Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 3 > orthopedic pathology (bone pathologies) > Flashcards

orthopedic pathology (bone pathologies) Flashcards

1
Q

common issues of bone pathologies

A

bones too soft

bones too brittle

bones not right shape (mineral content)

tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SSx of bone pathologies

A

bone pain

visible deformity

easily fractured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

diagnostic methods for bone pathologies

A

imaging:
X-ray

Bone scan (nuclear radiography)

**

genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

bone scan (nuclear radiography)

A

A whole-body bone scan is a nuclear medicine test to check your bones for issues or changes.

You receive an injection of a substance called a radiotracer. The radiotracer collects in areas of irregular activity and highlights these areas on an imaging scan.

It’s painless and safe for most people.

A bone scan is a type of nuclear radiology procedure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

treatments (bone pathologies)

A

medication
E.g.
Bisphosphonates slow bone density loss
(decrease osteoclast activity; increase osteoblast activity –> esp after menopause)

other Treatment:
Surgery
(removing tumours?
surgically fixing fractures/weak areas?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

osteoporosis

A

Progressive and systemic metabolic disease of decreasing bone mass/density

Bone breaks down over time and becomes brittle, thin, and breaks easily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

osteopenia

A

Osteopenia
Low bone mass
Precursor to osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

osteoporosis classifications (primary/secondary)

A

Primary osteoporosis unrelated to any underlying disease or condition (80-95%)

–> primary = idiopathic / age-related

–> secondary = Secondary osteoporosis due to medication or other conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

osteoporosis risk factors

A

Hormonal status (e.g. menopause)

Age (decrease estrogen in women with age)

Ethnicity (caucasian females)

Sedentary Lifestyle

Smoking (decreases estrogen)

Alcohol

Family history

Diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

osteoporosis other risk factors

A

Depression (hormones)

Weight (hormones)

Medications (steroids, chemotherapy)

Female

High caffeine intake

Malnutrition
Malabsorption (vtitamin d, c, calcium, etc.)

Endocrine disorders (hormones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

osteoporosis SSx

A

Asymptomatic

Height loss
(compressed vertebrae –> thoracic kyphosis, lumbar hypolordosis, protracted head/neck)
–> note dowager’s hump

Postural changes
–> “

Compression fractures
(compressed vertebrae)

Back pain (sharp with no cause)
–> lumbar vertebrae compression, nerve compression (??)

Fractures

Muscular pain and spasm
–> reflex muscle guarding (?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

osteoporosis Dx

A

History, physical assessment

Dual-energy X-ray absorptiometry (DEXA):

—> Low levels of x-rays used to measure mineral density

—> Standard x-rays cannot detect small decreases of bone mass

Lab tests
Blood tests:
can help determine levels of minerals and hormones

useful to determine WHY bone density is low
—> WHICH component is affecting bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DXA test vs standard X-ray

A

A DXA scan (bone density test) is a quick, painless way to check your bone health.

It’s similar to a regular X-ray, but measures the strength and mineral content of your bones instead of just taking pictures of them.

“The DXA scanner on the other hand is designed to measure the density of body tissue but does not produce a high-quality picture.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

osteoporosis Tx

A

Prevention
Critical age between 10 and 30 years

Lifestyle
Decrease alcohol, tobacco, caffeine intake
Increase weight bearing activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which ages are important to develop good habits for maintaining good bone density throughout life

A

between 10 and 30 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

osteoporosis medication for treatment

A

Medication:

Estrogen (hormone therapy)

Calcitonin – inhibits osteoclasts

Bisphosphonates (decrease osteoclast activity, increase osteoblast activity)

Calcium and vitamin D supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

other important factors

A

Adequate sunshine (vitamin d)

Diet high calcium, vitamin D and protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

bone tumour types

A

Tumours can be osteoblastic
—> Excessive bone is laid down

Tumours can be osteolytic
—> Bone is destroyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

benign bone tumours

A

can be via
bone cells,
cartilage cells,
and fibroblasts

Can cause pathological fracture

Can cause neurological symptoms ( via MASS EFFECT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pathological fracture define

A

A broken bone caused by disease, often by the spread of cancer to the bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mass effect define

A

“It can be used to describe any lesion in the body if it exerts displacement of adjacent structures”

(E.g. benign bone tumours on nerves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

differentiating myositis ossificans vs. bone tumour

A

Differentiating between myositis ossificans and extraskeletal osteosarcoma is critical.

The zoning pattern of growth in myositis ossificans is an important diagnostic point.

Osteosarcoma displays disorderly growth of atypical hyperchromatic and pleomorphic tumor cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

benign bone tumours treatment?

A

Treatment is dependent on symptoms
—> If tumour is compressing adjacent structures, surgery is performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

osteoma (type of benign bone tumour)

A

Slow growing

Usually asymptomatic

Usually occur on the skull or mandible, but can sometimes be found in the cervical region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

osteoma risk factors

A

Most osteomas have no identifiable cause. A small percentage are present or develop soon after birth.

Others are believed to result from inflammation or trauma.

In rare cases osteomas may be a component of an underlying hereditary disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

osteochondroma

A

Bone tumor with cartilage (chondro) cap

MOST COMMON benign bone tumor

Found in children because they tend to grow at growth plates (cartilage)

Usually asymptomatic

Often an INCIDENTAL FINDING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the most common benign bone tumour?

A

OSTEOCHONDROMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what population is osteochondroma found in?

Why?

A

children

@ growth plate (cartilage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

why is osteochondroma generally via “INCIDENTAL FINDING”

A

Because many osteochondromas do not cause any discomfort or other symptoms, they are often discovered by accident when an X-ray is done for an unrelated reason, such as a traumatic injury.

This is called an incidental finding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

incidental finding define

A

Incidental medical findings are previously undiagnosed medical or psychiatric conditions that are discovered unintentionally and during evaluation for a medical or psychiatric condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

enchondroma

A

Cartilaginous tumor

Arise from growth plate/chondrocytes abnormalities

Usually found in children or young adults
10 – 30 years of age (?)

Fairly common

Usually asymptomatic
—> Found incidentally

“Osteochondromas most commonly occur in the hands and feet, and enchondromas typically involve the iliac crests and metaphyses of long bones.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

osteoid osteoma

A

Bone tumor

Usually found in children and adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

osteoid osteoma clinical presentation

A

Clinical presentation
—> Classically cause night pain which is relieved by aspirin*

—> Mass effect

—> Risk factor for Fx

34
Q

osteoma vs osteoid osteoma

A

“An osteoid osteoma is a benign (noncancerous) bone tumor that usually develops in the long bones of the body such as the thighbone and shinbone.”

osteoma?
“Usually occur on the skull or mandible, but can sometimes be found in the cervical region”

35
Q

osteoma vs osteoid osteoma (histology)

A

Different histology than osteoma

36
Q

Giant cell tumour

(aka OSTEOCLASTOMA)

A

Thought to be via overproliferation of osteoclasts

Occurs when growth plate is closed; therefore typically seen in early adulthood (20-30 years of age)

Osteolytic bone tumour

37
Q

osteoclastoma surgical treatment (?)

A

Traditional surgical treatments have mostly employed intra-lesioned resection and bone cement reconstruction;

however, these may cause unexpected damage around neurovascular structures.

38
Q

resection define

A

the process of cutting out tissue or part of an organ.

39
Q

bone cement?

A

Bone Cement Injection?

This procedure is used to help fill open or weak spaces in bones.

40
Q

aneurismal bone cyst

A

aneurism = “widen out” / dilation/bulge

cyst = “bladder”

Expansile and osteolytic tumour

Primarily seen in children and adolescents

Idiopathic

41
Q

aneurismal bone cyst, primarily seen in

A

children and adolescents

42
Q

more about aneurysmal bone cysts

A

Aneurysmal bone cysts are non-malignant, tumor-like, vascular lesions comprised of blood-filled channels.

Although they can occur in any bone, they are most common in the femur, tibia, and vertebrae. [1]

Their expansile nature may result in pain and inflammation, and disruption of joints and growth plates

43
Q

Fibrous dysplasia

A

Congenital abnormality in osteoblastic differentiation and maturation

Leads to progressive replacement of normal bone with fibrous tissue (scar-like tissue)

Defect is usually localized to one bone

44
Q

MALIGNANT BONE TUMOURS

A

Have the capacity to metastasize

Often do so aggressively by invading locally and destroying adjacent tissues

Less common than benign tumours

Usually associated with constant and severe pain or night pain

45
Q

Skeletal Metastasis

A

Most common malignant tumours of the skeleton (via metastasis from tumour located elsewhere in body)

70% of all malignant bone tumours
—> Breast, prostate, lung and kidney cancers account for 80% of osseous metastases

80% of malignant tumours are axial tumours

46
Q

what cancers account for 80% of all osseous metastases?

A

Breast, prostate, lung and kidney cancers

47
Q

what percentage of malignant tumours are axial tumours

A

80% of malignant tumours are axial tumours

48
Q

clinical presentations of malignant bone tumours

A

fractures, cachexia, bone pain

49
Q

cachexia

A

weakness and wasting of the body due to severe chronic illness.

kakos = bad
hexis = habit

50
Q

a typical pattern (not always the case)

(where benign vs malignant tumours are)

A

generally malginant bone tumours are @ axial skeleton

& benign bone tumours are @ appendicular skeleton

51
Q

multiple myeloma

A

Most common primary malignant bone tumor

Characterized by proliferation of malignant plasma cells and a subsequent overabundance of abnormal proteins and infiltration of red bone marrow.

Occurs in individuals over age 40.
—> 70% are between 50 – 70 years of age.

52
Q

primary vs secondary tumour

A

secondary = via metastasis

primary = not via metastasis

53
Q

mutiple myeloma age

A

Occurs in individuals over age 40.
—> 70% are between 50 – 70 years of age.

54
Q

why called mutiple myeloma

A

A cancer cell or malignant plasma cell is called a myeloma cell.

Myeloma is called “multiple” because there are frequently multiple patches or areas in bone marrow where it grows.

55
Q

multiple myeloma SSx

A

Bone pain

Pathologic fractures

Anemia (@ bone marrow)

Recurrent infection (@ bone marrow, so WBC)

Proteinuria

Renal failure

56
Q

why renal failure and proteinuria in multiple myeloma?

A

Multiple myeloma (MM) is a type of blood cancer that affects white blood cells called plasma cells. These cells help to fight infection.

In MM, the abnormal plasma cells produce abnormal proteins that can bind to other proteins in the kidneys. This can result in kidney damage.

57
Q

why proteinuria?

A

fenesterated capillaries in kidneys damaged

proteins leak through

58
Q

osteosarcoma

A

Second most common primary malignant bone tumor

Typically seen in young patients (10-20 years of age)

59
Q

most common vs second most common PRIMARY malignant bone tumour

A

multiple myeloma = most common

osteosarcoma = second most common

60
Q

also considered a blood tumour?

A

multiple myeloma (b/c @ RBM – related to blood)

61
Q

osteosarcoma clinical presentation

A

Clinical presentation:
—> Pain is common
—> Soft tissue mass and swelling
—> Pathological fracture

62
Q

chondrosarcoma

A

Cartilaginous tumor

Typical age group is 30 – 50 years of age

63
Q

chondrosarcoma clinical presentation

A

Clinical presentation:
—> Pain
—> Palpable mass
—> Pathological fracture

64
Q

Ewing’s Sarcoma

A

Composed of undifferentiated bone marrow cells

Occurs in MALES aged 10-20

Found in the diaphysis of long bones

—> Poor prognosis
(high mortality)

65
Q

Ewing’s Sarcoma – undifferentiated bone marrow cells?

A

Ewing sarcoma is a type of tumor that forms from a certain kind of cell in bone or soft tissue.

Undifferentiated small round cell sarcoma may also form in the bone or soft tissue.

A genetic condition may increase the risk of Ewing sarcoma and other sarcomas.

“This biopsy shows an undifferentiated small round cell sarcoma involving bone with focal areas of necrosis”

66
Q

recall low level of differentiation =

A

recall low level of differentiation = high level of malignancy

67
Q

Fibrosarcoma

A

Rare malignant tumor of fibroblasts and collagen

—> Can be found in other soft tissues as well

Occurs in people 30-60 years of age

68
Q

Fibrosarcoma presentation

A

Usually found around the knee

Localized pain and swelling with long duration of symptoms

69
Q

Malignant Fibrous Histiocytoma

A

Composed of mesenchymal stem cells

Very aggressive tumour
—> Commonly metastasizes

Most commonly found in people 50-70 years old

70
Q

Hodgkin’s Lymphoma

A

Type of lymphoma that typically spreads through predictable lymphatic pathways

Note:
Presence of Reed-Sternberg cells, which are abnormal B cells
—> Reed-Sternberg cells are pathognomonic

71
Q

Hodgkin’s Lymphona – clinical presentation

A

Painless lymphadenopathy

Night sweats

Weight loss/cachexia

72
Q

recall lymphadenopathy

A

Lymphadenopathy refers to the swelling of lymph nodes which can be secondary to bacterial, viral, or fungal infections, autoimmune disease, and malignancy.

73
Q

Hodgekin’s lymphoma prognosis

A

90% curable if detected early

late detection = worse prognosis (?)

74
Q

osteomyelitis

A

Inflammation of bone caused by infectious microorganism, usually bacteria (also could be fungus, parasite, virus)

Acute – initial infection

Chronic – delayed treatment, relapse, delayed healing, prolonged infection

75
Q

osteomyelitis etiology

A

Most common - staphylococcus aureus (RECALL ALSO MOST COMMON CAUSE FOR INFECTIOUS (septic) ARTHRITIS)

Also streptococcus, pneumococcus, Haemophilus influenzae, E. coli, salmonella

Often polymicrobial

From infected wounds, blood, open wounds, surgery

76
Q

osteomyelitis, Risk factors

(weakened IS)

A

Chronic illness (weaker IS)

Steroids use or immunosuppressive drugs (weak IS)

Age (weaker IS)

Malignancy (weak IS)

Malnutrition (weaker IS)

77
Q

osteomyelitis SSx

A

Varies depending on host age and health status and on organism involved

Can include:
—> Fever, severe pain
—> Edema, erythema, tenderness
—> Low grade fever

78
Q

erythema vs hyperemia (??)

A

Hyperaemia – increased blood in a part, resulting in distension of the blood vessels.

Erythema – a redness of the skin occurring in patches of variable size or shape.

79
Q

Osteomyelitis, Dx, Tx

A

Diagnosis:
History
X-ray
Bone scan
Cultures

Treatment:
Antibiotics
Surgery

80
Q

bone marrow culture (test?)

A

Bone marrow culture is an examination of the soft, fatty tissue found inside certain bones. The bone marrow tissue produces blood cells.

This test is done to look for an infection inside the bone marrow.

It is often done to diagnose prolonged fever that remains unexplained after other tests.

81
Q

osteomyelitis why surgery?

A

Surgery. Depending on the severity of the infection, osteomyelitis surgery may include one or more of the following procedures:

Drain the infected area.

Opening up the area around your infected bone allows your surgeon to drain any pus or fluid that has accumulated in response to the infection.

82
Q
A

Semester 3 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions