?
  4. __ is a classis microscopic lesion of RA
A
  1. hands, feet, knees, ankles, elbows, wrists.
  2. any age, BEFORE the age of 50
  3. women
  4. pannus = tissue formed in the joint affected by the disease, causing loss of bone and cartilage
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48
Q

Still’s Disease is a type of __ in __ people

A

RA in young people

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49
Q
  1. Cause of RA?
  2. But it may be initiated by a __
  3. some people have a __ tendency to develop the disease
  4. Research suggests it may be a ___ disease
A
  1. unknown
  2. bacterial/viral infection
  3. genetic tendency
  4. autoimmune
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50
Q
  1. RA is marked by proliferative inflammation of the __ causing deformity, ankylosis, and invalidism.
  2. the earliest changes in RA occur in the __
A
  1. synovial membranes

2. synovia

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51
Q

___ = stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease.

A

Ankylosis

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52
Q

RA characteristics:

  1. serum immunoglobins?
  2. subcutaneous ___
  3. symmetric ___
  4. other symptoms
A
  1. anti-IgG antibodies = rheumatoid factor
  2. rheumatoid nodules
  3. polyarthritis
  4. fatigue, malaise, anorexia, weight loss, fever, myalgias
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53
Q

Rheumatoid arthritis (RA) is a ____, inflammatory, peripheral polyarthritis

A

symmetric

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54
Q

Myalgia is

A

muscle pain

55
Q
  1. Rheumatoid arthritis, systemic lupus erythematous, polyarteritis nodosa, dermatomyositis, and scheroderma are all ____ diseases
  2. they all have in common =
A

collagen disease.

2. inflammatory damage to CT and BV with disposition of fibrinoid material

56
Q

Polyarteritis nodosa, also known as Panarteritis nodosa,[ Kussmaul disease or Kussmaul-Maier disease is a ___, which become swollen and damaged from attack by rogue immune cells.

A

vasculitis of medium and small-sized arteries

57
Q

Vasculitis is a group of disorders that destroy __by inflammation. Both arteries and veins are affected

A

blood vessels

58
Q

Paget’s Disease:

  1. aka
  2. characterized by normal serum __ and __ and increased __
  3. It is a chronic/acute disorder of the skeleton
  4. It can affect __ bone
  5. Bones growth is
  6. bones __ and become __
A
  1. osteitis deformans
  2. normal calcium and phosphate, increased alkaline phosphatase
  3. chronic
  4. any, most common: pelvis, femur (thighbone), skull, shin, spine, vertebrae, collarbone (clavicle), and upper arm (humerus)
  5. abnormal
  6. enlarge and become soft
59
Q

Paget’s is characterized by a marked __ in bone remodeling

60
Q

Paget’s cause is ___ although it tends to run in __

A

unknown, families

61
Q

Paget’s occurs mainly in what population?

A

elderly white males.

62
Q

Signs and symptoms of Paget’s? Dental signs?

A

pain, hearing and vision problems, enlarged head, and intraorally the teeth SPREAD

63
Q
  1. Symptoms of Paget’s develop fast/slow?

2. People with Paget’s are predisposed in developing ___

A
  1. slow

2. osteosarcomas

64
Q
  1. Page’ts disease of bone is characterized by an extremely high level of __
  2. normal levels of
  3. enlargement of the ___
  4. increased incidence of __
A
  1. alkaline phosphatase
  2. normal ca and phosphorous
  3. skull enlarges
  4. osteosarcoma
65
Q
  1. Paget’s disease may be discovered due to a change in __
  2. Affected areas may be _to touch
  3. And It often results in
A
  1. hat size
  2. warm
  3. deafness
66
Q
  1. Von Recklinghausen’s Disease aka
  2. bone disorder caused by __
    3, characterized by decreased serum___ and increased serum __
A
  1. osteitis fibrosa cystica
  2. hyperparathyroidism
  3. decreased phosphorous
    increased ca and alkaline phosphatase
67
Q

Serum acid phosphatase levels are ELEVATED in patients with ____

A

prostate cancer

68
Q

Osteitis deformans aka

A

paget’s disease

69
Q

degenerative arthritis

degenerative joint disease aka

A

osteoarthritis

70
Q

Which occurs most commonly in elderly women and is associated with the postmenopausal state and estrogen deficiency?

A

osteoperosis

71
Q
  1. osteoporosis is a disease characterized by __ bone and __ bone mass
  2. these changes predisposes the bone to _
  3. the most common forms are?
A
  1. porous, reduced
  2. fracture
  3. senile and postmenopausal osteoperosis
72
Q
  1. ___osteoporosis, formerly known as osteoporosis type II, has been recently recognized as a geriatric syndrome with a particular pathophysiology.
  2. It has been pointed out that senile osteoporosis is the product of a skeleton in an ___ stage of life and also due to a deficiency caused by ___,
A
  1. Senile

2. advanced, calcium

73
Q

Factors related to pathogenesis of osteoporosis:

A
  1. age related changes in bone cells and matrix have strong impact on bone metabolism
  2. reduced physical activity increases the rate of bone loss b/c mechanical forces stimulate normal bone remodeling.
  3. genetic factors
  4. calcium in body
  5. hormone influences = estrogen deficiency
74
Q

T/F Hyperthyroidism, leukemia, lymphoma, and multiple myeloma can also cause osteoporosis.

75
Q

malignant tumor originating from ____ = termed carcinoma

A

epithelial cells

76
Q

Common malignancies, such as breast, colon, and lung cancer, are almost always carcinoma/sarcoma.

77
Q

is a cancer that arises from transformed cells of mesenchymal origin. Thus, malignant tumors made of cancerous bone, cartilage, fat, muscle, vascular, or hematopoietic tissues are, by definition, considered sarcomas.

78
Q

what is mesenchyme

A

Mesenchyme is a type of tissue characterized by loosely associated cells that lack polarity and are surrounded by a large extracellular matrix. Mesenchymal cells are able to develop into the tissues of the lymphatic and circulatory systems, as well as connective tissues throughout the body, such as bone and cartilage. A sarcoma is a cancer of mesenchymal cells

79
Q

___is a type of cancer of the blood or bone marrow characterized by an abnormal INCREASE of immature white blood cells called “blasts”. It is a broad term covering a spectrum of diseases. In turn, it is part of the even broader group of diseases affecting the blood, bone marrow, and lymphoid system, which are all known as hematological neoplasms.

80
Q

____ is a type of blood cancer that occurs when B or T lymphocytes, the white blood cells that form a part of the immune system and help protect the body from infection and disease, divide faster than normal cells or live longer than they are supposed to. May develop in the lymph nodes, spleen, bone marrow, blood or other organs and eventually they form a tumor.

81
Q

Joint mice found in which disease

A

osteoarthritis = dislodged pieces of cartilage and subchondral bone in the joint.

82
Q

Bone eburnation = what disease

A

osteoarthritis = progressive erosion of the articular cartilage = exposes subchondral bone plate = becomes new articular surface = friction from opposing surface smooths and polishes the exposed bone giving it a POLISHED IVORY APPEARANCE

83
Q

Osteophytes (bony spurs) can form at the distal interpharangeal joints . this is called __ nodes. this is associated with what disease

A

Heberdan nodes = distal

osteoarthritis

84
Q

Osteophytes (bony spurs) can form at the proximal interpharangeal joints . this is called __ nodes

85
Q

which is the most common joint disease:

osteoporosis or osteoarthritis

A

osteoarthritis

86
Q

___ aka brittle bone disease

A

osteogenesis imperfecta (OI)

87
Q

OI is an autosomal dominant disorder characterized by multiple __ with __ trauma

A

multiple, minimal

88
Q

OI is caused by ___

A

mutations in genes that code for type I collagen

89
Q

Myasthenia gravis is a ___ disorder

A

autoimmune

90
Q

myasthenia gravis is caused by autoantibodies to ___

A

postsynaptic acetylcholine receptors of the neuromuscular junction.

91
Q
  1. Ptosis

2. diplopia

A
  1. a drooping of the upper or lower eyelid

2. double vision

92
Q

myasthenia gravis presents as

A

ptosis, diplopia, difficulty chewing, speaking, or swallowing

93
Q

in OI the teeth are poor bc of malformation of

A

dentin (dentinogenesis imperfecta)

94
Q

All of the following are features of Albers-Schonberg disease except one:

a. anemia
b. multiple bone fractures
c. decreased bone density
d. blindness
e. deafness

A

c. decreased bone density

95
Q

Albers-Schonberg disease is aka (2)

A

osteoPetrosis, marble bone disease. Means STONE BONE

96
Q

Albers-Schonberg characterized by ___bone resorption and ___ skeletal sclerosis due to impaired formation or function of what cells

A

reduced bone resorption,
diffuse skeletal sclerosis
osteoclasts

97
Q

how do you get osteopetrosis

A

inherited (rare disease)

98
Q
  1. which disease dothe bones harden, becoming denser
  2. in which the bones become less dense and more brittle
  3. in which the bones soften.
A
  1. Albers-Schonberg/marble bone/osteoporosis
  2. osteoporosis
  3. Osteomalacia/rickets
99
Q

In osteopetrosis the bones are stonelike however they are abnormally ___ and fracture __ like a piece of chalk.

A

brittle, easily

100
Q

Osteopetrosis occurs in two clinical forms?

A
  1. autosomal recessive malignant infantile form-most sever form = results in death, usually occurs in first decade of life.
  2. a less severe autosomal dominant variant
101
Q

Main features of this disease is:

  • multiple fractures in spite of increased bone density
  • anemia as a result of decreased marrow space
  • blindness, deafness, and CN involvement due to narrowing and impingement of neural foramina
A

osterpetrosis: (It can cause osteosclerosis)

102
Q

___is caused by vitamin C deficiency. Characterized by bone lesions leading to impaired osteoid matrix formation which is caused by the failure of ___ and __ required for __ synthesis.

A

Scurvy, proline and lysine hydroxylation in collagen synthesis

103
Q

___ is caused by primary or secondary hyperthyroidism. widespread osteolytic lesions are characteristic

A

von Recklinghausen disease of bone aka osteitis fibrosa cystic

104
Q

in fibrous dysplasia, ___ are often the presenting complaint

A

pathologic fractures

105
Q
  1. Albright syndrome

2. Albers-Schonberg disease

A
  1. polysostotic fibrous dysplasia associated with endocrine disturbance
  2. osteopetrosis
106
Q

Match the disease with the site:

a. Kohler’s disease
b. Freiberg infraction
c. Scheurmann disease
d. Perthes’ disease
e. Osgood-Schlatter disease

  1. head of femur
  2. tibial tuberosity or patellar tendon insertion
    3 tarsal navicular bone
  3. intervertebral joints
  4. metatarsal head
A
  1. d: Head of femur: Perthes’ disease
  2. e: Tibial Tuberosity: Osgood schlatter
  3. a: tarsal navicular bone: kohler’s
  4. c: intervertebral joints: scheurmann
  5. b: metatarsal head: Freiberg infraction
107
Q

osteochondrosis (osteochondritis) is a term used to describe a group of disorders affecting the ___skeleton

108
Q

metatarsal bones are a group of five long bones in the __

109
Q

___, is a form of avascular necrosis in the metatarsal

A

Freiberg infraction

110
Q

Avascular necrosis and aseptic necrosis is used to describe

A

osteochondrosis: during rapid bone growth years blood supply to the growing ends (epiphyses) became insufficient resulting in necrotic bone usually near joints. Avascular necrosis = degeneration followed by reossification.

111
Q

Osteitis deformans aka

A

paget’s disease of the bone

112
Q

Osteitis deformans (Paget’s disease) presents as a mixed radiopaque and radiolucent lesion b/c the mixed stage of the disease features prominent __ and __

A

osteolysis and osteogenesis

113
Q

paget’s disease of the bone is a __ bone disease that involves bone __ and __ that results in deformity

A

metabolic, destruction and regrowth

114
Q

the cause of paget’s disease is NOT ENTIRELY known but it is thought to be caused in part by a

A

childhood virus.

115
Q

A virus particle known as ___ has been identified within the bone cells of individuals with Paget’s disease. this virus particle is not found in normal bone

A

Paramyxovirus nucleocapsid.

relationship has been identified but clear connection bw two has not been identified

116
Q

Paget’s disease commonly involves the spine, pelvis, skull, femur, tibia. may be monostotic (one area) or polyostotic (2areas) or widespread. The __ may enlarge and cause __ if the CN are damaged by the bone growth

A

skull, hearing loss

117
Q

Paget’s disease = abnormal bone ___ is characteristic due to increase of what cells

A

architecture caused by increase in both OSTEOBLAST AND OSTEOCLAST activity.

118
Q

Intraorally the teeth ___ in Paget’s disease

119
Q

the marked increase in serum alkaline phosphatase levels associated with __ disease means?

A

Paget’s, increased osteoblastic activity and bone formation

120
Q

In paget’s disease we see an elevated 24 hour urine level of ___ which means

A

elevated hydroxyproline = excreted by kidneys = index of osteoclastic hyperactivity

121
Q

The mosaic bone pattern also referred to as the jigsaw pattern of bone and a classic cotton wool appearance is seen in ___

A

Paget’s disease (osteitis deformans)

122
Q

osteitis fibrosa cystica aka

A

von Recklinghausen’s disease of bone

123
Q
  1. which disease do you see normal calcium, phosphorous but high alkaline phosphatase
  2. which disease do you see increased alkaline phosphatase AND calcium, Decreased phosphorous
A
  1. paget’s = high Phosphatase (think P) = osteitis deformans

2. von Recklinghausen’s

124
Q
  1. Condensing Osteitis aka ___
  2. appears on xray as a ___ lesion representing a localized bony reaction to a low grade inflammatory stimulus.
  3. usually seen at the __ of a tooth.
  4. especially what teeth?
A

1, sclerosing osteitis

  1. diffuse radiopaque
  2. apex
  3. MANDIBULAR MOLARS
125
Q

Osteoid is the bone protein matrix composed primarily of

A

type 1 collagen

126
Q
  1. When there is insufficient Vitamind D or osteoblast dysfunction the osteoid does not mineralize properly. instead it accumulates. when the newly formed bone of the growth plate does not mineralize the growth plate becomes ___
  2. this results in the clinical diagnosis of __ and is not seen in adults b/c?
A
  1. thick, wide and irregular.

2. rickets, bc adults no longer have growth plates

127
Q

when remodeled bone does not remineralize, _____ occurs. this occurs at __ ages

A

osteomalacia, all ages

128
Q
  1. Osteomalacia on xrays:

2. what other disease has diffuse radiolucency on xrays

A
  1. diffuse radiolucency

2. osteoporosis

129
Q

In Ricket’s craniotabes may occur = ?

A

bones of skull softer, flattened posterior skull can be seen

130
Q

in ricket’s why may you get caries

A

teeth erupt later bc of under mineralization. enamel can be poor quality = caries

131
Q

what are the 2 things you see in the thorax with rickets

A

Rachitic rosary: thickening of costochondoral junctions (looks like beads under skin in the ribs area)

Harrison groove: semicoronal impression groove over the abdomen at level of insertion of diaphragm

132
Q

5 histological stages of fracture healing

A
  1. fracture
  2. REACTIVE PHASE: granulation tissue forms around fractured bone ends
  3. REPARATIVE PHASE: Granulation tissue replaced by callus
  4. REPARATIVE PHASE: replacement of callus by lamellar bone
  5. REMODELING PHASE: remodeling of bone to normal contour
133
Q

Fractured bone causing mechanical disruption of bone marrow fat may cause a

A

fat embolism

NBDE PART 1 MICRO/PATH (20 decks)

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