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OS2 > Musculoskeletal Pathology > Flashcards

Musculoskeletal Pathology Flashcards

1
Q

Stages of pagets

A
  • Osteoclastic
  • Mixed osteoclastic-osteoblastic
  • Osteoblastic
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2
Q

_________ inflammation in dermatomyositis. ________ inflammation in polymyositis.

A

Perimysial; Endomysial

NOTE: perimysial inflammation is characterized by CD4 cells, while endomysial inflammation is characterized by CD8 cells

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3
Q

__________ is more specific than rheumatoid factor in early and fully established rheumatoid arthritis

A

Anti-CCP (anti-cyclic citrullinated peptide) antibodies

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4
Q

mechanism of osteopetrosis

A
  • Defective metaphyseal remodeling
  • Small neural foramina compress exiting nerves
  • Primary spongiosa fills medullary cavity
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5
Q

What are the types of Ehler Danlos Syndrome?

A

I/II- Classic

  • Skin and joint hypermobility, atrophic scars, easy bruising
  • Autosomal dominant
  • COL5A1, COL5A2

III- Hypermobility

  • Joint hypermobility, pain, and dislocation
  • Autosomal dominant

IV- Vascular

  • Thin skin, arterial or uterine rupture, bruising, small joint hyperextensibility
  • Autosomal dominant
  • COL3A1

VI- Kyphoscoliosis

  • Hypotonia, joint laxity, congenital scoliosis, ocular fragility
  • Autosomal recessive
  • Lysyl hydroxylase (PLOD1)
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6
Q

Why is hepatosplenomegaly seen in osteopetrosis?

A

Bone growth in the medullary cavity prevents hematopoiesis in the bone marrow. This leads to extramedullar hematopoiesis (i.e. in liver)

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7
Q

Laboratory findings of RA

A
  • Rheumatoid factor; marker of tissue damage and disease activity
  • Neutrophils and high protein in synovial fluid
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8
Q
  • Bilateral proximal muscle weakness
  • Rash of the upper eyelids
  • Red papules on the elbows, knuckles, and knees
A

Dermatomyositis

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9
Q

What is the affected molecule in achondroplasia?

A

FGFR3 (receptor)

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10
Q

Long, tapering fingers and toes called ____________.

A

Arachonodactyly

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11
Q

Another name for hyperparathyroidism

A

von Recklinghausen’s disease of bone

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12
Q

Tamoxifen

A
  • SERM
  • Binds to estrogen receptor
  • Antiestrogenic on mammary epithelium, hence its use in both the prevention and treatment of breast cancer
  • Proestrogenic on uterine epithelium
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13
Q

___________ are extra bone pieces that occur within a suture in the cranium.

A

Wormian bones

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14
Q

Symptoms of multiple myeloma

A
  • Elevated calcium
  • Renal failure
  • Anemia
  • Bone lesions
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15
Q
  • Low back pain
  • Bamboo spine
  • Aortic regurgitation
A

Ankylosing spondyloarthritis

  • Vertebrae bodies fuse
  • Uveitis and aortitis
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16
Q

Components of hyaline cartilage

A

Water

Type II collagen

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17
Q

Activation of _________ on osteoclast precursor stimulates tyrosine kinase cascade.

A

M-CSF (Monocyte colony stimulating factor)

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18
Q

cause of primary gout

A

Hyperuricemia related to overproduction or decreased excretion of uric acid (derived from purine metabolism).

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19
Q

Transcient bacteremia (children) seeds _________.

A

Metaphysis

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20
Q

Mechanism by which CA2 defect leads to osteopetrosis

A
  • CA2 required by osteoclasts and renal tubule cells to generate protons from carbon dioxide and water
  • Absent CA2 prevents osteoclasts from acidyfing resorption pit and solubilizing hydroxyapatite
  • Absent CA2 blocks acidification of urine by renal tubule cells causing renal tubular acidosis
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21
Q

osteoprotegerin

A

“Decoy” RANKL receptor that binds RANKL to prevent RANK-RANKL interaction, which leads to decreased osteoclast activity

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22
Q

Synoviocytes function

A

Produce proteins, hyaluronic acid (lubricant, nutrition for cartilage)

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23
Q

Causes of avascular necrosis

A
  • Trauma or fracture
  • Steroids
  • SCA
  • Caisson disease
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24
Q

Why does carbonic anhydrase type II defeciency result in osteopetrosis?

A

Acidic environment required for osteoclast activity is loss

NOTE: Renal tubular acidosis is also seen, due to decreased tubular reabsorption of HCO3-.

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25
Q

What is the characteristic cell of liposarcoma?

A

Lipoblast

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26
Q

What is the cause of the ankylosis of joints seen in RA?

A

Myoblasts

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27
Q

Hereditary multiple osteochondromatois

A
  • Mutations in EXT1 (more severe) and EXT2 genes
  • Rarely give rise to chondrosarcoma
    • Growth after puberty
    • Increasing pain
    • Associated with thickening of cartilagenous cap
    • Overal diameter >8cm
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28
Q

Complications of RA

A

Anemia of chronic disease

Secondary amyloidosis

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29
Q

treatment for septic arthritis

A
  • methicillin resistant S. Aureus
    • Vancomycin
  • Pseudomonas aeruginoa
    • Ceftazidime
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30
Q

Benign tumor associated with Gardener’s syndrome

A

Osteoma

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31
Q

histology of avascular necrosis osteonecrosis

A

Dead bone with epty lacunae

Fat necrosis

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32
Q

Pseudogout is due to deposits of __________.

A

calcium pyrophosphate dihydrate (CPPD)

NOTE: Synovial fluid shows rhomboid-shaped crystals with weakly positive birefringence under polarized light

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33
Q

Acute treatment for gout?

A

Colchicine

NSAIDs

Corticosteroids

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34
Q

What soft tissue tumors are associated with Li-Fraumeni syndrome?

A

Breat CA, OS, RBS, glioblastoma

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35
Q

Another name for reactive arthritis

A

Reiter syndrome

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36
Q

Causes of von Reckinghausen’s disease of bone

A
  • Excessive or inappropriate PTH levels due to autonomous PTH secretion
    • Primary due to parathyroid adenoma
      • Hypercalcemia
    • Secondary due to underlying renal disease
      • Hypocalcemia due to renal failure stimulates PTH hypersecretion
        • Nodular parathyoid hyperplasia in all 2 pathathyroid glands
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37
Q

How does one get osteomyelitis from Brucella?

A

Unpasteurized goat’s milk

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38
Q
  • Radiology
    • Pseudofracture diagnostic (looser’s zone)
    • Generalized osteopenia, rarefied pale bone
A

Osteomalacia

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39
Q

What is the affected molecule in osteogenesis imperfecta (types 1-4)?

A

COL1A1, COL1A2 (Type 1 collagen)

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40
Q

Raloxifene

A
  • Selective estrogen receptor modulator
  • Produces estrogen-agonistic effects on bone and lipid metabolism
  • Produces estrogen-antagonistic effects on uterine endometrium and breast tissue
  • FDA-approved SERM for treatment/prevention of postmentopausal OP
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41
Q

What are the characteristics of seronegative spondyloarthropathies?

A
  • Lack of rheumatoid factor
  • Axial skeleton involvement
  • HLA-B27
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42
Q

FGF3

A

inhibits chondrocyte proliferation and aids chondrocyte differentiation

*Activating mutation in this gene in achondroplasia

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43
Q

What factors upregulate M-CSF and RANKL?

A

PTH, PGE2, activate vitamin D

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44
Q

Histology

  • Increased unmineralized osteoid, widened osteoud seams
A

osteomalacia

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45
Q

Risk factors for osteosarcoma

A

Familial RB

Paget

Radiation exposure

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46
Q

Sequestrum

A

Lytic focus

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47
Q

Dysostosis

A

disorder of the development of bone, in particular affecting ossification

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48
Q

Characteristics of parvovirus in adults

A
  • Acute tenderness of joints/arthitis hands, wrists, and knees for 2 wk; in 10% months
  • Chronic anemia/RBC aplasia
  • Sickle cell anemia, HIV+
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49
Q

Bine morphogenic proteins (BMP)

A

TGF-Beta family, chondropcyte proliferation/hypertrophy

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50
Q

Gout is the deposition of ___________ crystals in tissues, especially the joints.

A

Monosodium urate

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51
Q

What soft tissue tumors are associated with Maffucci syndrome?

A
  • Spindle cell hemangioma
  • Multiple enchrondomas
  • 15% risk of chondrosarcoma
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52
Q

Degenerative disorder characterized by muscle wasting and replacement of skeletal muscle by adipose tissue

A

Dystrophy

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53
Q

Cardio problems in Marfan syndrome

A
  • Dilated aortic root/ascending aorta
  • Cystic medial necrosis
  • Aortic dissection
    • Dilated aortic root
    • Blood in false lumen
      • Occulsion of carotid artery
    • Hemorrphage rupturing through aortic wall into pericardium
    • Fatal cardiac tamponade
    • Cause of death in 30-45%
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54
Q

How does Vitamin D raise serum calcium and phosphate?

A
  • Acts on:
    • Intestines
    • Kidney
    • Bone
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55
Q

__________ is due to defective mineralization of osteoid.

A

Rickets/ Osteomalacia

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56
Q

Causes of secondary gout

A
  • Leukemia and myeloproliferative disorders
    • Increased cell turnorver leads to hyperuricemia
  • Lesh-Nyhan syndrome
    • X-linked deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
  • Renal insufficiency
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57
Q

Gain of function mutations seen in achondroplasia

A
  • Point mutation (Arg for Gly375) in FGFR3 on 4p16.13
  • Constitutive activation of FGFR3 suppressing growth
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58
Q

Biopsy that reveals amosaic pattern of lamellar bone, would indicate what?

A

Paget’s disease

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59
Q

How is Vitamin D activated?

A
  • 25-hydroxylation by the liver
  • 1-alpha- hydroxylation by the proximal tubule of the kidney
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60
Q

Bracydatyly with trident hand

A

Achondroplasia

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61
Q

Cardiac rhabdomyoma is associated with _________.

A

Tuberous sclerosis

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62
Q

Synovial fluid anaylsis in Rheumatoid arthritis

A
  • Inflammatory with neutrophils
  • High protein content
  • Low viscocity
  • Poor mucin clot
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63
Q

Histologic hallmark of chronic osteomyelitis

A

Dead bone (sequestrum)

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64
Q

Fibrillin

A
  • Glycoprotein, major component of microfibrils in extracellular matrix
  • Makes a sheath around elastin
  • Abundant in microfibrils in aorta, ligaments, and lens
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65
Q

In Marfan syndrome, elastic aortic wall is replaced by structurally weak _______.

A

Glycosaminoglycans

  • Consequence: Aortic dilation
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66
Q

Adult forms of osteopetrosis have an increased risk of _______.

A

Osteomyelitis, especially jaw

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67
Q

Site of hematogenous acute ostomyelitis

A

Metaphysis because it has increased nutrient rich arteries and relatively fewer phagocytic cells than the physis or diaphysis

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68
Q

Lab findings of rhabdomyosarcoma

A

Desmin positive

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69
Q

First work up in swollen painful joint

A

Arthrocentesis

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70
Q

Angioid streaks on retina

A

Paget Disease of Bone

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71
Q

Unmineralized bone formed during remodeling.

A

Osteomalacia

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72
Q

treatment for methiciliin sensitive S.Aureus

A

Naficillin/Oxacillin or Cefazolin

73
Q

What is the affected molecule in oteopetrosis?

A
  • Autosomal dominant (adult)
    • LRP5 (receptor)
  • Infantile form
    • Autosomal recessive
    • RANKL (receptor ligand)
  • Renal tubular acidosis
    • CA2
    • Autosomal recessive
  • Late onset, type 2
    • CLCN7
74
Q

Histology: Cortex of stalk merges with cortex of host bone so medulalry cavities is continuous

A

Osteochondroma

75
Q

How is diagnosis of osteomyelitis made?

A

Blood culture

76
Q

Outcomes of chronic gout

A
  • Development of tophi
    • White chalky aggregates of uric acid crystals with fibrosis and giant cell reaction in the soft tissue and joints
  • Renal failure
    • Urate crystas may deposit in kidney tubules
77
Q

Benign tumor of osteoblasts surrounded by a rim of reactive (sclerotic) bone

A

Osteoid osteoma

78
Q

Laboratory finding of gout

A
  • Synovial fluid shows needle-shaped crystals with negative birefrigence under polarized light
79
Q

Characteristics of Reactive arthritis

A
  • Arthritis
  • Urethretis
  • Conjunctivitis
80
Q

RUNX2

A

Osteoblast differentiation

81
Q

Types of OI

A

I- Normal life span, childhood fractures

  • Normal stature

II- Fatal in utero or perinatal, intrauterine fractures

III- Progressive, deforming

  • Growth retardation

IV- Compatible with survival

82
Q

Denosumab is a ________ inhibitor.

A

RANKL

83
Q

What role of TGF-b play in marfan Syndrome?

A
  • Fibrillin-1 directly binds a latent form of TGF-β, keeping it sequestered and unable to exert its biological activity.
    • reduced levels of fibrillin-1 allow TGF-β levels to rise due to inadequate sequestration.
      • an inflammatory reaction releasing proteases that slowly degrade the elastic fibers and other components of the extracellular matrix is known to occur.
84
Q

How is bone density measured?

A

DEXA scan

85
Q

Open-wound bacteremia (adults) seeds _______.

A

Epiphysis

86
Q
  • Chalky white friable deposits
  • Oval granular blue-gray aggreagtes
  • Blocky shor crystals with blunt ends measuring 0.5-5 microns
A

Pseudogout

87
Q

PTH and PTHrP

A

Osteoclast activation

88
Q

Treatment of osteoid osteoma and osteoblastoma

A

Radiofrequency ablation, complete excision

NO radiation (could transform into osteosarcoma)

89
Q

Clinical presentations of Ehler Danlos Syndrome

A
  • Joint dislocations, joint hypermobility
  • Hyperextensible highly stretchable skin
  • Fragile thin skin with “cigarette paper” texture
  • Poor wound healing with atrophic scars
  • Easy bruising with ecchymoses
90
Q

What soft tissue tumors are associated with Gardner syndrome?

A

Colon polyps, colon CA, desmoid

91
Q

When are disseminated conococcal infections exacerbated in women?

A

During menses

92
Q

Defect in Ehler Danlos Syndrome

A

Abnormal collagen

93
Q

Ankylosing spondyloartiritis involves the ___________ and the __________.

A

Sacroiliac joint; spine

94
Q
  • Rhabdomyoblast large cells with abundant pink striated cytoplasm
  • +IHC:
    • Desmin
    • Myogenin, MYOD1
A

Embroyonal RMS

NOTE: Alveolar RMS is also positive for desmin

95
Q

Most of the OI mutations are autosomal dominant except?

A

OI II

96
Q

Best outcome of osteosarcoma

A

100% necrosis at limb-salvage resection

97
Q

Cause of mutations in achondroplasia

A

Sporadic and related to increased paternal age

98
Q

migratory arthritis involves which locations?

A

Knees> shoulders> elbows> ankles

99
Q

Lineage of giant cell tumor of bone

A

Probably monocyte-macrophage

100
Q

Key feature of psoriatic arthritis

A

Pitting and/or ridging of nails

101
Q

OA chondrocytes produce ______ and _______.

A

IL-1 AND TNF-a

  • IL-1 and TNF-a stimulate production of catabolic metalloproteinases and inhibit the synthesis of type II collagen and proteoglycans
102
Q

What dysplasia/neoplasia is associated with MG?

A

Thymic hyperplasia or thymoma

103
Q

Classic location of avascular necrosis

A

Convex ends of long bones

104
Q

Presentation of rickets

A
  • Pigeon-breast deformitity- inward bending of the ribs with anterior protrusion of the sternum
  • Frontal bossing
  • Rachitic rosary
  • Bowing of legs in ambulating (walking) children
105
Q

Most common forms of ostoporosis

A

Senile and postmenopausal

106
Q

3 routes of spread for osteomyelities

A
  • Hematogenous spread
  • Extension from contiguous site
  • Direct implantation (trauma/surgery)
107
Q

Juvenile Idiopathic Arthritis

A
  • Heterogenous group of disorders
  • unknown cause/pathogenesis
  • Arthtitis before age of 16
    • peristence for at least 6 weeks
108
Q

Compare woven bone to lamellar bone

A

Woven bone

  • Produced quickly
    • More cellular and disorganized
    • Haphazard, less strong than lamellar bone
  • pathologic: near osteomyelitis, fracture callus

Lamellar bone

  • Produced slowly so stronger
  • Outer cortex thicker
  • Central medulla
    • Bony trabeculae
      • Richest in vertebrae and femoral neck
109
Q

X-ray: Diffuse osteopenia

A

OI

110
Q

Why is AKP elevated in osteomalacia?

A

Due to activation of osteoblasts

111
Q

What causes the blue sclera seen in osteogenesis imperfecta?

A

Thinning of sclera collagen reveals underlying choroidal veins

112
Q

Common cause of septic arthritis in children less than 2 yrs?

A

H. influenzae

113
Q

What components of complement are activated by crystals in gout?

A

C3a, C5a

114
Q

Which cytokines are necessary for the maturation of osteoclasts?

A

IL-1, IL-3, il-6, IL-11, TNF, Monocyte-Colony stimulation factor (CSF)

115
Q

What factors lead to decreased bone resorption?

A

TGF-beta

  • Decreases RANKL and increases osteoprotegrin

Estrogen

  • Decreases M-CSF and increases osteoprotegrin

Bone morphogenetic proteins

Testosterone

LDL receptor related proteins 5 and 6

Oral calcium

Calcitonin

116
Q

Receptors of _____ detect increased PTH.

A

OSTEOBLASTS

*Osteoblasts release mediators that stimulate osteoclast activity

117
Q

Clinical features of osteogenesis imperfecta

A
  • Multiple fractures of bone (can mimic child abuse)
  • Blue sclera
  • Hearing loss (bones of middle ear are easily fractured)
118
Q

Albright syndrome

A
  • Precocious sexual development
  • Large irregular (“coast of Maine”) serpiginous macules on neck, chest, back, shoulder, pelvis
119
Q

RANKL is secreted by __________.

A

Osteoblasts

REMEMBER: Osteoblasts regulate osteoclasts

120
Q
  • Endochondomatosis plus
  • Cutaneous, subcutaneous, and cavernous hemangiomas, often bilateral extensive with calcified thrombi in x-ray
A

Maffucini Syndrome

NOTE: Ollier disease presents with enchrondromatosis

121
Q

What role does PTH play in Vitamin D activation?

A
  • PTH activates a-1-hydroxylase in proximal tubules of the kidneys
    • a-1-hydroxylase converts 25-hydroxyvitamin D to active metabolite, 1,25-dihydroxyvitamin D3

NOTE: In chronic renal failure loss of a-1-hydroxylase contributes the inability to make active Vitamin D, SO LOW 1,25 dihydroxycholecalciferol (active vitamin D) AND CONSEQUENT OSTEOMALACIA

122
Q

Clinical features of Lambert-Eaton syndrome

A
  • Anticholinesterases do not improve symptoms
  • Resolves with resection of cancer
  • proximal muscle weakness that improves with use
    • Eyes are usually spared
123
Q

Histologic variation of osteosarcoma

A
  • Osteoblastic
  • Chondroblastic
  • Fibroblastic
  • Parosteal
    • Better prognosis
  • Periostal
124
Q

Function of osteocytes

A

Control calcium phosphorus homeostasis

125
Q

Location of osteomas

A

Surfaces of facial bones

126
Q

End result of paget disease

A

Thick, sclerotic bone that fractures easily

127
Q

Joint stiffness that worsens during the day

A

Osteoarthritis

128
Q

X-ray:

  • Destructive, motheaten, permeative
  • Lamellated “onionskin” periosteal reaction
A

Ewing Sarcoma

129
Q

Paraneoplastic disorder associated with lambert-eaton syndrome?

A

Small cell carcinoma of the lung

130
Q

X-ray: Well- circumscribed oval lucencies with thin rim of radiodense bone (O ring sign), “popcorn” calcifications

A

Enchondroma

131
Q

Characteristics of congenital syphyllis

A
  • Saber shin
  • Notched incisors
  • “Mulberry” molers
132
Q

Labs of osteomalacia

A
  • Decreased Ca, phosphate
  • Increased PTH, AKP
133
Q

Sausage fingers or toes

A

Psoriatic arthritis

134
Q

Gene involved in polyostic fibrous dysplasia

A

GNAS: Alpha subunit of the Gs protein receptor

*Associated with Albright Syndrome

135
Q

Cause of achondroplasia

A

Activating mutation in FGFR3, leading to inhibition of cartilage growth

NOTE: Intramembranous bone formation is not affected.

136
Q

Tick must be attached for greater than _______ hrs in lyme disease.

A

24

137
Q

X-ray: juxta-articular osteopenia and mirrar image symmetry with marginal erosions

A

Rheumatioid arthritis

138
Q

major causes of osteonecrosis

A

Trauma/fracture

Corticosteroids

Alcohol

SCA

139
Q

Clinical characteristics of Rheumatoid arthritis

A
  • Morning stiffness improves with activity
  • Symmetric involvement of PIP joints of the fingers (swan neck deformity), wrists (radial deviation), elbows, ankles, and kneess
  • DIP is usually spared
140
Q

What sites are affected by osteoarthritis?

A
  • Hips
  • Lower lumbar spine
  • Knees
  • DIP
  • PIP
141
Q

What lab work should be gathered for septic arthritis?

A
  • CBC
  • ESR
  • CRP

NOTE: Arthrocentesis ( a needle can be inserted into the joint and joint fluid aspiration obtained for evaluation)

142
Q

X-ray reveals abony mass with a radiolucent core

A

Osteoid osteoma

143
Q

Chronic papillary synovitis (synoviocyte hyperplasia) is associated with which disease?

A

lyme

144
Q

Clinical features of Paget’s disease

A
  • Bone pain
  • Increasing hat size
  • Hearing loss
  • Lion-like facies
  • Isolated elevated alkaline phosphatase
145
Q

Common sites of osteomyelitis

A
  • Children- long bones
  • Adults- vertebrae/discs
146
Q

Characteristics of X-linked muscuar dystrophy

A
  • Calf pseudohypertrophy
  • Serum creatine kinase is elevated
147
Q

Dentinogensis imperfecta

A

Opalescent blue gray yellow teeth

148
Q

____________ due to fibrous replacement of bone, subperiosteal thinning.

A

Brown tumors

149
Q

Secondary causes of OA

A

Obesity

Recurrent injury

Alkaptonuria

  • Accumulation of homogenestic acid

Sickle Cell Anemia

Avascular necrosis

Diabetes

150
Q

Albers-Schonberg disease

A
  • Absent/reduced bone resorption
  • Failure of osteoclast development or function
  • Diffuse symmetric skeletal scleoris

*Associated with Osteopetrosis

151
Q

Marfan Syndrome is the result of what type of mutation?

A

Defective fibrillin-1 (FBN-1) missense or splice site mutations on Chromosome 15

152
Q

Chronic treatment to prevent acute gout

A
  • probenecid- for underexcretors
  • Allopurinol- for overproducers
153
Q

Laboratory findings in dermatomyositis

A
  • Increased creatine kinase
  • Positive ANA anti-Jo-1 antibody
  • Perimysial inflammation (CD4 cells) with perifascular atrophy on biopsy
154
Q

Ewing sarcoma is a malignant proliferation of poorly-differentiated cells derived from __________.

A

Neuroectoderm

155
Q

Because Marfan Syndrome affects connective tissue, skeleton, eyes, and cardio. It is said to exhibit _________.

A

Pleiotropy

156
Q

treatment for dermatomyositis

A

Corticosteriods

157
Q

Findings of infectious arthritis

A
  • Warm joint
  • Limitied range of motion
  • Fever
  • Increased WBC
  • Elevated ESR
158
Q

Multinucleated macrophages with 6-12 nuclei that originate from circulating monocytes.

A

Osteoclasts

159
Q

In adults, woven bone occurs after _______ and in _________.

A

Fractures; Paget’s disease

160
Q

What caused an increased rick for chrondrosarcoma?

A

Ollier Disease, Maffucini syndrome

*Mutation in isocitrate dehydrogenase 1 (IDH1) or IDH2

161
Q

What drugs can precipitate gout?

A

Thiazides and lead toxicity

162
Q

___________ are contraindicated with osteoporosis.

A

Glucocorticoids

*Worsen prognosis

163
Q

Treatment for Paget’s disease

A
  • Calcitonin- inhibits osteoclast function
  • Bisphosphonates- induces apoptosis of osteoclasts
164
Q

How do people with dystrophin defect usually die?

A

Cardiac or respiratory failure; myocardium is commonly involved

165
Q

Treatment for osteomyelitis

A
  • Drainage via needle aspiration
  • Prolonged IV antibiotics
  • Splinting and cast immobilization
  • Surgery debridement/ removal of dead bone
166
Q

90% of osteosarcomas metastses to _________.

A

Lungs

167
Q

Most common extra-articular manifestation RA

A

Rheumatoid nodule

  • •Central fibrinoid necrosis, palisading rim CD68+ epithelioid histiocytes, lymphocytes
168
Q

In sodium urate gout, blue color is ______ to the axis of compensation and yellow color is _______ to the axis of compensation.

A

Perpendicular; parallel

169
Q

What factors lead to an increase in bone resorption?

A
  • RANKL
  • IL-1, TNF- alpha
  • PTH AND PTHrP
  • Sclerostin
  • Monocyte-Colony Stimulating Factor (M-CSF)
  • Glucocorticoids

REMEMBER: Glucocorticoids are contraindicated in osteoporosis and may worsen prognosis

170
Q

X-ray of Polyostic fibrous dysplasia

A
  • Shaft expanded with a “Shepherd’s crook” deformity
  • Trabecular pattern is replaced by a ground glass appearance
171
Q

X-Ray: Lytic focus (abcess) surrounded by sclerosis of bone

A

Osteomyelitis

172
Q

Common sites of rhabdomyosarcoma

A

Head and neck; vagina in young girls

173
Q

Which drugs are bisphosphates?

A

Alendronate

Ibandronate

Risedronate

Zoledronate

174
Q

______________ is due to an autosomal dominant defect in collagen type I synthesis.

A

Osteogenesis imperfecta

175
Q

Complications of pagets

A
  • High output cardiac failure
  • Osteosarcoma
176
Q

True or false. Paget disease is a localized process involving one or more bones but does not involve the entire skeleton.

A

True

177
Q

Patient presents with:

  • Anemia
  • Thrombocytopenia
  • Leukopenia
  • Vision and hearing impairment
  • Hydrocephalus
A

Osteopetrosis

178
Q

Osteocyte surrounded by matrix

A

Osteocytes

NOTE: Osteocytes are conected via canaliculi and receive nutrient blood supply via Haversian canal

179
Q

Synovitis leading to formation of a pannus

A

Rheumatouid arthritis

OS2 (10 decks)

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