P4 PATHOLOGY Flashcards
pathology of osteonecrosis & osteoporosis
death of bone & BM due to interference of blood supply & absence of infection is known as
Aseptic / avascular bone necrosis
mention at least 4 causes of osteonecrosis
1- emboli
2- systemic diseases
3- radiation
4- trauma
5- corticosteroids
6- idiopathic factors
7- specific focal bone necrosis
8- thrombosis
mention the 2 types of specific focal bone necrosis
- legg-calve-perthes disease
- Kohler disease
Necrosis of navicular bone is seen in which disease
Kohler disease
legg-calve-perthes disease location
femoral head
legg-calve-perthes disease age group
children
type of detachment seen in the shown coronal section of femoral head
partial detachment
type of detachment seen in the shown coronal section of femoral head
Complete detachment
in shown histology of femoral head
Describe what is seen
normal mature trabeculae of cancellous bone evenly distributed osteocytes
in shown histology of femoral head
Describe what is seen
Necrotic bone with empty lacunae & necrotic BM spaces showing dystrophic calcification
healing of necrotic cortical bone by
cutting cones / needles
healing of necrotic cancellous bone is by
creeping substitution
a metabolic bone disease characterised by diffuse lesions with reduced mineralised bone mass is known as
Osteoporosis
Osteoporosis mostly are seen at ( location )
Cancellous bones of vertebrae , ribs . Pelvis , end of long bones
balance of activity of osteoblasts , osteocytes & osteoclasts is known as
Remodelling
accretion , deposition , bone formation , osteoblastic bone lesions are all activities of
osteoblasts
resorption , rarefaction , osteopenia , bone removal , bone loss & lytic lesions are all activities of
osteoclasts
gross pictures of osteoporosis case
Describe what is seen
- changes in size , shape , architecture of vertebral bodies
- biconcave deformity
-protrusion / herniation of IVD into vertebrae - fracture collapse
- micro-architectural deterioration
State whether the shown gross image is normal / abnormal vertebral body
normal
gross pictures of osteoporosis case
Describe what is seen
- shorten vertebra due to multiple compression fractures
-biconcave deformity - loss of horizontal trabeculae
- thickened vertical trabeculae
Showing vertebral osteoporosis
Describe what is seen
Thinning of trabeculae & loss of intertrabecular connections on bone
in the shown histology of osteoporosis case
Describe what is seen
- lamellar bone trabeculae reduced in size & thickness
- loss of interconnection
Physiological osteoporosis is seen in
senile patients
post menopausal ladies
type of fractures seen in pathological osteoporosis
- vertebral crush / compression fracture
- distal radius ( colle’s )
- femur - neck fracture
- neck of humerus
type 1 osteoporosis ( post menopausal ) is due to
Increased activity of osteoclasts due to decreased oestrogen
age group of type 2 primary (senile ) osteoporosis
above the age of 70
most common cause of 2ndry osteoporosis
Corticosteroids
effect of corticosteroids on osteoblastic activity
Inhibit their activity
Effect of hyperparathyroidism on osteoclast activity
Increase their activity > secondary osteoporosis
Effect of hyperthyroidism on osteoclast activity
Increase osteoblastic activity > increased bone turnover
Genetic syndrome seen in males leading to 2ndry osteoporosis
klienfelter syndrome
Genetic syndrome seen in females leading to 2ndry osteoporosis
Turner syndrome
cancers of thyroid , GIT , kidney & neuroblastomas produce lytic lesions by stimulating what cells
osteoclasts
cancers of prostate , stomach , breast & lungs causes bone Formation by stimulating what cells
Osteoblasts
small cell carcinoma of the lung causing secondary osteoporosis is seen in what syndrome
paraneoplastic syndrome
Direct inhibitor of osteoblasts & calcium absorption
alcohol
