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Orthobullets > OITE - Basic Science > Flashcards

OITE - Basic Science Flashcards

1
Q

Calcitonin’s role in bone metabolism?

A

-Inhibits osteoclastic bone resorption, by binding CTR (receptor)
-decreases osteoclast resorption at the ruffled border
“calcitOnin Opposes bOne resOrption”

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2
Q

Which Ig subtype does rheumatoid factor target?

A
  • Rheumatoid factor (IgM) attaches to IgG forming imm complex
  • IgM is only one that is a pentamer
  • IG is only Ab which can cross placenta giving passive immunity to fetus
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3
Q

Psoriatic arthritis, what is it?

A
  • Seronegative spondyloarthropathy in 5-20% with psoriasis
  • Distal phalax acrolysis
  • Dactylitis “sausage digits”
  • Pencil in cup xray of phalanges
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4
Q

Herniated disks are associated with spontaneous increase in production of:

A
  • OPG (osteoprotegerin)
  • IL-1 beta
  • RANKL
  • PTH
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5
Q

COX action?

A

-catalyze formation of PG and thromboxane from arachidonic acid

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6
Q

COX-1 action?

A

-generates PG responsible for maintenance/protection of GIT

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7
Q

COX-2 action?

A

-generates PG responsible for inflammation and pain

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8
Q

Function of hemeobox gene product?

A

regulates somatization of the axial skeleton

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9
Q

What is the function of Cathepsin K, produced by osteoclasts?

A
  • released by osteoclasts at the ruffled border to function to RESORB bone
  • Cathepsin K inhibits (role for osteoporosis?)
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10
Q

GILT enzymes?

A

Reduce di-sulfide bonds

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11
Q

3 features of bone grafting to know?

A
  • Compression strength
  • Resorption rates
  • Drainage (calcium sulfate)
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12
Q

Which bone graft substitute have the fastest resorption characteristics?

A

Calcium sulfate

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13
Q

Is COX-2 expressed under normal condiitons?

A

No, only found during general states of inflammation

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14
Q

What zone do physeal fx typically occur?

A

Zone of provisional calcification in HYPERTROPHIC zone

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15
Q

Peak bone mass in men and woman is most dependent on which sex steroid?

A

Estrogen - prevents bone loss by inhibiting bone resorption

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16
Q

Osteocalcin?

A
  • most abundant noncollagenous protein in bone
  • secreted by OSTEOBLASTS
  • promotes mineralization and bone formation
  • inhibited by PTH and stimulated by VitD
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17
Q

Organic components of bone?

A

Collagen
Proteoglycans
Matrix protein (osteocalcin, osteonectin, osteopontin)

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18
Q

What is renal osteodystrophy?

A
  • Pathologic bone condition in pts with underlying kidney disease
  • increased PTH secretion
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19
Q

Renal osteodystrophy, what is the key pathophysiological step leading to osteomalacia?

A

-Uremia related phosphate retention
-inadequate phosphorus secretion
-insoluble calcium phosphate removes calcium from circulation
hypocalcemia occurs

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20
Q

What is hypopohsphatasia and what lab values does it lead to?

A
  • AR disorder due to inborn error in production of alk phosphatase
  • Low serum alkaline phosphatase levels
  • ALP is a marker of bone formation
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21
Q

What is Rickets?

A

Defect in mineralization of osteoid matrix caused by inadequate calcium and phosphate

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22
Q

Which serum marker is most closely associated with colorectal carcinoma?

A

CEA - colorectal
CA 19-9 pancreatic
CA 125 ovarian
CA 15-3 breast AFP - hepatocellular carcnioma

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23
Q

Muscle injury, what is the first listed cells to appear following acute injury?

A

-Neutrophils

Then macrophages

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24
Q

SOX-9 is a key transcription factor in the differentiation of what cell lineage?

A

Cartilage differentiation from chondrocytes

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25
Q

Vitamin B12 deficiency causes what?

A

-peripheral sensory neuropathy
Signs
-Decreased DTR, babinski, fatigue/depression

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26
Q

How do you increase strength and stability of an exfix construct?

A

2 cortices better than 1 separating the pins is better
pins closer to fx
shorter pins better
bigger pins better

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27
Q

Adductor myodesis benefit in AKA?

A
  • improves outcomes by creating dynamic balance force facilitating ambulation
  • provides soft tissue cushion beneath osseous amputation and
  • enhances prosthetic fitting
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28
Q

Myoelectric prosthesis candidate? its features?

A
  • best candidate is transradial amputation
  • good cosmesis
  • heavier, but good for overhead activities, sedentary
  • less sensory feedback
29
Q

Galvanic corrosion?

A

wear in dissimilar metals in proximity with difference between their electric potentials, results in a flow of current between them

30
Q

4 types of corrosion?

A
  • crevice corrosion
  • fretting corrosion
  • pitting corrosion
  • galvanic corrosion
31
Q

Chromium, molybdenum and cobalt are basic components of which implant material?

A

Cobalt alloy

32
Q

Which metal is closest to bone in Youngs modulus?

A

Titantium

33
Q

Stainless steel?

A
  • Iron with chromium in it

- resistant to corrosion

34
Q

Lead toxicity affects growth by inhibiting what?

A

PTHrP (parathyroid hormone related peptide)

and TGH-beta1

35
Q

3 P for Plumbism?

A 
Painful belly (colic constipation)
Polka-dotted RBC 
Peripheral palsies: RADIAL NERVE
36
Q

3 b’’s for Plumbism?

A

Blue (burton’s) gum lines
Basophilic Blue stippling
Bright BONY BANDS metaphysis (in growing bones)

37
Q

Which medication replaces normal coagulation factors with Decarboxylated factors?

A
  • Warfarin prevents Vit K gamma carboxylation

- II, VII, XI, X, Protein C and S

38
Q

Etiology of FES (fat embolism syndrome) in TKA ?

A

intramedullary instrumentation

39
Q

CXR of FES

A

like ARDS, “Snow Storm Lung”

40
Q

What are the Biphasic Clinical stages of FES?

A
  • Immediate, fat emboli i 90% of long bone fx, block vessels

- Delayed 24-72 hrs (Facids stimulate complement to ARDS)

41
Q

What part of the articular cartilage has the highest concentration of proteoglycans and lowest conc of Water?

A

Deep layer

42
Q

What type of collagen starts at Tidemark in cartilage?

A

Cartilage Type 10

43
Q

What kind of collagen is found predominantly in cartilage?

A 
Type 2 (90-95%)
Type X is only in calcified cartilage zone
44
Q

What is the result of a Type 1 collagen defect?

A

bONE collagen

-Type 1 defect leads to OI

45
Q

Ehlers-Danlos syndrome defect?

A

Type 1 and Type 3 collagen defect

46
Q

Gout “YUPAN”

A

Yellow Urate Parallel ( to compensator)
Negative birefringence
Needle Shaped

47
Q

What about CPPD?

A

Positive birerefringence

Blue crystals

48
Q

Which genetic polymorphisms are associated with osteoporosis?

A

Calcitonin
Estrogen receptor-1
Vit D receptor
Type 1 collagen alpha-1 chain

49
Q

MED spinal involvement?

A

No

50
Q

Pseudoachondroplasia, spine involvement? Genetic mutation?

A

Yes

COMP

51
Q

Daily calcium and Vit D recommendation for women?

A

age >50 –1200 mg calcium, 800-1000 IU Vitamin D

age

52
Q

Longterm bisphosphates associated with what kind of fx?

A
  • Atypical Subtroch femoral stress fx

- Jaw osteonecrosis

53
Q

What is the primary mode of bisphosphonate excretion?

A

-Renal excretion

is contra-indicated in pts with severe renal disease

54
Q

What mode of inheritance are structural protein deficits in ortho?

A 
Autosomal dominant
(collagen, fibrillin, FGF)
55
Q

If it is enzymatic defect, what is the typical mode of inheritance?

A 
autosomal recessive
(cerebrosidase, carbonic anhydrASE, etc).
56
Q

What is genetic anticipation?

A

=disease develops earlier in life in each successive generation

57
Q

What is genetic imprinting?

A

A single working copy of a gene is inherited

nonworking or silenced gene is usually methylated

58
Q

What species of bacteria is known to produce MecA?

A
  • MRSA is most common carrier
  • MecA forms penicillin binding protein 2A
  • alters efficacy of beta-lactam antibiotics
59
Q

Clinical trials pyramid?

A

Level 1 - RCT
Level 2 - Prospective cohort
Level 3 - Retrospective cohort, or Case control study
Level 4 - Case series Level 5 - Case report

60
Q

HOw is radiation exposure increased?

A
  • Larger body part is imaged
  • Extremity is positioned closed to X-ray source
  • Large C-arm > mini C arm
61
Q

What factors can one use to decrease radiation exposure?

A
  • Minimizing exposure time -protective shielding
  • Maximizing distance
  • Colliminator
  • Inverted position relative to patient
62
Q

What term in stats defines accepting the null hypothesis, when it is in fact not true?

A

Type 1 error - null hypothesis is REJECTED even though it is correct
Type II error - nuLL hypothesis is aCCepted, even though it is in fact not correct

63
Q

What are type 2 errors due to ?

A

Inappropriate study power

AKA false negative rate

64
Q

Study power formula?

A

Power = 1 - beta (type2 error)

  • is an estimate of probability of finding an association in a research study when on actually exists
  • 80% is appropriate power
65
Q

What injury independently predicts poor outcome in polytrauma pts?

A

Foot injury

-SF 36, WOMAC, and other validated outcome measure tools

66
Q

Joint reaction force increases or decreases, as the acetabular component is moved medial in THA?

A

Joint rxn force decreaes, due to decreasing abductor tension

67
Q

in a single-sided leg stance, what is the body and leg weight relative to total body weight?

A

5/6th of total body weight

68
Q

What cell expresses RANKL?

A
  • Expressed on osteoblasts

- RANK receptor is on osteoclast precursor cell (causing bone resorption)

Orthobullets (6 decks)

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