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

SBD Flashcards

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
Q

Ward’s triangle

A

confluence of the trabecular groups, forms a triangle of radiolucency

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26
Q

radiographic hip features (osteoporosis)

& clinical

A

alteration of trabecular pattern, thin cortices, at risk for insufficiency fx
Clinical: high hyroxyproline lab value

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27
Q

MC primary tumor in adults

A

plasma cell myeloma (multiple myeloma)

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28
Q

Other path findings with osteoporosis/osteopenia

A

mets, anemia, nutritional deficiencies, diabetes mellitus, immunodeficient, chronic liver disease

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29
Q

diffuse significant osteopenia (esp in young patient), compression fx, patho fx, multiple lytic calvarial lesions, punched out lesions

A

Multiple Myeloma

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30
Q

How do you evaluate for Osteoporosis

A

DEXA scan

31
Q

Regional Osteoporosis

A

immobilization and disuse, reflex sympathetic dystrophy syndrome, transient regional osteoporosis (initially in hip, migrates–ie. knee on opposite side)

32
Q

Disuse osteoporosis

A

disuse inhibits osteoblastic activity

immobilization, paralysis, inflamm jt disease, extremity injury

33
Q

Reflex sympathetic dystrophy

A

acute pain, regional osteoporosis following trivial trauma, >50, hands
-reflex hyperactivity of SNS

34
Q

Clinical findings of Reflex Sympathetic Dystrophy

A

pain (intense, burning), swelling, vasomotor disturbances, trophic skin changes (atrophy of skin, pigment abnormalities)

35
Q

Imaging of Reflex sympathetic dystrophy

A

soft tissue swelling, regional osteoporosis (rarely bilateral)

36
Q

Transient osteoporosis of the hip

Patient profile

A

unknown etiology, 30-50 y/o, MC males (3:1), assoc w/ pregnancy in 3rd trimester (MC L hip), usually bilateral in men

37
Q

Transient osteoporosis of the hip

clinical

A

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
Q

altered bone quality, lack of calcium salts deposited, abornormal high ratio of osteoid to mineralized bone

A

osteomalacia

39
Q

Causes of Osteomalacia

A

Vit D metabolism (rickets in kids)

Renal tubular phosphate loss (X-linked hypophosphatemia)

40
Q

Rad features of Osteomalacia

A

osteopenia, coarsed trabeculation
looser lines, milkman’s syndrome
basilar invagination, acetabular protrusion

41
Q

What is a looser line?

A

(osteomalacia) linear region of unmineralized osteoid, usually bilat & symmetrical at right angles to the bone

42
Q

infant/young children deficiency in Vit D, Ca, or phosphate

A

Rickets

43
Q

Rad findings in Rickets

A

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
Q

Scurvy (aka Barlows)

A

long term Vit C deficiency

45
Q

Clinical findings of Scurvy

A

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
Q

Rad features of Scurvy

A

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
Q

overactivity of parathyroid gland

A

hyperparathyroidism

48
Q

Primary hyperparathyroidism

A

parathyroid gland adenoma, MC type
MC cause: hypercalcemia
elevated PTH levels
hypophosphatemia

49
Q

Secondary hyperparathyroidism

A

chronic renal disease, hemodialysis (renal osteodystrophy)

stimulates PTH release

50
Q

Tertiary hyperparathyroidism

A

dialysis patients

Parathyroid gland acts independent of serum calcium levels

51
Q

Maintains circulating Ca Fe
stimulates osteoclasts
increase ca absorption through sm intestine
renal tubular phosphate excretion and Ca absorption

A

parathormone

52
Q

Hyperparathyroidism

patient profile

A

30-50 y/o, women, bone pain, fx, weakness, lethargy, polyuria, polydipsia, hypertonia, renal stones, pancreatitis
elevated alkalkine phosphatase, elevated PTH

53
Q

Stones, bones, abdominal groans, and psychiatric moans

renal stones, peptic ulcers, pancreatitis, confusion, lethargy, weakness

A

hyperparathyroidism

54
Q

Rad findings HPT

A

osteopenia, subperiosteal resorption, distal tuft resorption, accentuated trabeculation, brown tumors, loss of cortical definition, soft tissue calcification

55
Q

most definitive rad sign of HPT

A

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
Q

Salt and pepper skull

A

HPT

57
Q

Rugger Jersey spine

A

HPT

58
Q

Lytic lesion w/ osteoclast and mononuclear cells and fibroblasts with focal hemorrhages
-hemodesiderin from the hemorrhage=brown color

A

brown tumor

59
Q

anterior pituitary hormones

A

Gh, ACTH, TSH, FSH/LH, Prolactin

60
Q

posterior pituitary hormones

A

ADH, oxytocin

61
Q

Clinical features of a pituitary tumor

A

headache, visual disturbances, generalized discomfort in extremities

62
Q

Sella Turcica measurements

A

16x12mm (across x depth)

63
Q

Significance of enlarged sella turcica

A

empty sella, tumor, aneurysm

64
Q

Excess Gh in adults after closure of open growth centers

A

acromegaly

65
Q

Excess Gh in children

A

gigantism

66
Q

Acromegaly Sx

A

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
Q

Rad features of Acromegaly

A

“spade-like” distal tufts, hooking osteophytes, increased jt spaces, widened shaft, increased tissue thickness, prominent frontal sinus & forehead, enlarged sella

68
Q

Hook osteophytes on metacarpal head=______

Hook osteophytes on distal head=_____

A

hemachromatosis (metacarpal)

acromegaly (distal)

69
Q

onset of Gh prior to skeletal maturation (open physis)

A

Gigantism

70
Q

disease caused by increased production of cortisol or by excessive use of cortisol or other steroids

A

hypercortisolism

71
Q

causes of hypercortisolism/cushings

A 
exogenous corticosteroid (immunosuppression pt)
Cushings: endogenous ACTH
72
Q

excessive glucocorticosteroid relesed by adrenal cortex, obese pt, moon face, accelerated hair growth, HTN, buffalo hump, purple striae on abdomen, vertebra & rib fx

A

Cushings

73
Q

Hypercortisolism rad features

A

osteopenia, compression fx, healing w/ excess callus, avascular necrosis, atherosclerotic plaqing

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