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Pathology 4, Quiz 4 > Skeletal System > Flashcards

Skeletal System Flashcards

0
Q

idiopathic avascular osteonecrosis of the epiphysis of the femoral head, leading to an interruption of the blood supply of the head of the femur close to the hip joint

A

Legg-Calve-Perthes syndrome

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1
Q

Genetic bone disorder in which people are born with defective connective tissue due to a deficiency of normal type-1 collagen

A

Osteogenesis imperfecta

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2
Q

softening of the bones in children, potentially leading to fractures and deformity

A

Rickets

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3
Q

one of the most frequent dz in many developing countries

A

rickets

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4
Q

dz characterized by low bone mass and structural deterioration of bone tissue

A

osteoporosis

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5
Q

osteoporosis may occur as a result of … or as a result of a more …

A

generalized loss of bone mass; localized process i.e. casted limb

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6
Q

What can result in accelerated osteoporosis?

A

underlying malabsorption d/o, hyperthyroidism, hyperparathyroidism

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7
Q

What leads to bone fragility and increased susceptibility to fractures in osteoporosis?

A

increased porous nature of osteoporotic bone

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8
Q

Main class of d/o’s leading to secondary osteoporosis

A

endocrine

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9
Q

Exaggerated curvature of the spine that results in a rounded or hunched back

A

kyphosis

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10
Q

Kyphosis is commonly seen in pts with osteoporosis due to…

A

compression fractures of vertebrae

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11
Q

aka osteitis deformans

A

Paget’s dz of bone

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12
Q

High bone turnover with accelerated osteoclast and osteoblast activity

A

Paget’s dz of bone

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13
Q

End result of Paget’s dz of bone

A

Increased calcification of bone

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14
Q

Paget’s dz of bone has a predilection for what?

A

increased bone deposition in the skull, pelvis, tibia, and femur

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15
Q

What is elevated in Paget’s dz of bone?

A

serum alkaline phosphatase

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16
Q

mosaic pattern of lamellar bone which is likened in appearance to a jigsaw puzzle

A

Paget dz of bone

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17
Q

Pathognomonic of Paget dz

A

mosaic pattern of lamellar bone

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18
Q

Osteopetrosis presents … while Paget dz most commonly develops …

A

at birth; 4th decade of life

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19
Q

Paget dz is most common in what population?

A

Caucasian males

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20
Q

Pts with Paget dz have an inc risk for what?

A

malignant neoplasms (osteosarcoma in the area of abnormal bone growth)

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21
Q

Cotton ball appearance

A

Paget dz

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22
Q

15% of cases of Paget dz affect … and 85% affect

A

one bone; multiple bones

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23
Q

widened bone with course trabecular marking is characteristic of

A

Paget dz

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24
Q

bones afflicted with Paget dz are … fractures

A

linear

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25
Q

rare inherited d/o whereby the bones harden and become more dense

A

osteopetrosis

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26
Q

infxn of the bone or bone marrow

A

osteomyelitis

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27
Q

term used to describe collectively all of the skeletal changes of chronic renal dz

A

Renal osteodystrophy

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28
Q

What are (4) changes of renal osteodystrophy?

A

inc osteoclastic bone resorption, osteomalacia, osteosclerosis, osteoporosis

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29
Q

Children with renal osteodystrophy are at an inc risk for

A

rickets

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30
Q

3 conditions associated with renal osteodystrophy

A

inadequate kidney function, secondary hyperparathyroidism, altered vit D metabolism

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31
Q

Some of the most common pathologic conditions affecting bone

A

fractures

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32
Q

fractures are classified as … when the overlying tissue is intact

A

simple (closed)

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33
Q

fractures are classified as … when the fracture site communicates with the skin surface

A

compound (open)

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34
Q

a fracture is … when the ends of the bone at the fracture site are not aligned

A

displaced

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35
Q

a fracture is called … when the bone is splintered or crushed

A

comminuted

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36
Q

If the break occurs in bone already altered by a disease process, it is described as

A

a pathologic fracture

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37
Q

A … is a slowly developing fracture that follows a period of increased physical activity in which the bone is subjected to repetitive loads

A

stress fracture

38
Q

Where do solitary bone cysts predominantly occur?

A

distal ends of long bones (femur and humerus)

39
Q

In which population are solitary bone cysts most common?

A

10-20yo male

40
Q

smooth, thin cortex in close proximity to the epiphysis on x-ray

A

solitary bone cyst

41
Q

symmetrical, bone diameter may be increased, cavity filled with clear or bloody fluid, no specific microscopic features

A

solitary bone cyst

42
Q

recurrence of solitary bone cyst is (common/uncommon)

A

uncommon

43
Q

Where do aneurysmal bone cysts most often occur?

A

metaphysis of the long bones and vertebrae

44
Q

Most frequent population for aneurysmal bone cysts

A

20-30yo females

45
Q

honey-combed appearance on x-ray

A

aneurysmal bone cysts

46
Q

distortion of bone and less symmetry to its shape

A

aneurysmal bone cysts

47
Q

Must be differentiated from osteosarcoma

A

Aneurysmal bone cysts

48
Q

recurrence of aneurysmal bone cysts (common/uncommon)

A

common (20-25%)

49
Q

expansion of the cortex and “honey-combed” appearance

A

aneurysmal bone cyst

50
Q

5 most common bone tumors

A

osteoid osteoma, osteosarcoma, Ewing sarcoma, multiple myeloma, metastatic lesions

51
Q

Osteoid osteoma is (benign/malignant)

A

benign

52
Q

small area of neoplastic tissue surrounded by wide zone of mature, reactive bone

A

osteoid osteoma

53
Q

Most osteoid osteomas are (solitary/mutliple)

A

solitary

54
Q

Multiple osteoid osteomas are seen in children with which syndrome?

A

Gardner syndrome

55
Q

Most common population for osteoid osteomas

A

children and young adults

56
Q

on x-ray: small, well circumscribed lesion which is round or oval, located in or near the cortex and surrounded by densely sclerotic bone

A

osteoid osteoma

57
Q

Lesion may have radio-lucent and radio-opaque aspects

A

osteoid osteoma

58
Q

grossly: area of gritty, cherry red tissue, surrounded by dense sclerotic bone

A

osteoid osteoma

59
Q

Where are osteoid osteomas usually located?

A

in or near the cortical area of a bone. Sometimes medullary area

60
Q

Microscopically: nidus is composed of narrow trabeculae of osteoid or newly formed bone produced by osteoblasts in richly vascularized parenchyma, surrounded by wide trabeculae and sclerotic bone

A

osteoid osteoma

61
Q

primary malignant tumor of bone

A

osteosarcoma

62
Q

Osteosarcomas represent approx. what percentage of all primary bone cancers?

A

20%

63
Q

75% osteosarcoma patients are what group?

A

children under 20

64
Q

Third most common malignancy in adolescents, after leukemia and lymphoma

A

osteosarcoma

65
Q

Osteosarcoma is more common in elderly pts with underlying

A

Paget dz of bone

66
Q

x-ray variable with combination of bone destruction and bone formation

A

osteosarcoma

67
Q

3 main types of osteosarcoma and percentages

A

25% lytic, 35% sclerotic, 40% mixed

68
Q

radio-lucency and radio-opacities and spicules of calcium in the soft tissue

A

osteosarcoma

69
Q

aggressive, rapid growth with high risk of local spread. May metastasize as “skip” lesions within the bone

A

osteosarcoma

70
Q

Early pulmonary metastasis is common

A

osteosarcoma

71
Q

Atypical cells with large nuclei and small amt of cytoplast and osteoid formation

A

osteosarcoma

72
Q

uncommon bone tumor usu found around knee in either distal femur and/or proximal tibia

A

fibrosarcoma

73
Q

Fibrosarcoma produces … but not…

A

collagen matrix; osteoid or chondroid

74
Q

Fibrosarcoma may be primary or arise in what conditions?

A

Paget dz, chronic osteomyelitis, prior bone infarct, bone irridation

75
Q

sheets of spindle shaped cells

A

fibrosarcoma

76
Q

Tumor of adulthood, most common in 30yo

A

Giant cell tumor

77
Q

Oval tumor cells and multinucleated tumor cells uniformly distributed throughout

A

giant cell tumor

78
Q

causes cortical erosion and thinning, which expands the bone contours without a border of new bone formation and sclerosis

A

giant cell tumor

79
Q

nonsclerotic but well defined

A

giant cell tumor

80
Q

small, rounded cells that are uniform in size and densely packed

A

Ewing sarcoma

81
Q

Males, average age 13-14

A

Ewing sarcoma

82
Q

uniform, densely packed, tumor cells with a single, round or oval nucleus, indistinct cellular borders with a size and appearance somewhat resembling lymphocytes

A

Ewing sarcoma

83
Q

mottled, “moth eaten” destructive lesion

A

Ewing sarcoma

84
Q

commonly infiltrates the medullary cavity and penetrates through the cortex

A

Ewing sarcoma

85
Q

malignant dz of plasma cells in the bone marrow

A

Multiple myeloma

86
Q

monoclonal overgrowth of one clone of plasma cells occurs which produces monoclonal immunoglobulin or paraprotein

A

multiple myeloma

87
Q

In adults, 75% of skeletal metastasis originate from which cancers?

A

breast, prostate, kidney, lung

88
Q

In children, bone metastasis most commonly originate from which cancers?

A

Wilm’s tumor, neuroblastoma, osteosarcoma, Ewing sarcoma

89
Q

Skeletal metastasis are typically (multifocal/focal)

A

multifocal

90
Q

Boney metastasis may appear as lytic, blastic, or mixed

A

metastatic breast cancer

91
Q

ivory vertebra sign

A

metastatic breast cancer or Paget dz

92
Q

3 primary ways to contract osteomyelitis

A

blood stream infxn, contiguous infxn (cellulitis), direct infxn (trauma)

Pathology 4, Quiz 4 (3 decks)

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