Miller's Facts

Question 1

diagnostic of hypophosphatasia

Answer 1

• low alk phos
• high urine phosphoethanolamine

autosomal recessive

Question 2

most common form of rickets

Answer 2

familial hypophosphatemic rickets

Question 3

familial hypophosphatemic rickets

Answer 3

x-linked
phosphate wasting (low serum, high urine)
normal serum calcium
low serum 1,25D
high alk phos

treat: phosphate replacement and high dose D3

Question 4

phenytoin can cause

Answer 4

osteoporosis

Question 5

general mechanism of bisphosphonates

Answer 5

inhibit osteoclast ruffled border function

Question 6

how long does transient osteoporosis of the hip take to resolve?

Answer 6

6-8 months

Question 7

causes of osteoporosis

Answer 7

• old age
• endocrine abnormality (menopause, addison’s, cushing’s)
• disuse
• alcoholism
• calcium deficiency

Question 8

causes of osteomalacia

Answer 8

• vitamin D deficiency
• hypophosphatemic syndromes
• renal tubular acidosis
• hypophosphatasia

Question 9

tetracycline bone biopsy for osteoporosis vs osteomalacia

Answer 9

osteoporosis labels normal

osteomalacia labels abnormal

Question 10

lab features of Paget’s disease

Answer 10

• elevated serum alkaline phosphatase

- elevated serum calcium and urinary hydroxyproline levels

Question 11

osteoclast changes associated with Paget’s disease

Answer 11

virus-like inclusion bodies

Question 12

water content in cartilage with OA goes:

Answer 12

up. .. water content elevates
- increased permeability
- decreased strength
- decreased young’s modulus

Question 13

what does vitamin C do

Answer 13

puts -OH group on proline

Question 14

type X collagen:

Answer 14

near calcified cartilage only
near the tidemark
Hypertrophic zone of the physis
Fracture callus and calcifying cartilaginous tumors

Question 15

chondroitin-4-sulfate age related changes

Answer 15

decreases with age

Question 16

chodnroitin-6-sulfate age related changes

Answer 16

remains constant

Question 17

keratin sulfate age relate changes

Answer 17

increases with age

Question 18

modulus of elasticity of cartilage with age

Answer 18

goes up (more brittle)

Question 19

modulus of elasticity of cartilage with OA

Answer 19

goes down (softer)

Question 20

collagen present in tendons

Answer 20

type XII

Question 21

what transcription factor stimulates chondrocyte formation?

Answer 21

SOX9

Question 22

superficial cartilage zone

Answer 22

• highest water content
• highest lubricin content
• flat, non-metabolic chondrocytes

opposes shear

Question 23

middle cartilage zone

Answer 23

• highest metabolism
• largest chondrocyte size
• greatest collagen size
• highest proteoglycan concentration
• lowest water content

opposes compression

Question 24

calcified cartilage zone

Answer 24

• has calcium hydroxyapatite crystals

- type X collagen is here