Muscoskeletal Pathology Flashcards
1
Q
Osteoblasts
A
Produce osteoid
2
Q
Osteocytes
A
Osteoblasts within bone in a lacuna
3
Q
Osteoclast
A
Multinucleated Resorts bone Reside in Howsips lacunae
4
Q
Explain signaling for bone resorption
A
RANKL and Macrophage stimulating factor expressed by osteoblasts bind with macrophages to convert them into osteoclasts Osteoprotegrin can block RANKL and prevent osteoclast formation and bone resorption
5
Q
Name the 6 categories of bone lesions
A
Congenital
Acquired
Fractures
Osteonecrosis
Osteomyelitis
Tumors
6
Q
Name the 4 Congenital Lesion
A
Osteogenesis Imperfecta
Anchodroplasia
Osteopetrosis
Fibrous Dysplasia
7
Q
Name the 5 Accquired Lesions
A
Osteoporosis
Paget Disease
Rickets Osteomalacia
Hyperparathyrodism
Scurvy
8
Q
Name the 2 Osteomyelitis Lesions
A
Pyogenic
Tuberculous
9
Q
Name the 3 Tumors of the bone
A
Bone-forming
Cartilage forming
Miscellaneous
10
Q
Osteogenesis Imperfecta
What causes it
2 examples
A
- Mutations of collagen type 1 (alpha 1 and alpha 2)
- Autosomal Dominant
- Multiple fractures
- Blue Sclera
- Hearing loss
- Dentinogenesis Imperfecta
11
Q
Achondroplasia
A
- FGFR3 Mutation
- Chondrocyte proliferation inhibition
- Growth of normal epiphyseal plates is repressed
- Autosomal dominant
- Avg life span
- Affects all bone that develop via endochondral ossification
12
Q
Osteopetrosis
A
- Reduced osteoclast-mediated bone resorption
- defective bone remodeling
- abnormally dense but brittle
- both autosomal recessive and dominant
- can cause many issues in infants
13
Q
Fibrous Dysplasia
A
- Replacement of bone with connective tissue
- None malignant
- 3 types
- Monostotic
- Polyostotic
- McCune Albright Syndrome
14
Q
Osteoporosis
A
- Reduced bone mass
- Existing bone has normal mineral content
- 5 main factors contributing
- Menopause
- Aging
- Nutrition
- Decreased physical activity
- Endocrine
15
Q
Paget Disease
A
- Random excess bone formation
- Repetitive episodes of frenzied regional osteoclast activity and resorption
- Osteolytic Stage
- Exuberant bone formation
- Mixed osteoclatic-osteoblastic stage
- Exhaustion of cellular activity
- Osteosclerotic stage
16
Q
Ricketts Osteomalacia
A
- Vitamin D deficiency
- Inadequate mineralization of bone
- Rickets: kids- epiphyseal plates open
- Osteomalacia:Adults- plates closed
- Weak tooth enamel, increased caries
17
Q
What does Parathyroid Hormine increase
A
- Overall it increases plasma calcium concentration
- Causes
- Ca out of kidney tubule
- Inc Ca release from bones into plasma
- Stimulates kidney to activate Vit D
- Lowers plasma phosphate concentration by increasing renal excretion of phosphate- preventing Ca to precipitate back into bone
18
Q
How is PTH secretion regulated
A
- Inhibited by calcium concentration
- Inhibited by active vitamin D
19
Q
Hyperparathyrodism
A
- Primary
- Excess secretion of PTH
- Secondary
- Increase in PTH from a chronic disease that causes hypocalcemia
- Ex Renal Failure
20
Q
Scurvy
A
- Deficiency in Vit C
- Leads to impaired osteoid matrix formation
- Manifestations
- Bleeding gums
- Subperiosteal hemorrhage
- Osteoporosis
21
Q
Langerhans Cell Histiocytosis
A
- A grp of disorders that exhibit histiocyte-like Langerhans cells that cause bone lesions
- 3 types
- Letterer-Siwe Disease
- Hand-Schuller Christian Disease
- Eosinophilic Granuloma of bone
22
Q
Osteonecrosis
A
- Ischemia causes loss of bone
- no infection
- Result of
- trauma
- bone infraction
- Corticosteroids
23
Q
Bisphosphonate- Associated Osteonecrosis
A
- Osteonecrosis in patient with history of bisphosphonate use
- drugs aimed at neutralizing osteoclasts
- Effects are highest in bones with active remodeling like the jaw
- BON develops after manipulation of bone, extraction, implant, perio, endo
- Caution and inform patient over the age of 3
24
Q
Osteomyelitis- Pyogenic
A
- Inflammation of bone and marrow
- Most are caused by bacteria (S. aureus)
- Hematogenous dissemination ( spread via blood)
- Contigous infection spread (back to back infections)
- Traumatic implantation (fractures)
25
Osteomyelitis- Tuberculous
* Mycobacterial infection of the bone
* Bone infections accompany 1-3% of pulmonary tuberculosis
* Long bones and vertebrae are favored
26
Bone forming tumors Benign
* Osteoma
* Osteoid Osteoma
* Osteoblastoma
27
Bone forming Tumors, Malignant
* Primary Osteosarcoma
* Secondary Osteosarcoma
28
Cartilage forming bone tumors, Benign 2
Osteochondroma
Enchondroma
29
Cartilage forming bone tumrs, Malignant 1
Chondrosarcoma
30
Miscellaneous bone tumors
Giant Cell Tumor of bone
Ewing Sarcoma
31
List the 6 types of joint arthritis
* Osteoarthritis
* Rheumatoid Arthritis
* Juvenile theumatoid arthritis
* Seronegative spondyloarthropathies
* Gout
* Pseudogout
* Infectious arthritis
32
List the 2 joint tumors
Ganglion and synovial cysts
Tenosynovial gian cell tumor
33
Osteoarthritis
* Most common joint disorder
* Common in 65+
* Degeneration of the articular cartilage
34
Osteoarthritis Primary and Secondary
* Primary
* Appears gradually with age
* No apparent Cause
* Secondary
* Common in youth
* Caused by trauma, deformity, diseases
35
Evolution of Osteoarthritis
Thinning of cartilage
Cartilage remnant
Destruction of cartilage
36
Rheumatoid Arthritis
* Systemic, chronic inflammatory autoimmune disease
* Rare, common in women
* Occurs bilaterally
* Likely combination of genetics and enviroment
37
Progression of Rheumatoid Arthritis
* Initiating event--\> Synovitis and Pannus
* CD4 helper T cells lead to
* Pain and stiffness
* Joint space narrowing and joint erosions
38
Atlanto-axial dislocation
Form of RA
Instability at joint btw C1-C2
Due to laxity of ligaments and cartilage destruction with RA
39
Juvenile RA
Similar to RA but in youth
Strong genetic component (HLA and PTPN22)
40
Seronegative Spondyloarthropathies
* Used to be considered RA
* Pathologic changes that originate in the ligamentous attachment (not synovium)
* No rheumatoid factor
* HLA associated
41
Gout
Uric acid accural in tissues
Monosodium urate crystals precipitate from supersaturated body fluids
Induce inflammation
42
Hyperuricemia
1. Precipitation of urate crystals in joints
2. Complement activation
3. Phagocytosis of crystals
4. Lysis and activation of neutrophils
5. Release of crystals
6. Release of lysosomal enzymes
* Precipitation of urate crystals in joints
* Phagocytosis by monocytes
* Release of cytokines
43
Primary and Secondary Gout
* Primary
* Hyperuricemia in the abscence of other disease
* enzyme defects
* altered high or low uric acid renal secretion
* Secondary
* Known cause of hyperuricemia
* Leukemia
* Renal disease
* Metabolic defects
* Symptoms
* joint pain, renal failure, urate stones
44
Pseudogout
* Chondrocalcinosis
* Calcium pyrophosphate crystal deposition
* 50+ years
* Crystal deposits in joint and triggger inflammation (similar to gout)
45
Infectious arthritis
* Bacteria lodge in joints during hematogenous dissemination
* 2 types
* Suppurative arthritis
* Lyme arthritis
46
Supporative Arthritis
H. influenzae in kids
S aureaus and N gonorrhea in adults
Those with deficient complement are more susceptible
Joint aspiration yields purulent fluid
47
Lyme arthritis
Infection B burgdorferi
Advances in stages
- Tick passes spirochetes
- Spirochetes spread
- 2-3 years later symptoms appear as arthritis
48
Ganglion Tumors of joints
Small tendon cyst (fluid filled)
Often near wrist
Bible therapy
49
Synovial cyst tumors of joints
Herniation of synovium thru joint capsule
50
Tenosynovial giant cell tumor
Catchall term for several benign neoplasms of synovium
51
Name the 6 types of tumors in soft tissues
Adipose
Fibrous
Fibrohistiocytic
Skeletal Muscle
Smooth muscle
Synovial
52
Name the 3 types of Skeletal muscle disorders
Inherited
Acquired
Autoimmune
