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Skeletal Pathophysiology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is arthritis?

A

Arthritis is a general term meaning “joint inflammation”

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2
Q

What are the two most common types of arthritis?

A

Osteoarthritis and rheumatoid arthritis

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3
Q

What is another name for osteoarthritis?

A

Degenerative Joint Disease

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4
Q

Where does osteoarthritis typically affect people?

A

It primarily affects the weight bearing joints of the hips and knees

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5
Q

What happens during osteoarthritis?

A

The bones and cartilage between the bones begins to breakdown

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6
Q

What are the causes of osteoarthritis
?

A

Research points to inflammatory processes or metabolic disorders

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7
Q

What are the signs and symptoms of arthritis?

A

Joint stiffness
Aching and pain with weather changes
Fluid around joints
Grating noises with joint movements (caused by bone on bone contact)

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8
Q

What diagnostic exams and tests can one undergo to diagnose osteoarthritis?

A

X-rays of the affected joint are used to determine if osteoarthritis is present.

Blood tests are used to determine if rheumatoid arthritis is present

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9
Q

What is the treatment for osteoarthritis?

A

-Anti-inflammatory drugs like aspirin

-Nonsteroidal anti-inflammatory drugs (NSAIDs) naproxen and feldene

-Intra-articular steroid injections may be tried for severe cases

-Sometimes hyaluronic acid containing medications are injected when other treatments do not work.

-Transplanting harvested cartilage cells from a patients healthy knee cartilage which are grown in a lab and then injected into the affected joint

-Surgical scraping of the diseased joint to remove deteriorated bone fragments

-Partial or Full joint replacement prostheses eg the
Birmingham hip resurfacing prosthesis

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10
Q

Why are hyaluronic acid injections used in osteoarthritis treatment?

A

They are used to replace joint fluid

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11
Q

What substances are surgical prostheses made out for osteoarthritis?

A

Metal, plastic or a combination of both

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12
Q

Briefly describe the Birmingham Hip Resurfacing prostheses

A

The head of the femur is replaced by an all metal prosthesis

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13
Q

What is an advantage of partial
Joint replacement?

A

It conserves more bone than conventional total joint replacement

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14
Q

Why is conserving bone during osteoarthritis replacement surgery important?

A

If additional surgery is needed in the future, the surgeon will have more natural bone to work with if a revision or new prosthesis is required.

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15
Q

What is rheumatoid arthritis
?

A

It is the second most common form of arthritis. It is a chronic, systematic inflammatory disease.

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16
Q

In which segment of the population is rheumatoid arthritis most commonly found?

A

It is typically found in females, it is three times as common in women than in men.

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17
Q

How does rheumatoid arthritis typically present?

A

It usually starts in the smaller joints of the hands and feet. As the disease progresses inflammation of the larger joints occurs.

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18
Q

How does rheumatoid arthritis show itself through your a person’s life?

A

There are flares or attacks of pain and inflammation followed by periods of remission.

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19
Q

What are the causes of rheumatoid arthritis?

A

It is an autoimmune disease, the body’s immune system attacks the synovial membranes of the joints triggering the inflammation.

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20
Q

What are the signs and symptoms of rheumatoid arthritis?

A

The immune response causes

-Edema(swelling)

-Tenderness

-Warmth in and around joints

-Tissue becomes granular and thick eventually destroying the articular capsules and bones

-Formation of scar tissue

-Atrophied bones

-Visible deformities due to bone malalignment and immobility

-Moderate to severe pain in affected joints

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21
Q

What are the diagnostic exams and tests for rheumatoid arthritis?

A

-Magnetic Resonance Imaging (MRI)

-X-rays

-Blood tests

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22
Q

What are the treatment options for rheumatoid arthritis?

A

-Anti- inflammatory drugs

-Exercise

-Heat or cold treatments

-cortisone injections

-low impact aerobic exercise
-warm water

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23
Q

What is bursitis?

A

Inflammation of the bursa, the fluid filled sac that cushions tendons

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24
Q

Where does bursitis mainly occur?

A

-Elbow
-Knee
-Shoulder
-Hip

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25
Q

What are the causes of bursitis?

A

-Overuse of joints
-Trauma to the joints
-Bacterial infection to the joints

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26
Q

What are the signs and symptoms of bursitis?

A

-Joint pain
-Swelling
-Tenderness in the structures surrounding the joint

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27
Q

How is bursitis diagnosed?

A

-Physical exam
-Patient history
-X-rays
-MRI
-Lab tests on fluid withdrawn from the bursa

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28
Q

What are the treatment options for bursitis?

A

-Bed rest
-Pain medication
-Steroid injections
-Aspiration of excess fluid from the bursa
-Antibiotics

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29
Q

What is a fracture?

A

Fractures are cracks, breaks, or splintering of a bone.

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30
Q

What is a complete fracture?

A

Complete fractures are fractures that go across the entire bone breaking it in two

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31
Q

What is an incomplete fracture?

A

An incomplete fracture only goes through part of the bone, it is not split in two

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32
Q

What is a comminuted fracture?

A

A comminuted fracture is a fracture in which the bone has broken into several different fractures.

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33
Q

What is a greenstick fracture?

A

A greenstick fracture is one in which the bone is bent, but only one side is fractured.

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34
Q

When do greenstick fractures occur most often?

A

They occur most often in childhood because the bones are still soft and pliable

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35
Q

What is an open fracture?

A

An open fracture is one in which the bone breaks through the skin

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36
Q

What is a dislocation?

A

A dislocation is the displacement of a bone end from the joint.

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37
Q

What are the causes for fractures and dislocations?

A

They are most often caused by falls, automobile accidents, and sports injuries. Fractures also may occur in people with bone disorders like:

-Tumors
-Osteoporosis
-Paget’s disease

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38
Q

What are the signs and symptoms of fractures and dislocations?

A

-After accident or fall
-Intense pain
-Localized swelling
-Bruising
-Bleeding
-a limb or joint displaced or deformed or out of place
-Numbness
-Loss of use of the limb

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39
Q

What is the diagnostic procedure for fractures and dislocations?

A

X-ray images and physical examination are used to diagnose fractures

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40
Q

What are the treatment methods for fractures and dislocations?

A

-Fractures and dislocations must be realigned and immobilized by casting or splinting

-Surgical placement of plates, screws, or pins.

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41
Q

What is Ewing Sarcoma Family of Tumors(ESFT)?

A

Ewing Sarcoma Family of Tumors is a group of tumors that affect different tissues. They primarily affect bone

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42
Q

What demographic is mostly affected by Ewing Sarcoma Family of Tumors?

A

It mostly affects caucasians between the ages of 10 and 20

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43
Q

What are the causes of Ewing Sarcoma Family of Tumors?

A

The causes of Ewing Sarcoma Family of Tumors are unclear.

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44
Q

Where do the tumors in the Ewing Sarcoma Family of tumors typically occur in the body?

A

Usually located in the lower extremities but they also occur in the pelvis, chest wall, upper limbs, vertebral column, and skull.

45
Q

What are the signs and symptoms of Ewing Sarcoma Family of Tumors?

A

Fever
Pain in the tumor location
Fractures
Bruises in the tumor location

46
Q

What is the diagnostic procedure for Ewing Sarcoma Family of Tumors?

A

-X-rays
-MRIs
-CT Scan
-Blood Test
-Biopsy

47
Q

What are the treatment options for Ewing Sarcoma Family of Tumors?

A

-Surgery
-Chemotherapy
-Radiation therapy
-Bone marrow transplant
-Stem cell transplant

48
Q

What is Hyperkyphosis?

A

An exaggerated kyphotic curvature of the vertebral column, most often of the thoracic (chest) level.

49
Q

What is another term for Hyperkyphosis?

A

Humpback

50
Q

What are the causes of adolescent Hyperkyphosis?

A

-Adolescent Hyperkyphosis may result from growth retardation or improper development of the epiphyses as a result of rapid growth.

51
Q

What are the causes of adult Hyperkyphosis?

A

The adult form of Hyperkyphosis is caused by aging and degenerative disc disease of the intervertebral discs and vertebral fracture from underlying osteoporosis

52
Q

What are the signs and symptoms of adolescent Hyperkyphosis?

A

-No symptoms other than visible back curvature
-mild pain
-tiredness
-tenderness
-stiffness of the thoracic spine

53
Q

What are the signs and symptoms of adult Hyperkyphosis?

A

The upper back is rounded and there may be pain, back weakness, and fatigue

54
Q

What is the diagnostic procedure for Hyperkyphosis?

A

-Physical Exam
-x-ray
MRI
CT scans

55
Q

What are the treatment options for childhood Hyperkyphosis?

A

-Exercise
-A firm mattress
-a back brace
-Harrington rods
-Spinal fusion or grafting in cases of neurological damage or disabling pain

56
Q

What is hyperlordosis ?

A

It is an exaggerated lordotic curvature of the lumbar region of the vertebral column.

57
Q

What is another term for hyperlordosis?

A

Swayback

58
Q

What are the causes of hyperlordosis?

A

-wearing high heels frequently as the elevated heel causes an inward positioning of the back as a counterbalance measure

59
Q

What are the signs and symptoms of hyperlordosis?

A

-The main sign is visual inward curvature of the lower back.

-mild pain with exaggerated curvature

60
Q

What is the diagnostic procedure for hyperlordosis?

A

-Physical exam
-X-ray
-CT Scan
-MRI

61
Q

What are the treatment options for hyperlordosis?

A

-Avoiding excessive heel height
- exercise
Appropriate footwear

62
Q

What is gout?

A

Gout is a type of arthritis that usually occurs more frequently with age.

63
Q

What is another term for gout?

A

Gouty Arthritis

64
Q

What are the causes of gout?

A

Gout is caused by deposits of uric acid crystals in the joints. People with gout cannot properly break down uric acid and remove it from the bloodstream.

65
Q

What are the signs and symptoms of gout?

A

-Sudden or chronic joint pain
-Pain commonly in the big toe
-Joint swelling and stiffness
-Fever

66
Q

What are the diagnostic criteria for gout?

A

-A specimen of joint fluid is aspirated from the affected joint and tested for uric acid crystals.

-Blood tests for high levels of uric acid and creatinine may also be performed

67
Q

What are the treatment options for gout?

A

-Pain medication
-Changes to a patient diet
-Elimination of foods that cause the formation of uric acid(meat, fish, beer and wine)
-Medication that increases uric acid elimination by the kidneys
-Medication that decreases uric acid production

68
Q

What are the Medication that increases uric acid elimination by the kidneys?

A

Uricosuric agents

69
Q

What are Medication that decreases uric acid production?

A

Xanthine oxidase inhibitors

70
Q

What is Osteogenesis Imperfecta?

A

It is a decrease in the amount of collagen in the bones which leads to brittle bones

71
Q

What is another name for Osteogenesis Imperfecta?

A

Brittle Bone Disease

72
Q

What are the 8 types of Osteogenesis Imperfecta?

A

Type I to Type VIII

73
Q

What is Type I Osteogenesis Imperfecta?

A

It is the mildest form which occurs more often than other types of

74
Q

What is Type II Osteogenesis Imperfecta?

A

It is the most severe form normally fatal within a few weeks of birth

75
Q

What is Type III Osteogenesis Imperfecta?

A

It is a severe form however infants live longer than those with type II

76
Q

What is type IV Osteogenesis Imperfecta?

A

It is a moderate form that is usually diagnosed later in childhood

77
Q

What is type V Osteogenesis Imperfecta?

A

It is similar to type VI except large callouses form around bone fractures. It accounts for only 5% of OI cases

78
Q

What is Type VI Osteogenesis Imperfecta?

A

It is an extremely rare, moderate form of OI. It is characterized by a defect in the mineralization of the bones.

79
Q

What is Type VII Osteogenesis Imperfecta?

A

A moderate form caused by inheritance of a recessive gene mutation. Similar to Type IV. Moderately abnormal bone growth occurs in this type.

80
Q

What is Type VIII Osteogenesis Imperfecta?

A

It is similar to type II and III, growth deficiencies are severe however, sclera are white in type VIII

81
Q

What are the causes of Osteogenesis Imperfecta?

A

It is hereditary

82
Q

What are the signs and symptoms of Osteogenesis Imperfecta?

A

-Fractures(All Types)
-Blue Sclera(Types I, II, III and IV)
-Dental Problems(Types III and IV)
-Hearing Loss(Type I)
-A triangular face(Type III)
-Abnormal Spinal Curves(Types I, III, IV, V and VI)
-Very small Stature(Types II, III, IV, VII and VIII)
-A small chest(Types II and III)
-Fractures at birth (Types II and III)
-Loose joints (Type IV)
-Muscle Weakness(Types I, III, and IV)
-Respiratory difficulties (Types I, II, III, and IV)

83
Q

What are the diagnostic criteria for Osteogenesis Imperfecta?

A

-Genetic tests to determine if there is mutations in genes associated with OI

84
Q

What are the treatment options for Osteogenesis Imperfecta?

A

-fracture repair
-surgery to strengthen bone by inserting metal rods
-dental procedures
-physical therapy
-braces to prevent bone deformity
-wheelchairs
-supportive aids and medications
-surgery for heart, lungs,

85
Q

What is Osteoporosis?

A

It is a condition in which bones become thin( more porous) over time.

86
Q

What demographics are most affected by Osteoporosis?

A

-Caucasians
-Women more than men

87
Q

Why does Osteoporosis occur?

A

It occurs because of hypocalcemia in which bone is broken down to release calcium and is not replaced in sufficient quantities leading to bone density decreases

88
Q

What are the causes of osteoporosis?

A

-Hormone deficiencies (estrogen in women testosterone in men)
-sedentary lifestyle
-lack of calcium and vitamin d in diet
-bone cancer
-corticosteroids excess (due to endocrine conditions)
-smoking
-excess alcohol consumption
-steroids use

89
Q

What are the signs and symptoms of osteoporosis?

A

-usually no symptoms in early stages of disease
-in later stages, patients may experience fractures (usually of spine, wrists, hips)
-back and neck pain
-loss of height over time
-abnormal curving of spine (Hyperkyphosis)

90
Q

What are the diagnostic criteria for osteoporosis?

A

-high risk patients with family history should get bone densitometry studies to catch disease before symptoms begin

91
Q

What are the treatment options for osteoporosis?

A

The most common treatments include:

-medications to prevent bone loss and relieve bone pain
-hormone replacement therapy
-lifestyle changes to prevent bone loss (exercise and supplements that contain calcium, vit d and phosphorus)
-cessation of smoking and low alcohol consumption

92
Q

What is osteosarcoma?

A

It is a type of bone cancer usually affecting bone of the lower limb that originates from osteoblasts the cells that make bone tissue

93
Q

What are the demographics most affected by osteosarcoma?

A

-children, teens, and young adults
-males more often than females

94
Q

What are the causes of osteosarcoma?

A

The etiology of this cancer is unclear

95
Q

What are the causes of osteosarcoma?

A

The etiology of this cancer is unclear

96
Q

What are the signs and symptoms of osteosarcoma?

A

-Pain in affected bones
-swelling around affected bones
-increase in pain with movement of the affected bones

97
Q

What is the diagnostic criteria for osteosarcoma?

A

-CT scan
-MRI
-X-rays
-bone scans
-biopsy

98
Q

What are the treatment options for osteosarcoma?

A

-Surgery
-Chemotherapy
-Radiation therapy
-Amputation followed by a prosthesis fitting to prevent metastasis

99
Q

What is Paget’s disease?

A

A disease that causes bones to become enlarged, deformed and weak.

100
Q

What are the demographics most affected by Paget’s disease?

A

People over 40

101
Q

What are the causes of Paget’s disease?

A

A virus or various hereditary factors

102
Q

What are the signs and symptoms of Paget’s disease?

A

-Bone pain
-Deformed bones
-fractures
-headaches and hearing loss of the bone affects skull bones

103
Q

What is the diagnostic criteria for Paget’s disease?

A

-X-rays
-Bone scans to visualize bone deformities

104
Q

What are the treatment options for Paget’s disease?

A

-Surgery to remodel bones
-Hip replacement
-Medications to prevent bone weakening
-Physical Therapy

105
Q

What is Scoliosis?

A

Scoliosis is an abnormal, C or S shaped, lateral curvature of the thoracic and or lumbar regions of the vertebral column

106
Q

What are the cause of scoliosis?

A

-It develops prenatally when vertebrae do not fuse together
-it also develops from diseases that cause weakness of the muscles that hold vertebrae together
-Other causes are unknown but they may be genetic

107
Q

What are the signs and symptoms of scoliosis?

A

-Vertebral column that looks bent to one side with one shoulder or hip appearing to be higher than the other
-back pain

108
Q

What are the diagnostic criteria for scoliosis?

A

Physical exam and spinal x-rays

109
Q

What are the treatment options for scoliosis?

A

-Back brace
-Surgery to correct lateral curvature
-physical therapy to strengthen muscles of the back and abdomen

Medical Assisting (21 decks)

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