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Pathology 3: Bone and Joint Pathologies > Pathologies of Bone > Flashcards

Pathologies of Bone Flashcards

1
Q

A discontinuity of bone. The most common type of bone lesion.

A

Fractures

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2
Q

What are the three major categories of fractures?

A
  1. Fracture caused by sudden injury [most common]
  2. Fatigue or stress fractures
  3. Pathologic fractures
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3
Q

The following are types of fractures. Except:

  1. Closed [simple]
  2. Open [compound]
  3. Complete fracture
  4. Incomplete
  5. Comminuted
  6. Compression
  7. Impacted
  8. Stress
  9. Aggravated
  10. Avulsion
  11. Pathologic
A

Except: 9

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4
Q

Type of Fracture wherein bone fragment connected to a ligament or tendon breaks off from main bone.

A

Avulsion

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5
Q

Type of Fracture wherein penetrates through the skin.

A

Open [compound]

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6
Q

_________ - occurs in a bone weakened by disease, e.g. secondary to osteoporosis or bone tumour .

A

Pathologic Fracture

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7
Q

What are the three Fracture types according to its orientation?

A
  1. Oblique - approx. 45 degrees to long axis of bone
  2. Spiral - twisting or torque
  3. Transverse - 90 degrees to long axis of bone
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8
Q

Five types of Epiphyseal Fractures:

A
  1. Type I
  2. Type II
  3. Type III
  4. Type IV
  5. Type V
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9
Q

_______ - compression fracture through the growth plate (least common), can often stunt growth

A

Type V

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10
Q

_______ - fracture through the growth plate which carries a corner of the metaphysis [occurs in 75% of cases]

A

Type II

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11
Q

______ - an oblique fracture through the epiphysis, growth plate and metaphysis.

A

Type IV

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12
Q

________ - fracture through the growth plate and a part of the epiphysis.

A

Type III

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13
Q

_______ - isolated fracture through the growth plate.

A

Type I

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14
Q

The following are named Fractures. Except:

  1. Jefferson’s
  2. Chauffeur’s
  3. Maisonneuve
  4. Washington’s
  5. Bucket handle
  6. Morton
  7. Lap Belt
  8. Bedroom
A

Except: 4

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15
Q

________ - also known as Dancer’s, transverse stress fracture of proximal shaft of fifth metatarsal.

A

Jones’ fracture

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16
Q

_______ - fracture of distal radius with dorsal displacement of distal segments. Often involves ulnar styloid process.

A

Colles’

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17
Q

________ - fracture of 4th or 5th metacarpal

A

Bar room

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18
Q

________ - partial dislocation of ankle with fracture of fibula above the lateral malleolus and rupture of distal tibiofibular ligament.

A

Pott’s

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19
Q

__________ - fracture of proximal fibula with disruption of tibiofibula syndesmosis from ankle eversion .

A

Maisonneuve

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20
Q

_______ - fracture of superior pubic ramus and ischiopubic junction on opposite sides and SI joint on side of impact. It is due to side impact .

A

Bucket handle

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21
Q

_______ - avulsion of spinous processes of lower cervicals caused by auto accident, diving, wrestling - [hyperflexion] .

A

Clay shoveler’s

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22
Q

_________ - fracture of tibial plateau

A

Bumper / Fender

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23
Q

__________ - fracture of anterior body of C2 through pedicles [hyperextension] .

A

Hangman’s

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24
Q

_________ - horizontal fracture through maxillary above apices of teeth .

A

LeFort [3 types]

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25
Q

_________ - burst fracture of C1 due to compression

A

Jefferson’s

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26
Q

________ - transverse fracture of usually L1, L2 or L3

A

Lap Belt, aka Chance

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27
Q

____________ - fracture of distal radius and ulna with ventral displacement of distal segments.

A

Smith’s, aka reverse Colles

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28
Q

The followiing are stages of Bone healing. Except:

  1. Hematoma formation [1-2 days]
  2. Formation of fibrocartilaginous callus called procallus [2 days to 3 weeks]
  3. Invasion of Macrophages to support osteogenesis.
  4. Bony callus formation [3rd to 4th week]
  5. Remodeling
A

Except: 3

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29
Q

True or False

  1. Healing also depends on the site of the fracture, the condition of the fragments, hematoma formation and other host factors.
  2. Healing depends on the age of the individual:

Children: 4-6 weeks
Adolescents: 6-8 weeks
Adults: 10-18 weeks

A

True

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30
Q

What are the treatment of Fractures?

A

Treatment:

  • Reduce fracture
  • Immobilization and splinting
  • Surgery to insert pins, screws or rods
  • Physical therapy to encourage healing and prevent contracture and adhesions
  • If conditions such as Complex Regional Pain Syndrome, embolisms or infections occur, more
    specific treatment may be required
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31
Q

_________ - refers to any painful state of the supporting structures of the body—bones, ligaments, joints, tendons or muscles.

A

Rheumatism

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32
Q

_________ - is a form of rheumatism in which the joints have become inflamed. Refers to many different diseases, most of which are characterized by inflammation of one or more joints. Inflammation, pain, and stiffness may also be present in the adjacent tissues.

A

Arthritis

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33
Q

A degenerative joint disease in which joint cartilage is gradually lost. Commonly known as wear-and-tear arthritis. The most common type of arthritis.

A

Osteoarthritis

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34
Q

What is the etiology of osteoarthritis?

A

It results from a combination of aging, obesity, irritation of the joints, muscle weakness, and wear and abrasion.

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35
Q

Osteoarthritis mainly affects:

A

Articular cartilage

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36
Q

The following are signs and syptoms of Osteoarthritis. Except:

  1. Pain
  2. Stiffness
  3. Crepitus
  4. Swelling nodes on interphalangeal joints
  5. Knees and hips are sore
  6. Bruising on the affected areas
  7. Morning stiffness until the joint is warmed up
  8. May have no early symptoms
  9. Nodes on the finger joints [Heberden and Bouchard
A

Except: 6

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37
Q

What are the diagnostic procedure to determine osteoarthritis?

A
  1. Physical exam and history
  2. X-ray can confirm
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38
Q

The followng are treatment of Osteoarthritis. Except:

  1. Analgesic or anti-inflammatory medication or herbs.
  2. Massage or acupuncture may help relieve pain and swelling.
  3. Cortisone injections in the joint
  4. Reduce stress on the joint but maintain strength and flexibility
  5. Pain management techniques
  6. Weight gain program
  7. Joint replacement surgery [Most
    common reason for hip and knee surgery]
A

Except: 6

Weight loss not weight gain

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39
Q

_________ - is the temporary displacement of two bones at the joint with complete loss of contact between the articulating surfaces.

A

Dislocation

40
Q

If the contact between the surfaces is only partially lost due to injury. This is called:

A

subluxation or separation

41
Q

Most common areas of dislocations and subluxations are the following. Except:

  1. Shoulder
  2. Elbow
  3. Wrist
  4. Mandible
  5. Jaw
  6. Hip
  7. Knee
A

Except: 4

42
Q

What are the causes of dislocation?

A
  1. Trauma from motor vehicle accidents [MVA] or sports
  2. Congenital or acquired damage can contribute
43
Q

What are the manifestations of dislocation?

A
  • Misshapen joint
  • Swelling
  • Discolouration
  • Loss of function and pain
  • Subluxations exhibit similar but less severe symptoms
44
Q

Treatment of Dislocation are the following. Which of these treatment is not included?

  1. Realign bones [reduction]
  2. Immobilization
  3. Bone transplantation
  4. Physical therapy
  5. Surgery may be required
  6. Pain modalities
A

Not included: 3

45
Q

Joint trauma that stretches or tears ligaments. Commonly occurs in the ankle, wrist, elbow and knee but the low back and sacroiliacjoints are common areas as well. This condition is called:

A

Sprain

46
Q

Grade of Severity of Sprain:

Microscopic damage but not torn. Minimal instability.

A

Grade I

47
Q

Grade of severity of Sprain:

Complete rupture. Gross instability. May be avulsion fracture. Significant swelling and loss of function.

A

Grade III

48
Q

Grade of severity of Sprain:

Partially torn. Swollen and muscle splinting evident. Moderate instability.

A

Grade II

49
Q

What are the causes of sprain?

A
  • Overstretch
  • Trauma
50
Q

What are the manifestations of Sprain?

A
  • Pain, swelling, redness, loss of function, heat []
  • Discolouration
51
Q

Treatment of Sprain are the following. Except:

  1. Rest, ice, elevate, compress [RICE]
  2. Analgesics or anti-inflammatory medications or herbs
  3. Brace, crutches or taping
  4. Amputation
  5. Surgery in severe cases
  6. Physical therapy
A

Except: 4

52
Q

This refers to a group of inherited disorders of connective tissue caused by mutations in the gene for collagen. It affects the skeleton, joints, ears, ligaments, teeth, sclera and skin.

A

Osteogenesis imperfecta

53
Q

Osteogenesis imperfecta is also nown as:

A

Brittle bone disease

54
Q

The following describes Type I Osteogenesis imperfecta. Which is not true?

  1. multiple function at birth, blue sclera, hearing problems, teeth
  2. function usually occur after the adolescent begins puberty
  3. stature is more or less unaffected
  4. this is the most common form
A

Answer: 2

55
Q

Describe Type II Osteogenesis imperfecta.

A

Type II

  • lethal
  • stillborn or die within a few days, due to crushing of bones
  • during delivery or uterine contractions
  • Sclera are blue
56
Q

An acute or chronic bone infection, usually caused by bacteria. Osteo relates to bone and myelo relates to the marrow cavity.

A

Osteomyelitis [Pyogenic Osteomyelitis]

57
Q

Usually bacterial cause from infection of an open wound. Can be from local trauma or can spread via the bloodstream [hematogenous route].

A

Acute Osteomyelitis

58
Q

What is the common bacteria that causes acute Osteomyelitis?

A

staphylococcus aureus

59
Q

What are the symptoms of Acute Osteomyelitis?

A
  • Fever
  • chills
  • malaise
  • pain
  • poor healing at wound site
  • wound drainage
60
Q

What are the areas that are commonly affected with Acute Osteomyelitis ?

A

children - the long bones are usually affected.

adults - the vertebrae and the pelvis [sacroiliac joints and symphisis pubis].

61
Q

Results when an acute infection persists longer than 6-8 weeks. Usually occurs in adult.

A

Chronic osteomyelitis

62
Q

True or False:

_Chronic osteomyelitis _

  • May persist for years or recur when resistance is lowered.
  • More difficult to diagnose since the symptoms are minimal
  • isolated
A

True

63
Q

What are common organisms that are commonly causeds Chronic osteomyelitis?

A
  • E. coli
  • pseudomonas
  • staphylococcus epidermidis
64
Q

__________ - a fragment of necrotic bone that is separated from the surrounding living bone.

A

Sequestrum

65
Q

_________ - new bone forms a sheath, around a necrotic sequestrum.

A

Involucrum

66
Q

_______ - the hole formed in the bone during the formation of a draining sinus.

A

Cloaca

67
Q

Tests for Chronic osteomyelitis may include the following. Except:

  1. Bone scan
  2. Lumbar puncture
  3. Blood cultures affected bones
  4. MRI
  5. Needle aspiration of the area around
  6. Bone lesion biopsy
A

Except: 2

68
Q

What are the treatment of Chronic osteomyelitis?

A
  1. Long-term antibiotics [6 weeks]
  2. Surgery and immobilization
69
Q

Condition that is usually caused by the spread of a primary infection elsewhere in the body (e.g.respiratory tract). Psoas abscess often associated with bone infection. More resistant to treatment. Treated with anti-tuberculosis drugs but may require surgery.

A

Tuberculous Osteomyelitis

70
Q

Tuberculous Osteomyelitis in the thoracic or lumbar spine is called:

A

Pott disease

71
Q

___________ - causes bones to grow too large and weak. Found in the spine, pelvis, skull, or leg bones. The disease may affect only one bone or several bones but it does not affect the entire skeleton.

A

Paget‘s disease

72
Q

Paget’s disease is also known as:

A

Osteitis Deformans

73
Q

What is the characteristic of bones with Paget‘s disease?

A

May break more easily

74
Q

True or False:

About one million people in the United States have Paget‘s disease. The disease is more common in older people and those of Northern European descent. Men are more likely than women to contract this disease.

A

True

75
Q

What is the cause of Paget‘s disease?

A

Doctors are not sure what causes Paget‘s disease. In some cases, it is thought that a virus may be the cause. It also tends to run in families.

76
Q

Phase 1 of paget’s disease is known as:

A

Intense Osteoclastic activity

77
Q

Phase 2 of Paget’s disease is known as:

A

Osteolytic - Osteoblastic activity [mixed]

78
Q

Phase 3 of paget’s disease is known as:

A

Dense bone deposition

79
Q

True or False:

Phase 1: Intense Osteoclastic activity

  1. Woven bone formation
  2. Ineffective mineralization
A

False

The following describes Phase II of paget’s disease

80
Q

What phase of Paget’s disease describes the following?

  1. Bone resorption predominates
  2. Bone turnover is 20 times normal rate
A

Phase 1: Intense Osteoclastic activity

81
Q

What phase of Paget’s disease that describes the following?

  1. Bone is disorganized and sclerotic
  2. Weaker than normal bone is created
A

Phase 3: Dense bone deposition

82
Q

Symptoms of paget’s disease. Which of the following are not included?

  1. Asymptomatic in 70% of cases
  2. Rest or night pain
  3. Weight bearing pain
  4. Warming of limb
  5. Limb bowing
  6. Occipital forehead dominant
  7. Skull enlargement
  8. Loose teeth
  9. Headaches
  10. Vision loss
A

Answer: 6 and 10

83
Q

Symptoms of Paget’s disease. True or False:

Symptoms get worse slowly and the disease does not spread to other bones.

A

True

84
Q

What are the Test done to determine presence of Paget’s disease?

A
  • Most often, Paget‘s disease is diagnosed with x-rays.
  • An alkaline phosphatase blood test.
  • A bone scan. Can show which bones the disease have been affected.
85
Q

What are the two main types of medicines that are approved to treat Paget‘s disease?

A
  1. Bisphosphonates
  2. Calcitonin
86
Q

These medicines help relieve pain and keep Paget’s disease from getting worse.

A

Bisphosphonates

87
Q

What is the hormone made by the thyroid gland that suppresses osteoclasts and promotes excretion of Ca and Ph in kidneys?

A

Calcitonin

88
Q

__________ - is a disease characterized by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fracture (broken bones), particularly of the hip, spine and wrist.

A

Osteoporosis

89
Q

Osteoporosis is often known as:

A

“the silent thief”

90
Q

What is the best defense against developing osteoporosis later?

A

Building strong bones during childhood and adolescence. Peak bone mass is achieved at an early age, age 16 in girls and age 20 in young men.

91
Q

Who are high risk in having Osteoporosis?

A

Women and men alike begin to lose bone in their mid-30s; as they approach menopause, women lose bone at a greater rate, from 2-5 per cent per year.

92
Q

The following are risk factors of Osteoporosis. Which is not included:

  1. age
  2. lack of activity
  3. vertebral compression fracture
  4. family history
  5. >3 months use of glucocorticoid drugs and medical conditions that inhibit absorption of nutrients.
  6. low potassium or vitamin intake.
  7. Probably a multifactorial cause.
A

Except: 6

93
Q

What are the treatment of Osteoporosis?

A
  1. Medications
  2. Bisphosphonates
  3. Selective estrogen receptor modulators
  4. Hormone replacement therapy
  5. Calcitonin
  6. Bone metabolism regulator: Denosumab
    is a new class of osteoporosis treatment
  7. human monoclonal antibody
  8. diet rich in calcium and vitamin D
  9. Regular exercise or physical activity
94
Q

What is the ideal daily intake of calcium?

A

about 1000 mg daily

95
Q

True or False:

Intake of Vitamin D.

400-1000 i.u. per day up to 50 yrs old [upper tolerance is 2000 i.u.]

A

True

96
Q

What is the normal daily intake of protein?

A

Protein - about 75 grams a day [bones are 50% protein]

Pathology 3: Bone and Joint Pathologies (6 decks)

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