nichols acquired bone dis

Question 1

factors in osteoporosis cause

Answer 1

inactivity, aging, hereditary, hormone changes

Question 2

consequences of osteoporosis

Answer 2

distal radius kyphosis prox femur hand/foot stiffness

Question 3

how does menopause affect osteoporosis

Answer 3

dec serum estrogen inc IL-1, IL-6, TNF increased RANK, RANKL increased osteoclast

Question 4

how does aging affect osteoporosis

Answer 4

dec replicative ability of osteoprogenitor cells dec synthetic activity of osteoblasts dec biologic activity of matrix-bound GFs reduced physical activity

Question 5

what contributes to peak bone mass

Answer 5

physical activity genetic factors nutrition

Question 6

Answer 6

osteoporosis

Question 7

Answer 7

osteoporosis on R vs normal on L

Question 8

Answer 8

compression fracture on background of osteoporosis

Question 9

Answer 9

bisphosphonates

Question 10

Denosumab

Answer 10

mAb that inhibes RANK/RANKL

Question 11

Odanacatib

Answer 11

TKI that inhibits lysosomal enzyme (cathepsin K) and inhibits osteoclasts

Question 12

some other Ab strategies to inhibit osteoblasts

Answer 12

inhibit Dkk1 or sclerostin

Question 13

PTH does what to bones?

Answer 13

anabolic bone substance! actually makes them stronger even though though putting Ca++ into blodo

Question 14

what is a simple fracture

Answer 14

not displaced

complete through bone

Question 15

compound fracture

Answer 15

displaced

one is through skin

Question 16

greenstick fracture

Answer 16

noncomplete

usually kids

Question 17

communited fracture

Answer 17

bone is in 2+ pieces

Question 18

pathologic fracture

Answer 18

technically all of them …

but one which occurs in a bone with underlying dis

Question 19

danger in compound fracture but not others

Answer 19

infection

Question 20

Initially callus formation

Answer 20

• blood clot
• after a few days, collagen, fblasts, dead cortex w empty lacunae, neovascularization

Question 21

what do you need for good healing?

Answer 21

VASCULARIZATION

Question 22

next phase of callus

Answer 22

vasculate periosteum, periostial reactive woven bone

cartilage growing

osteoclasts remodeling

after months, trabec are formed, lookin good

Question 23

Answer 23

bone is rebuilding on R, but still a callus is seen

you need the two ends to line up! signal for a callus requires this proximity.

Question 24

Answer 24

resolving hemorrhage

fractured bony trabeulae that have lacunae EMPTY= dead bone (dark pink)

can see new osteoid (light pink) w new osteocytes

Question 25

Answer 25

fibrous tissue connects ends of healed, previously broken bone. no union of bone w bone therefore a FIBROUS NONUNION

Question 26

Answer 26

osteonecrosis see infarct upper R, wedge shaped, pale, at periph.

Question 27

Answer 27

diffusely congested, hemorrhagic marrow in sickle cell crisis --\> osteonecrosis. see an old lacunae in the upper travec w no nuclei in it.

Question 28

describe osteonecrosis in sickel cell

Answer 28

soft tissue swell w new bone form moth eaten lytic process chroncii infarcts, secondary osteoarthritis irregular slcerosis, lucency bone in bone appearence is new cortex in old bone

Question 29

Answer 29

osteomyelitis necrosis --\> hemorrhage --\> purulence

Question 30

chronic infection of bone has what....

Answer 30

macs NOT LYMPHOCYTES! what!! Osteomyelitis is ALWAYS neutrophliic bc it is an infection that is just renewing itself over and over. so much purulence, often draining sinuses

Question 31

Answer 31

dead necrotic bone bc lacunae empty old blood clot neuts!

Question 32

what can happen in osteomyelitis

Answer 32

draining sinuses reactive (involucrum)necrotic (sequestrum) periosteum

Question 33

Answer 33

subperosteal shell of reactive viable new bone: INVOLUCRUM old inner necrotic cortex: SEQUESTRUM

Question 34

Answer 34

In this proximal femur with Paget disease, there is irregular thick, coarse cortex and replacement of normal cancellous bone with coarse, thick bundles of trabecular bone.

Question 35

Answer 35

Humerus showing lytic (1), mixed (2), and sclerotic (3) phases, all in the same bone.

Question 36

Answer 36

In the osteosclerotic phase, irregular lamellar bone with prominent cement lines predominates as shown to the right here:

Question 37

cause of Paget

Answer 37

SQSTM1 mutation, chronic viral infection, environmental factors

Question 38

most feared complication of paget disease

Answer 38

sarcoma

Question 39

vit D defy in kids/ adults

Answer 39

rickets/ osteomalacia

Question 40

osteoeptrosis vs osteosclerosis

Answer 40

dis category of disorder osteoclasts vs dis of janky bone (poorly mineralized, etc. more diffuse)

Question 41

Answer 41

von kossa stain osteomalacia/rickets calcified tissue is black light pink is unmineralized osteoid. normally, the mature trabec should be mineralized all the way out

Question 42

PTH?

Answer 42

mobilze calcium into blood

Question 43

symptoms of high PTH

Answer 43

hyperCa --\> renal stones, tetany moans (ow), bones, stones

Question 44

Answer 44

brown tumor from resected rib showing cystic and hemorrhagic charcter of hyperparathyroidism