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Get your own study shit you lazy fucking piece of shit! > SBD > Flashcards

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1
Q

Hormones & nutrients stimulating bone production

A

Gh, T3/T4, Calcitonin, Vit C, Vit D

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2
Q

Hormones inhibiting bone production

A

PTH, Cortisol

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3
Q

increased radiolucency or decreased density of bone

-resorption exceeds formation

A

osteopenia

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4
Q

Causes of increased radiolucency/Decreased bone density

A

osteoporosis, osteomalacia, hyperparathyroidism, rickets, scurvy, neoplasm

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5
Q

linear radiolucencies

A

osteomalacia

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6
Q

Hormone that produces subperiosteal and subchondral resorption

A

HPT

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7
Q

Produces focal lesions

A

plasma cell myeloma

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8
Q

How much bone loss is needed before detected on X-ray?

A

30-50%

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9
Q

Qualitatively normal, quantitively deficient bone

A

osteoporosis

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10
Q

compression fx, increased thoracic kyphosis, bony fx (prox femur, ribs, humerus, radius) are common in….

A

Osteoporosis

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11
Q

hip fx ____ in women eveyr 5 yeras after 60

A

double

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12
Q

Senile osteoporosis, postmenopausal osteoporosis, transient/regional osteoporosis

A

primary osteoporosis

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13
Q

corticosteroids, malignancy, infxn, arthridities, disuse, RSD

A

secondary osteoporosis

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14
Q

Age-related osteopenia

A

senile & postmenopausal osteoporosis

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15
Q

Endocrinopathy (osteopenia)

A

acromegaly, hyperparathyroidism, cushings, pregnancy, heparin, alcoholism

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16
Q

gradual loss of skeletal mass seen with advancing age

A

senile osteoporosis

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17
Q

increased bone loss seen in women following menopause

A

postmenopausal osteoporosis

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18
Q

Characteristics of senile/postmenopausal osteoporosis

A

pain (due to microfx), loss of ht/compression fx, increased kyphosis

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19
Q

Osteoporosis risk factors

A

female, >70y/o, caucasian or asian, early onset of menopause, long postmenopausal interval, inactivity

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20
Q

Modifiable osteoporosis risk factors

A

smoking, alcohol, caffeine (excess), excess dietary protein consumption, lack of Ca, lack of sunlight

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21
Q

Osteoporosis rad features

A

osteopenia, cortical thinning (pencil-thin), resorption of nonstress-bearing trabeculae, accentuated vertical struts, altered vertebarl shape, changes in vertebral contour, uniform decrease in radiodensity, wedge-shaped vertebrae (fish/codfish deformity, schmorls nodes, endplate infractions)

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22
Q

Decreased bone density, trabecular changes (accentuated primary trabeculae/pseudo-hemangioma), washed out, cortical thinning, changes is vertebral shape

A

Cod Fish deformity

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23
Q

Osteoporosis in an extremity

A

thinned cortices, endosteal scalloping, loss of secondary trabeculae, risk of fx

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24
Q

Trabecular patterns of the hip

A 
Primary compressive (medial), secondary compressive (lateral), primary tensile (across)
*look at picture in book*
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25
Ward's triangle
confluence of the trabecular groups, forms a triangle of radiolucency
26
radiographic hip features (osteoporosis) | & clinical
alteration of trabecular pattern, thin cortices, at risk for insufficiency fx Clinical: high hyroxyproline lab value
27
MC primary tumor in adults
plasma cell myeloma (multiple myeloma)
28
Other path findings with osteoporosis/osteopenia
mets, anemia, nutritional deficiencies, diabetes mellitus, immunodeficient, chronic liver disease
29
diffuse significant osteopenia (esp in young patient), compression fx, patho fx, multiple lytic calvarial lesions, punched out lesions
Multiple Myeloma
30
How do you evaluate for Osteoporosis
DEXA scan
31
Regional Osteoporosis
immobilization and disuse, reflex sympathetic dystrophy syndrome, transient regional osteoporosis (initially in hip, migrates--ie. knee on opposite side)
32
Disuse osteoporosis
disuse inhibits osteoblastic activity | immobilization, paralysis, inflamm jt disease, extremity injury
33
Reflex sympathetic dystrophy
acute pain, regional osteoporosis following trivial trauma, >50, hands -reflex hyperactivity of SNS
34
Clinical findings of Reflex Sympathetic Dystrophy
pain (intense, burning), swelling, vasomotor disturbances, trophic skin changes (atrophy of skin, pigment abnormalities)
35
Imaging of Reflex sympathetic dystrophy
soft tissue swelling, regional osteoporosis (rarely bilateral)
36
Transient osteoporosis of the hip | Patient profile
unknown etiology, 30-50 y/o, MC males (3:1), assoc w/ pregnancy in 3rd trimester (MC L hip), usually bilateral in men
37
Transient osteoporosis of the hip | clinical
sudden pain, antalgia, limp self-limiting 3-12 mo periarticular osteoporosis, jt space remains normal, diffuse bone marrow edema on MRI (Dec T1, inc T2)
38
altered bone quality, lack of calcium salts deposited, abornormal high ratio of osteoid to mineralized bone
osteomalacia
39
Causes of Osteomalacia
Vit D metabolism (rickets in kids) | Renal tubular phosphate loss (X-linked hypophosphatemia)
40
Rad features of Osteomalacia
osteopenia, coarsed trabeculation looser lines, milkman's syndrome basilar invagination, acetabular protrusion
41
What is a looser line?
(osteomalacia) linear region of unmineralized osteoid, usually bilat & symmetrical at right angles to the bone
42
infant/young children deficiency in Vit D, Ca, or phosphate
Rickets
43
Rad findings in Rickets
wide, bulky growth plates (fraying) lack of mineralization in cartilage matrix, overgrowth, zone of provisional calcification is absent. Splaying (cupping) of weakened bone at metaphysis and physis junction Bowing deformities Rachitic rosary (chest, due to cartilage overgrowth) Paintbrush metaphysis
44
Scurvy (aka Barlows)
long term Vit C deficiency
45
Clinical findings of Scurvy
low serum levels, cartilage slow to proliferate, osteopenia, spontaneous hemorrhage (due to capillary fragility), cutaneous petechiae, bleeding gums, hematuria, jt swelling, pain supine often mistaken for child abuse
46
Rad features of Scurvy
osteopenia, wide metaphysis dense zone of provisional calcification (white line of Frankel)--delayed conversion to bone Pelken's spurs Wimberger's sign: radiodense sclerosis around epiphysis, radiolucent centrally Trummerfeld's zones: scorbutic zone (radiolucent band) subperiosteal hemorrhage corner sign
47
overactivity of parathyroid gland
hyperparathyroidism
48
Primary hyperparathyroidism
parathyroid gland adenoma, MC type MC cause: hypercalcemia elevated PTH levels hypophosphatemia
49
Secondary hyperparathyroidism
chronic renal disease, hemodialysis (renal osteodystrophy) | stimulates PTH release
50
Tertiary hyperparathyroidism
dialysis patients | Parathyroid gland acts independent of serum calcium levels
51
Maintains circulating Ca Fe stimulates osteoclasts increase ca absorption through sm intestine renal tubular phosphate excretion and Ca absorption
parathormone
52
Hyperparathyroidism | patient profile
30-50 y/o, women, bone pain, fx, weakness, lethargy, polyuria, polydipsia, hypertonia, renal stones, pancreatitis elevated alkalkine phosphatase, elevated PTH
53
Stones, bones, abdominal groans, and psychiatric moans | renal stones, peptic ulcers, pancreatitis, confusion, lethargy, weakness
hyperparathyroidism
54
Rad findings HPT
osteopenia, subperiosteal resorption, distal tuft resorption, accentuated trabeculation, brown tumors, loss of cortical definition, soft tissue calcification
55
most definitive rad sign of HPT
subperiosteal resorption - (@ margins of middle & prox phalanges of 2nd & 3rd digits) - outer cortical erosiion (frayed/lace-like) - widened jt space and osteolysis (AC & SI jts) - loss of lamina dura in teeth
56
Salt and pepper skull
HPT
57
Rugger Jersey spine
HPT
58
Lytic lesion w/ osteoclast and mononuclear cells and fibroblasts with focal hemorrhages -hemodesiderin from the hemorrhage=brown color
brown tumor
59
anterior pituitary hormones
Gh, ACTH, TSH, FSH/LH, Prolactin
60
posterior pituitary hormones
ADH, oxytocin
61
Clinical features of a pituitary tumor
headache, visual disturbances, generalized discomfort in extremities
62
Sella Turcica measurements
16x12mm (across x depth)
63
Significance of enlarged sella turcica
empty sella, tumor, aneurysm
64
Excess Gh in adults after closure of open growth centers
acromegaly
65
Excess Gh in children
gigantism
66
Acromegaly Sx
headache, enlarged heart/liver/kidneys, fatigue, excess perspiration, visual disturbances, sleep apnea, amenorhea/impotence, frontal bossing, enlarged nose/tongue/lips, widened teeth, enlarged hands/feet heel pad thickness >23mm
67
Rad features of Acromegaly
"spade-like" distal tufts, hooking osteophytes, increased jt spaces, widened shaft, increased tissue thickness, prominent frontal sinus & forehead, enlarged sella
68
Hook osteophytes on metacarpal head=______ | Hook osteophytes on distal head=_____
hemachromatosis (metacarpal) | acromegaly (distal)
69
onset of Gh prior to skeletal maturation (open physis)
Gigantism
70
disease caused by increased production of cortisol or by excessive use of cortisol or other steroids
hypercortisolism
71
causes of hypercortisolism/cushings
``` exogenous corticosteroid (immunosuppression pt) Cushings: endogenous ACTH ```
72
excessive glucocorticosteroid relesed by adrenal cortex, obese pt, moon face, accelerated hair growth, HTN, buffalo hump, purple striae on abdomen, vertebra & rib fx
Cushings
73
Hypercortisolism rad features
osteopenia, compression fx, healing w/ excess callus, avascular necrosis, atherosclerotic plaqing

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