musculoskeletal path

Question 1

group of hereditary conditions characterized by abnormal development of type I collagen, a major component of bone matrix, but also present in many tissues including skin, joints, and eyes

Answer 1

osteogenesis imperfecta (OI) aka brittle bone disease

Question 2

group of rare hereditary disorders characterized by deficient osteoclastic activity with resultant defective bone remodeling

Answer 2

osteopetrosis aka marble bone disease

Question 3

increased porosity of the skeleton resulting from reduced bone mass, with an associated increased bone fragility and increased prevalence of fractures

Answer 3

osteoporosis

Question 4

fairly common bone disorder characterized by repetitive episodes of frenzied, regional osteoclastic activity and bone resorption (osteolytic stage), followed by exuberant osteoblastic activity and bone formation (mixed osteoclastic-osteoblastic stage), and finally by an apparent exhaustion of cellular activity (osteosclerotic stage)

Answer 4

Paget disease (osteitis deformans)

Question 5

one of the most common endocrine disorders; an important cause of hypercalcemia

Answer 5

primary hyperparathyroidism

Question 6

caused by any condition associated with a chronic depression in the serum calcium levels, because low serum calcium leads to compensatory over activity of the parathyroid glands

Answer 6

secondary hyperparathyroidism

Question 7

____ is by far the most common cause of secondary hyperparathyroidism

Answer 7

renal failure

Question 8

an infection spreading through the medullary spaces of a bone

Answer 8

osteomyelitis

Question 9

characterized by progressive replacement of normal bone by fibrous tissue intermixed with unorganized, woven bone

Answer 9

fibrous dysplasia

Question 10

bone and osteoid producing malignancy

Answer 10

osteosarcoma

Question 11

most common disorder of the joints and is a very frequent, if not inevitable, part of aging

Answer 11

osteoarthritis (degenerative joint disease)

Question 12

disorder caused by tissue accumulation of excessive amount of uric acid

Answer 12

gout

Question 13

arises upon precipitation of urate crystals in the synovial fluid and membranes

Answer 13

acute gouty arthritis

Question 14

group of inherited abnormalities of muscle which vary from mild motor weaknesses to severe life-threatening alterations (progressive degeneration of muscle fibers)

Answer 14

muscular dystrophies

Question 15

X-linked recessive disorder caused by the absence of a structural protein, termed dystrophin, and is seen in about 1/3500 live male births

Answer 15

Duchenne muscular dystrophy

Question 16

autoimmune disease which results in destruction of acetylcholine receptors in the neuromuscular junction and is manifested by weakness and prominent fatigability of voluntary muscles

Answer 16

myasthenia gravis

Question 17

the histopathologic features of Paget disease form a _______; radiographically, the bone shows a mixture of radiolucent-radiopaque areas referred to as _____

Answer 17

mosaic pattern of bone

cotton-wool pattern

Question 18

complication of Paget disease characterized by overgrowth of facial and cranial bones

Answer 18

leontiasis ossea (lion face)

Question 19

patients with Paget disease will display elevated levels of _____ and _____

Answer 19

urinary hydroxyproline (from increased bone resorption) and serum alkaline phosphatase (from increased bone apposition)

Question 20

treatment for paget disease

Answer 20

calcitonin, biphosphonates and analgesics (for bone pain)

Question 21

can be observed in patients with hyperparathyroidism; lesions are histopathologically identical to central giant cell granuloma of the jaws

Answer 21

osteitis fibrosa cystica (cyst-like brown tumors of bone)

Question 22

in more than 95% of cases, primary hyperparathyroidism is caused by ______

Answer 22

parathyroid adenomas or hyperplasia (less commonly by parathyroid carcinoma, but more severe)

Question 23

constellation of symptoms classically associated with primary hyperparathyroidism

Answer 23

painful bones, renal stones, abdominal groans, and psychic moans

Question 24

treatment for primary hyperparathyroidism

Answer 24

removal of the affected gland/tumor

Question 25

treatment for secondary hyperparathyroidism

Answer 25

renal transplant; vitamin D supplementation

Question 26

in osteomyelitis, bacteria can colonize the spaces within bone through one of three pathways:

Answer 26

1. hematogenous spread (especially staph aureus)
2. contiguous infection (i.e. odontogenic infections)
3. direct traumatic introduction/implantation following fracture or surgery

Question 27

70% of all cases of fibrous dysplasia

Answer 27

monostotic fibrous dysplasia (single bone)

Question 28

pattern of cellular fibrous CT intermixed with elongated trabeculae of immature woven bone seen in fibrous dysplasia

Answer 28

Chinese characters

Question 29

the ill-defined radiopacity (seen in films with high detail) or ill-defined radiolucency in less detailed films- seen in fibrous dysplasia is described as _____

Answer 29

ground glass appearance

Question 30

_____ is the most frequent clinical presentation of osteosarcoma, however, _____ can also be the first sign of disease

Answer 30

a painful enlarging mass; pathologic fracture

Question 31

the radiographic appearance of osteosarcoma is generally that of a large, destructive mixed radiolucent-radiopaque lesion that may present with a ______

Answer 31

“sunburst” appearance

Question 32

a characteristics feature of osteosarcoma is the formation of an ____ between the neoplastic bone and the cortex, called _____

Answer 32

acute angle; Codman’s triangle

Question 33

the fundamental feature of osteoarthritis is _____; changes that follow in the underlying bone are secondary

Answer 33

degeneration of the articular cartilage