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D&T test 6 - endocrine, dermatology, MSK > Path: Bone: 1 > Flashcards

Path: Bone: 1 Flashcards

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Dermatology Board Prep flashcards
1
Q

Presence of woven bone in an adult indicative of?

A

always an abnormal process

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2
Q

What is MC cz of disability

A

arthritis

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3
Q

4 Non-inflammatory arthropathies

A 
1. Osteoarthritis (DJD)
Secondary to ischemia
			2.  AVN
			3. Legg-calve-perthes dz
4. Neuropathic arthropathy/Charcot joint
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4
Q

3 Inflammatory arthropathies

A

RA, Lyme, Psoriatic

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5
Q

WHat is MC form of arthritis

A

Osteoarthritis (DJD)

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6
Q

Risks for OA (3)

A

obesity, trauma, age (all “wear and tear”)

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7
Q

OA: pain increases with

A

use

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8
Q

cause of Neuropathic joint (charcot joint)

A

loss of sensation

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9
Q 
Rheumatoid Arthritis 
# of joints involved, laterality, symmetry, large vs small joints?
A

Polyarticular, bilateral, symmetrical (small > large)

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10
Q

3 Risks for AVN:

A

steroids, SSD, trauma

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11
Q

RA: pain increases with

A

rest

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12
Q

MC joint affected in gout

A

1st MTP

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13
Q

Gout histology (include birefringence color and property)

A

Needle shaped crystals, yellow under parallel light, blue under perpendicular = (-) birefringent

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14
Q

Pseudogout what crystals

A

Calcium pyrophosphate crystals

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15
Q

Diff between Endochondral and intramembranous formation

A

Endochondral formation: preformed cartilaginous model

Intramembranous formation: no cartilage model, bone laid directly on fibrous layer of mesenchyme

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16
Q

Define Osteomyelitis

A

Definitioin: inlfammation of bone

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17
Q

Etiology and MC cz of osteomyelitis + 2 other causes

A

Almost always dt infx

  1. MC= S. aureus
  2. Salmonella with SSD: if G(-)
  3. Blastomycosis and Histoplasmosis –> fungal osteomyelitis
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18
Q

CP of osteomyelitis

A

acute systemic illness. Symptoms may be overt or subtle

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19
Q

radiology of osteomyelitis

A

Destructive focus surrounded by edema and sclerosis

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20
Q

Dx of osteomyelitis

A

Blood: Cultures positive

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21
Q

4 complications of osteomyelitis

A

○ pathologic fracture
○ Secondary amyloidosis (dt acute phase reactant ASS–> AA–> deposition)
○ Endocarditis
4. SqCC in sinus site, rarely osteosarcome

22
Q

Define Sequestrum:

A

entrapped necrotic bone fragments (in osteomyelitis)

23
Q

what is involucrum

A

Osteomyelitis some dead bone is left (sequestrum) with a shell of woven, viable bone around it (known as an involucrum)

24
Q

pott dz aka

A

tuberculosis osteomyelitis

25
Q

Elevated Alkaline phosphatase (ALP) indicates?

A

Increased when osteoblasts are active (alkaline environment is required to lay down bone)

26
Q

bone cancer is ix by what levels of the following things:
PTH
Ca
Phosphorus

A

PTH: Low level = bone cancer
Ca: high level = bone cancer
Phosphorus: low level = bone cancer

27
Q

Osteopetrosis : dt? findings (3)

A

dt decreased marrow = anemia, thrombocytopenia, leukopenia

28
Q

Mineralization normal or dysfunctional: osteoporosis, osteomalacia

A 
osteoporosis = normal
osteomalacia = defective (low vit D)
29
Q 
Levels in osteomalacia:
Ca: 
PO4:
ALP:
PTH:
A

Ca: low
PO4: low
ALP: high
PTH: high

30
Q 
Levels in osteoporosis:
Ca: 
PO4:
ALP:
PTH:
A

all normal

31
Q 
Levels in Paget:
Ca: 
PO4:
ALP:
PTH:
A

ALP is only high one

32
Q 
Levels in osteopetrosis:
Ca: 
PO4:
ALP:
PTH:
A

all normal

33
Q

pathology of osteoporosis

A

reduction in trabecular bone mass

34
Q

2 radiologic findings (and hallmark) of OA

A

1) Loss of joint space = hallmark

2) Marginal osteophytes (bone spurs)

35
Q

“named” Joint findings in hands in OA (and joint(s) involved)

A

in OA BOTH DIP and PIP are involved: Heberden Nodes

Bouchard nodes

36
Q

Hallmark gross finding on subchondral bone in OA

A

Eburnation = polished ivory appearance

37
Q

gross finding in OA

A

pitting articular cart

38
Q

What cuases a Subchondral cyst?

A

Synovial fluid accessing subchondral space through cracks in articular cartilage

39
Q

Joint involved in charcot joint is related to underlying disease: which?

1) Ankle: ?
2. Knee, hip, spine: ?

A

1) Ankle: DM

2. Knee, hip, spine: tertiary syphillis

40
Q

Hallmark gross finding in RA

A

Pannus: inflammed synovium –> granulation tissue covering articular cartilage (destroys and fuses joint)

41
Q

finger joint findings in RA and how differs from OA

A

PIP only affected in RA

PIP and DIP in OA

42
Q

What causes joint destruction and deviation in a pannus

A

myofibroblast proliferation

43
Q

What is a Rice body and where found?

A

fibrin with PMNs in the synovium

44
Q

Subchondral formations in RA (and diff bt OA)

A 
RA = Subchondral resorption  
OA/DJD = subchondral sclerosis (bone formation)
45
Q

What is a rheumatoid nodule and where are they found

A

A Palisading granuloma:
Macros, lymphos, plasma cells surrounding necrotic area

Seen in GI tract, lungs, heart

46
Q

Risk factors for AVN (4)

A

Chronic steroid use, SSD, fractures, barometric trauma (“the bends”)

47
Q

What 2 hallmark radiologic sign is seen in AVN

A
  1. Crescent sign (hallmark)- separation between articular cart and underlying subchondral bone
  2. wedge shaped infarct
48
Q

What is Legg-Calve-Perthes Disease

A

AVN of femoral head in kids

49
Q

What is gout

A

Monosodium-urate (MSU) crystal deposition in joints

50
Q

Pseudogout/ Chondrocalcinosis/ Calcium pyrophosphate deposition disease presents how? findings? histo

A

findings: Calcification (CPPD) deposits in cartilage, menisci, synovium
CP: arthritis
Histo: Rhomboid-shaped, blue-purple crystals (Positive birefringence)

D&T test 6 - endocrine, dermatology, MSK (22 decks)

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