MSK path V

Question 1

osteopenia

Answer 1

decreased bone mass

Question 2

osteoporosis

Answer 2

osteopenia that is severe and increase risk of fracture

Question 3

type of neuropathy assoc with osteoporosis

Answer 3

radiculopathies from collapsing vertebrae

Question 4

iatrogenic osteopenia

Answer 4

over Tx hyperthyroid

Question 5

primary causes osteopenia

Answer 5

idiopathic
postmenopausal
senile

Question 6

what contributes to senile and postmenopausal types of osteopenia

Answer 6

age related changes, reduced physcial activity, genetic factors, Ca nutritional state, hormonal influences

Question 7

what increases in menopause

Answer 7

IL1 IL6 TNF
RANK and RANKL
osteoclast activity

Question 8

what happens to bone mass from aging

Answer 8

decreased replication
decrease synthetic activity of osteoblasts
decreased activity of GF
reduced physical activity

Question 9

why are the vertebral bodies susceptible in osteoporosis postmenopausal

Answer 9

have greatest SA

trabecular plates lose connections

Question 10

explain bone changes in senile osteoporosis

Answer 10

Cx is thinned by subperiosteal and endosteal resorption
Haversian systems widened
can mimic cancellous bone

Question 11

complications in fractures of long or big bones in osteoprosis can lead to what

Answer 11

PE and pneumonia

Question 12

what is osteitis deformans

Answer 12

paget disease

icnreased disordered

Question 13

phases of pagets

Answer 13

osteolytic
mixed
osteosclerotic

Question 14

moasic pattern of lamellar bone

jigsaw puzzle like appearance from prominent cement lines

Answer 14

pagets

Question 15

the mosaic pattern in pagets means what

Answer 15

in sclerotic phase

Question 16

clinical sign pagets

Answer 16

usually asymptomatic

probably fracture

Question 17

majority pagets is monostotic or poly

Answer 17

poly

Question 18

what bones are most involved inpagets

Answer 18

axial skeleton and proximal femur

Question 19

leontiasis ossea

Answer 19

enalrgement craniofacial skeleton from remodeling in pagets

Question 20

what benign lesions develop in pagets

Answer 20

giant cell tumor, giant cell reparative granuloma, extra osseous masses of hematopoietic tissue

Question 21

malignant development of pagets

Answer 21

sarcoma

Question 22

lab finding in pagets

Answer 22

increased alkaline phosphatase

normal Ca and phosphorus

Question 23

what will you feel over painful lesion if pagets

Answer 23

increased temperature because increase in blood flow to that area

Question 24

bowing

thickeing of cortical and cancellous bone is called what and seen when

Answer 24

saber bone

seen in pagets

Question 25

rickets and osteomalacia

Answer 25

Vit D deficiency in children and adults

Question 26

what happens in Vit D deficiency

Answer 26

under-mineralization of bone

Question 27

what is rachitic rosary baby

Answer 27

abrnomal mineral homeostasis from rickets "string of beads"

Question 28

post common cause hyperPTH

Answer 28

PTH adenoma

Question 29

what happens to bone in hyperPTH

Answer 29

increase osteoclast activation increase bone resoprtion and Ca mobilization PTH mediates effect because increases RANKL expression

Question 30

mineral effects of hyper PTH

Answer 30

increased resorption of Ca by renal tubules increased urinary excretion of phosphates increased synthesis of active Vit D 1,25 OH by kidneys

Question 31

increased active vit D will do what

Answer 31

increase Ca absorption in gut and mobilize bone Ca buy inducing RANKL

Question 32

what will occur in hyperPTH if ostoclasts proliferate

Answer 32

dissecting osteitis, looks like train tracks

Question 33

what is a brown tumor

Answer 33

benign from a fracture( can be caused by dissecting osteitis) blood turns into hemosiderin which gives brown appearance

Question 34

renal osteodystrophy

Answer 34

skeletal changes that occur in chronic renal disease(assoc with dialysis) metabolic acidosis will cause bones to soften osteopenia, osteomalacia, hyper PTH and growth retardation

Question 35

hyperPTH can lead to

Answer 35

osteoprosis, brown tumors osteitis fibrosa cystica

Question 36

simple fracture

Answer 36

overlying skin intact

Question 37

compound fracture

Answer 37

bone communicates with skin surface

Question 38

comminuted fracture

Answer 38

bone is fragmented

Question 39

displaced fracture

Answer 39

ends of bone at fractures site are not aligned

Question 40

stress fracture

Answer 40

slowly developing fracture that follows a period of increased physical acitivity in which bone is subjected to repetitive loads

Question 41

green stick fracture

Answer 41

extending only partially through bone, seen in infants because bone is still soft

Question 42

pathologic fracture

Answer 42

involving bone weakened by underlying disease process, such as tumor

Question 43

conditions assoc with osteonecrosis

Answer 43

``` alcohol bisphosphonate use corticosteroid administration CT disorders gaucher disease infection pregnancy radiation therapy sickle cell crisis trauma tumors ```

Question 44

what artery gets compromised in avascular necrosis of femoral head

Answer 44

branch of obturator that supplies superior part of femoral head

Question 45

what bone is not affected by medullary infarcts

Answer 45

cortex because collateral flow

Question 46

subchondral infarct morphology

Answer 46

wedge shaped segment of tissue undergoes necrosis | overlying cartilage remains viable because nutrients from synovial fluid

Question 47

what occurs in necrotic area of bone

Answer 47

saponification

Question 48

osteomyeltisis

Answer 48

inflammation of bone and marrow | almost always secondary to infection