Musculoskeletal Pathologies Flashcards
1
Q
Dysostosis
A
Developmental anomaly of bone or cartilage
2
Q
Syndactyly frequency
A
1 in 2,500 births
3
Q
Sprengel’s deformity
A
Undescended scapula
4
Q
Sprengel’s deformity can cause
A
Renal and cardiac malformations
5
Q
Dysplasia
A
Mutations interfere with growth
6
Q
Height to be considered a dwarf
A
<4’10”
7
Q
MC form of dwarfism
A
Achondroplasia
8
Q
Mutated gene in achondroplasia
A
FGFR3
9
Q
Achondroplasia
___ are spontaneous
___ are autosomal dominant
A
90%
10%
10
Q
Spontaneous achondroplasia MC from
A
Sperm (high paternal age)
11
Q
Freq of achondroplasia
A
1 in 10,000
12
Q
____ is inhibited in achondroplasia
A
Growth plates
13
Q
Symptoms of achondroplasia
A
Short/bowed long bones
Frontal bossing
Midface hypoplasia
Trident hand
14
Q
Frontal bossing
A
Excessive curvature of frontal bone
15
Q
Bullet vertebrae in achondroplasia an cause
A
Hyperlordosis
Kyphosis
Scoliosis
16
Q
Spinal abnormalities in achondroplasia
A
Bullet vertebrae
Spinal stenosis
17
Q
Spinal stenosis can occur in
A
Foramen magnum
Spinal canal
18
Q
Achondroplasia treatment growth hormone
A
Somatotropin
19
Q
Thanatophoric dwarfism
A
Extremely small thorax and short long bones
20
Q
Thanatophoric dwarfism is __ and ___
A
Rare
Fatal
21
Q
Osteogenesis imperfecta aka
A
Brittle bone disease
Type 1 collagen disease
22
Q
Thanatophoric means
A
Death loving
23
Q
Type 1 osteogenesis imperfecta
A
Normal lifespan
24
Q
Type 2 osteogenesis imperfecta
A
Lethal in utero
25
Osteogenesis imperfecta is autosomal ___
Dominant
26
Osteogenesis imperfecta results in
Mutated type 1 collagen
| Alpha 1 or 2 chains
27
Childhood osteogenesis imperfecta can result in
```
Fractures
Bowing
Scoliosis
Hearing loss
Dwarfism
```
28
Cleidocranial dysostosis
Absent clavicle
29
Klippel-feil syndrome
Congenital fusion of >2 cervical vertebrae
30
“Blue sclera” can be observed in this condition
Osteogenesis imperfecta
31
Adjusting is ___ in osteogenesis imperfecta
Contraindicated
32
Zebra stripe sign
Bisphosphonates cyclically given to treat osteogenesis imperfecta in children
33
Osteopetrosis aka
Marble bone disease
34
Osteopetrosis has low ___ activity
Osteoclasts
35
Treatment for osteopetrosis
Low calcium intake
| Stem cell transplant
36
Skeletal sclerosis
Hardening
37
Bony stenosis in osteopetrosis can cause
CN palsies
38
Osteopetrosis can cause abnormal
Hematopoiesis
39
Abnormal hematopoiesis can cause
Fatigue (low RBC)
| Infections (low WBC)
40
X-ray features of osteopetrosis
No medullary canal
| Erlenmeyer flask deformity
41
Osteoporosis
Severe bone mineral density reduction at least -2.5 SD from normal
42
Osteoporosis is evaluated with a ___ scan
DEXA
43
Osteoporosis fractures are common in
Trabecular bone
44
MC places for fracture with osteoporosis
Vertebral bodies
Femur
Calcaneus
45
Osteopenia
Bone mineralization below normal but not severe
Between 1 and 2.5 SD below normal
46
Bone mineralization peaks between
25-30 yo
47
Osteoblasts activity ____ with age
Decreases
48
Senile osteoporosis
Age related loss in bone mineralization
49
Activity decreases with age, which ___ bone loss
Accelerates
50
Menopause causes ___ osteoclast Activity
Accelerated
51
Osteoclast activity in menopause is stimulated by
Low estrogen
52
Compression fractures on vertebral bodies can cause ___ (MC in women with osteoporosis)
Dowager’s hump
53
Complications of osteoporosis
Immobility
Spinal deformity
Pulmonary embolism
Pneumonia
54
Drug that can decrease osteoclast activity
Bisphosphonates
55
Vitamin D deficiency in kids
Rickets
56
Rickets can cause
Stunted growth
Bowing of lower extremities
Increased fracture risk
57
Vit D deficiency in adults
Osteomalacia
58
____ less severe than rickets and mimics osteoporosis
Osteomalacia
59
Hyperparathyroidism
Elevated PTH levels
60
PTH regulates
Blood calcium levels
61
PTH stimulates ___ activity
Osteoclast
62
Primary hyperparathyroidism
Parathyroid glands overproduce PTH
63
Primary cause of primary hyperparathyroidism
Adenoma of parathyroid gland
64
Primary hyperparathyroidism MC in
Women age 50
65
Secondary hyperparathyroidism primary cause
Chronic kidney disease
66
Chronic kidney disease can cause ____, which results in elevated ___
Hypocalcemia
PTH
67
Other cause of secondary hyperparathyroidism
Vit D deficiency
68
Symptoms of hyperparathyroidism
Hypercalcemia
Kidney stones
Brown tumor
69
Brown tumor
Non-neoplastic
Develops following localized osteolysis
70
Steps of developing brown tumor
1. Bone weakens
2. Hemorrhage occurs
3. Macrophages accumulate
4. Fibrotic tissue fills area
71
Skeletal changes due to hyperparathyroidism
Resorption of trabecular and cortical bone
Osteitis fibrosa cystica
72
Hyperparathyroidism:
| Radiological appearance of vertebral bodies
Rugger jersey spine
73
Hyperparathyroidism:
| Radiological appearance phalanges
Resorption of cortex
| Primarily on radial side of middle and distal phalanges
74
Hyperparathyroidism:
| Radiological appearance calvaria
Salt and pepper skull
75
Hyperparathyroidism:
| Radiological appearance long bones of lower extremity
Osteitis fibrosa cystica
76
Paget Disease of bone aka
Osteitis deformans
77
Paget Disease involves both ___ and ___ activity
Osteoclasts
Osteoblasts
78
Paget Disease results in
Sclerotic phase
79
Weak bone with “shaggy” appearance
Paget Disease
80
“Jigsaw puzzle” mosaic pattern
Paget Disease
81
Paget disease is mostly ____
Idiopathic
82
Most paget Disease is
Asymptomatic
83
Paget disease: if symptomatic, MC pain present in
Neck and back
84
Largest risk factor for paget disease
Increasing age
85
Ivory vertebrae sign can indicate
Paget disease
Metastatic cancer (prostate)
Lymphoma
86
Treatment for paget disease
Bisphosphonates
87
MC diagnosed with paget disease at age
70
88
Classifications of fractures
```
Complete vs incomplete
Closed
Compound
Comminuted
Displaced
```
89
Closed fracture
Intact overlying tissue
90
Compound fracture
Skin ruptured
91
Comminuted fracture
Fragmented/splintered
92
Displaced fracture
Distal segment misaligned
93
Pathological fracture
Site of any pathology
94
Stress fracture
Microfractures
95
Stress fractures MC
Lower leg/foot
96
Sex MC for paget Disease
Men
97
Incomplete fractures are more common in
Children
Aka green stick fracture
98
Type 1 SHF
Fracture that goes straight through growth plate
99
Type 1 SHF cannot occur in
Adults
| Growth plates fused
100
Type 1 SHF has a ___ prognosis
Favorable
101
Type 2 SHF occurs
When fracture goes through growth plate and metaphysis
102
MC form of SHF
Type 2 SHF
103
Type 2 SHF has ___ prognosis
Favorable
104
Type 3 SHF
Fracture goes through growth plate and epiphysis
105
Type 3 SHF has an epiphyseal fragment without
Associated metaphysical fracture
106
SHF stands for
Salter-Harris fracture
107
Worst prognosis SHF
Type V
108
Least common SHF
Type V
109
SHF types that occur with articular fracture
Type III, IV
110
Type IV has ____ due to severity
Poor prognosis
111
Delayed fracture healing can be due to
```
Nonunion
Comminution
Inadequate immobilization
Infection
Nutrition deficiency
Advanced age
```
112
MC cause of AVN
Fracture
113
Osteonecrosis is painful if present with
Joint surface
114
Other causes of AVN
Corticosteroids
Vasculitis
Embolism
Irradiation
115
10% hip dislocations cause
AVN
116
Osteomyelitis
Bone marrow inflammation from infection
117
Types of osteomyelitis
Pyogenic
| Mycobacterial
118
Osteochondritis dissecans
Osteonecrosis at knee joint
119
Large AVN can cause
Osteoarthritis
120
Corticosteroids use can cause AVN at
Hip
121
Involucrum
Woven bone to wall off infection in osteomyelitis
122
MC cause of osteomyelitis
Hematogenous infection
123
Pyogenic osteomyelitis MC from
Staph Aureus
124
Pyogenic osteomyelitis in neonates from
E. coli
| Group B Strep
125
Pyogenic osteomyelitis sickle cell disease
Salmonella
126
Sequestrum
Entrapped necrotic bone
127
Draining sinus
Pus drains into surrounding soft tissues
128
Mycobacterial osteomyelitis occurs from
TB infection
129
TB osteomyelitis spreads via
Hematogenous (MC) or lymphatic
130
TB can cause
Caseous granulomas
131
TB in vertebral bodies
Pott Disease
