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msk/rheum > nichols acquired bone dis > Flashcards

nichols acquired bone dis Flashcards

1
Q

factors in osteoporosis cause

A

inactivity, aging, hereditary, hormone changes

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2
Q

consequences of osteoporosis

A

distal radius kyphosis prox femur hand/foot stiffness

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3
Q

how does menopause affect osteoporosis

A

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

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4
Q

how does aging affect osteoporosis

A

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

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5
Q

what contributes to peak bone mass

A

physical activity genetic factors nutrition

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6
Q
A

osteoporosis

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7
Q
A

osteoporosis on R vs normal on L

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8
Q
A

compression fracture on background of osteoporosis

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9
Q
A

bisphosphonates

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10
Q

Denosumab

A

mAb that inhibes RANK/RANKL

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11
Q

Odanacatib

A

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

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12
Q

some other Ab strategies to inhibit osteoblasts

A

inhibit Dkk1 or sclerostin

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13
Q

PTH does what to bones?

A

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

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14
Q

what is a simple fracture

A

not displaced

complete through bone

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15
Q

compound fracture

A

displaced

one is through skin

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16
Q

greenstick fracture

A

noncomplete

usually kids

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17
Q

communited fracture

A

bone is in 2+ pieces

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18
Q

pathologic fracture

A

technically all of them …

but one which occurs in a bone with underlying dis

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19
Q

danger in compound fracture but not others

A

infection

20
Q

Initially callus formation

A
  • blood clot
  • after a few days, collagen, fblasts, dead cortex w empty lacunae, neovascularization
21
Q

what do you need for good healing?

A

VASCULARIZATION

22
Q

next phase of callus

A

vasculate periosteum, periostial reactive woven bone

cartilage growing

osteoclasts remodeling

after months, trabec are formed, lookin good

23
Q
A

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.

24
Q
A

resolving hemorrhage

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

can see new osteoid (light pink) w new osteocytes

25
Q
A

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

26
Q
A

osteonecrosis

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

27
Q
A

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

28
Q

describe osteonecrosis in sickel cell

A

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

29
Q
A

osteomyelitis

necrosis –> hemorrhage –> purulence

30
Q

chronic infection of bone has what….

A

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

31
Q
A

dead necrotic bone bc lacunae empty

old blood clot

neuts!

32
Q

what can happen in osteomyelitis

A

draining sinuses

reactive (involucrum)necrotic (sequestrum)

periosteum

33
Q
A

subperosteal shell of reactive viable new bone: INVOLUCRUM

old inner necrotic cortex: SEQUESTRUM

34
Q
A

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.

35
Q
A

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

36
Q
A

In the osteosclerotic phase, irregular lamellar bone

with prominent cement lines predominates

as shown to the right here:

37
Q

cause of Paget

A

SQSTM1 mutation, chronic viral infection, environmental factors

38
Q

most feared complication of paget disease

A

sarcoma

39
Q

vit D defy in kids/ adults

A

rickets/ osteomalacia

40
Q

osteoeptrosis vs osteosclerosis

A

dis category of disorder osteoclasts

vs

dis of janky bone (poorly mineralized, etc. more diffuse)

41
Q
A

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

42
Q

PTH?

A

mobilze calcium into blood

43
Q

symptoms of high PTH

A

hyperCa –> renal stones, tetany

moans (ow), bones, stones

44
Q
A

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

45
Q
A

msk/rheum (3 decks)

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