Nutritional, Metabolic and Endocrine Disorders Flashcards
What is the most common metabolic bone disorder described as a skeletal disease, characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture?
Osteoporosis
After the age of 35, how much cortical bone is lost per year? Trabecular bone?
Cortical bone: 1% per year
Trabecular bone: 2% per year
At menopause, how much does this loss accelerate? Lumbar spine?
10 fold 20 fold (6% per year)
At what age does sex ratio or bone loss equalize between male:female?
80 years old
How likely is someone to get a mid femur stress fracture for patients taking Bisphosphonates compared to untreated women?
50x
What may Progressive angular kyphotic deformity within 1 year of spinal compression fracture result in?
Spinal Stenosis
What is an effective and minimally invasive procedure in which acrylic bone cement is injected to stabilize and strengthen a collapsing vertebral body?
Vertebroplasty
What percent of patients with osteoporotic compression fracture will experience another fracture within 1 year?
20%
What uses a balloon dilatation of vertebral body, with subsequent instillation of polymethylmethacrylate?
Kyphoblasty
What DEXA score is a comparison of a person’s bone density with that of a healthy 30-year-old of the same sex?
T-score
What DEXA score is a comparison of a person’s bone density with that of an average person of the same age and sex?
Z-score
What is a normal T-score?
> -1
What T-score indicates osteoporosis?
What is most commonly used to assess the strength of vertebrae in assessment of fracture risk?
Quantitative CT
How much percent loss of bone mass is needed to indicate osteoporosis?
30-50%
What are 2 Roentgen signs of osteoporosis?
cortical thinning
altered trabecular pattern
What is the Vertebral body shape of osteoporosis?
Vertebra Plana (compression of anterior and posterior portions of vertebral body)
What is a Loss of anterior vertebral body height called?
Wedge vertebra
Where are wedge vertebra most commonly seen?
mid thoracic and TL junction
What is a Hour-glass or fish vertebrae and is Due to pressure of nucleus pulposus upon weakened endplates?
Biconcave vertebra
What do vertebra plana’s have inside the vertebral body?
GAS
What presents with marked sacral tenderness on physical examination, and rami fractures present with pain in the low back, groin, or hip?
Sacral Insufficiency Fractures
What is the characteristic sign of a Sacral Insufficiency Fracture?
H-pattern/Honda sign
What 2 parts of the body does Reflex Sympathetic Dystrophy Syndrome (RSDS) (rapid progressive osteoporosis) usually affect?
hand and shoulder
Who does Reflex Sympathetic Dystrophy Syndrome (RSDS) usually affect?
> 50yo
Which hip of females does Transient Osteoporosis of Hip typically affect?
Left hip
What may Transient Osteoporosis of Hip be associated with?
pregnancy
What age group does Transient Osteoporosis of Hip affect?
20-40 year olds
When would you expect a full recovery from Transient Osteoporosis of Hip?
3-12 months
What does Transient Osteoporosis of Hip affect?
Bone marrow edema in the femoral head and neck
In regards to Immobilization Osteoporosis, what does immobilization do to osteoblastic activity?
inhibit
In regards to Immobilization Osteoporosis, what does immobilization do to osteoclastic activity?
accelerate
There are 4 patterns to Disuse Osteoporosis, which one has all bones involved have similar degree of bone loss and is the most common form?
Uniform
There are 4 patterns to Disuse Osteoporosis, which one is localized circular lucencies predominate, especially in the epiphyseal regions?
Spotty
There are 4 patterns to Disuse Osteoporosis, which one is linear transverse subchondral or metaphyseal Lucent zones?
Bands
There are 4 patterns to Disuse Osteoporosis, which one is lamination or scalloping loss of definition in the outer and inner cortical margins?
Cortical
What means soft bones and is also known as adult rickets and has a Lack of calcium deposited in osteoid?
Osteomalacia
What are characteristic features of pseudofractures (looser lines) of Osteomalacia?
Fractures at right angles to cortex
Uncalcified osteoid
Bilateral and Symmetrical
What minerals are deficient in rickets?
Vitamin D, calcium, or phosphate
What kind of drugs can cause rickets?
anticonvulsant drugs (Dilantin)
What age does rickets usually develop?
6-12 months old
What are unmineralized osteoid along anterior rib cage for rickets known as?
Rachitic Rosary
Do growth plates widen or narrow with rickets?
Widen
How many months of vitamin C need to be administered before symptoms and skeletal changes occur with scurvy?
4 months
What is a clinical hallmark of scurvy?
spontaneous hemorrhages from capillary fragility
What are all the radiographic features of scurvy?
osteopenia white line of Frankel Wimberger's Ring Corner Sign Pelken's Spurs Trummerfield Zone Subperiosteal hemorrhage
What is an accumulation of fibrous tissue produces localized cyst like destructive bone lesions that are brown in color?
Brown Tumors
What is a brown tumor associated with?
Hyperparathyroidism
What is the Pathologic Hallmark of Hyperparathyroidism?
Subperiosteal Bone Resorption
What is a radiographic feature involving the skull with hyperparathyroidism?
Salt and Pepper Skull
What is a radiographic feature involving the spine with hyperparathyroidism?
Rugger Jersey Spine
What kind of arteries do Monckeberg medial calcific sclerosis affect?
medium-sized muscular arteries
Is there vascular narrowing with Monckeberg medial calcific sclerosis?
No
What is your diagnosis? These are the clinical findings: --Hepatosplenomegaly – Yellowing of skin – Dermatitis – Pruritis – Alopecia
Hypervitaminosis A
What is a secretory Eosinophilic Adenoma of anterior pituitary gland produces intramembranous bone tissue growth, and subcutaneous tissue hypertrophy?
Acromegaly
If the above occurs prior to closure of the growth plates, what is it called?
Gigantism
What does the heel pad thickness have to be in order for it to be labeled as acromegaly?
> 20mm
What part of the bone does lead primarily affect?
Metaphysis
Why does lead mostly affect the distal femur, both ends of the tibia, and distal radii in children?
they’re the most rapidly growing bones
What is the radiographic feature of lead poisoning?
dense metaphyseal bands