Non-neoplastic Bone Disease Flashcards

1
Q

what are the different types of non-neoplastic bone disease

A

osteoporosis, osteomalacia, hyperparathyroidism, avascular necrosis, Paget’s disease

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2
Q

what is osteoporosis

A

decreased bone mass

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3
Q

what is osteopenia and osteoporosis defined as

A
osteopenia = 1-2.5 SD below normal bone mass`
osteoporosis = >2.5 SD below normal bone mass
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4
Q

what risk is osteoporosis associated with

A

significant risk of fracture

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5
Q

what causes localised osteoporosis

A

lack of use

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6
Q

what can cause primary generalised osteoporosis

A

idiopathic, post-menopausal, senile(with age)

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7
Q

give some secondary causes of generalised osteoporosis

A

endocrine disorders(eg Cushing’s), drugs(eg alcohol), GI disorders(eg malabsorption)

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8
Q

what hereditary factors affect bone mass

A

polymorphisms in bone affecting bone metabolism

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9
Q

what environmental factors affect bone mass

A

physical activity, muscle strength, diet, hormonal status

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10
Q

describe how increased age changes the bone

A

reduced proliferative and biosynthetic capacity of osteoblasts

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11
Q

what is the main cause of osteomalacia

A

Vitamin D deficiency, due to diet or lack sun exposure

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12
Q

what role does vitamin D play in the bone

A

stimulates absorption of calcium and stimulates osteoblasts to release osteocalcin

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13
Q

what does vitamin D deficiency lead to the in the bone

A

hypocalcaemia and elevated PTH(parathyroid hormone)

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14
Q

what pathology is seen in osteomalacia

A

impaired mineralisation of bone matrix, newly formed osteoids are not fully mineralised

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15
Q

what effect does osteomalacia have on the bone

A

weakens it, more susceptible to fracture

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16
Q

describe what avascular necrosis is

A

necrosis of bone and marrow

17
Q

what is avascular necrosis a result of

A

result of loss of effective vascular supply, can result from trauma/fractures

18
Q

what can avascular necrosis lead to

A

bone and joint damage can lead to total hip replacement

19
Q

give some examples of predisposing factors for avascular necrosis

A

alcohol, corticosteroids, connective tissue disorders, sickle cell disease

20
Q

describe the usual shape and location of the infarct in avascular necrosis

A

shape = wedge

usually subchondral

21
Q

describe the effects of parathyroid hormone(PTH) in bones

A

activates osteoclasts, increases resorption Ca, increases urinary phosphate excretion, increases synthesis active Vit. D

22
Q

describe the interplay between PTH and Ca in hyperparathyroidism

A

PTH elevates serum Ca, Ca usually inhibits PTH, but not in hyperparathyroidism

23
Q

what pathology is seen in bones in hyperparathyroidism

A

continued osteoclasis, osteoporosis, brown tumours and osteitis fibrosa cystica(rarely seen)

24
Q

what effect does osteoclasis have on the bone

A

decreases bone mass and increases risk of fracture, deformity and degenerative joint disease

25
Q

describe the brown tumour pathology seen in hyperparathyroidism

A

mass of reactive tissue, includes giant cells, osteoporotic, can become cystic

26
Q

describe what Paget’s disease(osteitis deformans) of bone is

A

abnormality of bone turnover

27
Q

when is Paget’s disease seen in patients

A

late adulthood

28
Q

what are the common symptoms of Paget’s disease

A

often asymptomatic

29
Q

what are the causes of Paget’s disease

A

cause uncertain, may be gene related or viral infection

30
Q

what are the 3 stages of Paget’s disease

A

osteolytic, mixed and osteosclerotic

31
Q

what occurs in the osteolytic and mixed stages of Paget’s disease

A
osteolytic = resorption pits with large osteoclasts
mixed = osteoclasis and osteoblastic activity
32
Q

what is the net results of the different stages of Paget’s disease

A

thick excess bone with abnormal reversal lines(mosaic pattern), bone matures but is porous and soft

33
Q

what bones can Paget’s affect and where does it usually affect

A
can affect any bones
usually axial(small bones less likely)
34
Q

what pathology is seen in Paget’s disease

A

pain, secondary malignancy, increased metabolism, enlargement and abnormal bone shape