Test #2 Flashcards
Failure of development of a bone; congential absence of a rib or clavicle or fingers or toes
Adactyly
A congenital abnormality characterized by an absence of upper or lower extremities or both
Amelia
Fusion of the fingers or the toes
Syndactyly
Development of long “spider-like fingers”; classic feature of Marfan’s syndrome; also observed in various disorders involving gnees that encode extracellular matrix proteins as in Ehlers Danlos Syndrome
Arachnodactyl
Type of dwarfism that is caused by a deficiency of thyroid hormones
Cretinism
This type of dwarfism is associated with pituitary abnormalities
Growth Hormone secretion (deficiency?)
This type of dwarfism is caused by a deficiency of growth hormone receptors
Laron-type dwarfism
A congenital form of dwarfism caused by abnormal formation of epiphyseal growth plates of long tubular bones
Achondroplasia
The deficit for Achondroplasia lies in genes encoding for what?
Fibroblast Growth Factor Receptor-3
Individuals with this disorder have short limbs, normal trunks, & relatively large heads. Longevity, intelligence, or reproductive status are not affected
Achondroplasia
This type of dwarfism usually causes death at birth or shortly thereafter. Caused by mutation of FGFR-3
Thanatophoric Dwarfism
Charateristics of Thanatophoric dwarfism
shortening of limbs, relative macrocephaly, small chest cavity, bell-shaped abdomen
Disorder where too little bone is formed due to a mutation of the genes encoding the chains of Type I collagen
Osteogenesis Imperfecta
A genetic disorder characterized by abnormal thickening of bones
Osteopetrosis AKA Marble Bone Disease AKA Albers-Schonberg Disease
Osteopetrosis is caused by?
An undefined defect in the juntion of osteoclasts, which do not reabsorb the bone
Osteopetrosis causes obliteration of the marrow space which leads to what?
anemia
A deficiency of this enzyme in osteopetrosis keeps osteoclasts from solubilizing hydroxyapatite crystals
Carbonic anhydrase II
Type of osteopetrosis where mutation in the genes causes osteoclast dysfunction by interfering w/ what?
chloride channels
A disease characterized by increase porosity of the skeleton resulting from reduced bone mass
Osteoporosis
Most common forms of osteoporosis?
Senile & post menopausal
What two endocrine diseases are assoc. w/ osteoporosis?
Cushing syndrome & hyperthroidism
Literally means “lack of bone”; radiologic term used to denote a decreased amount of bone visible on x-ray
Osteopenia
Characterized by a defect in matrix mineralization related most often to lack of or disturbance of metabolism of Vit. D
Rickets (children)/Osteomalcia (Adults)
Miscellanceous bone disease of uncertain cause; characterized by a “collage of matrix madness”; caused by slow viral infection of paramyzovirus
Osteitis Deformans (Paget’s Disease)
Paget’s Disease can cause bone overgrowth can cause the bone to be heavier than normal which will lead to what?
Secondary osteoarthritis
What levels are elevated in Paget’s disease?
Blood alkaline phosphoatase
Symptoms for Paget’s Disease are readily suppressed by what?
Calcitonin & biphosphonates
Assoc. w/ increased bone resorption of cortical bone & replacement of bone trabeculae w/ fibrous tissue
Osteitis Fibrosa Cystica AKA Von Recklinghausen Disease AKA Hyperparathyroidism
The most typical changes in Osteitis Fibrosa Cystica are seen where?
Middle phalanges of the index & middle fingers
Bone loss in Osteitis Fibrosa Cystica leads to microfractures & secondary hemorrhages that elicit an influx of multinucleated macrophages & an ingrowth of fibrous tissue creating what?
Brown tumor
What is the hallmark of severe hyperparathyroidism?
Increased bone cell activity peritrabecular fibrosis & cystic brown tumors
Skeletal changes of chronic renal disease such as increased osteoclastic bone resorption mimicking Osteitis Fibrosa Cystica, delayed matrix mineralization, osteosclerosis, growth retardation, & osteoporosis
Osteodystrophy
Two major types of osteodystrophy
High turnover osteodystrophy & Low turnover disease (aplastic)
Osteodystrophy is found in what type of patient?
Chronic renal dialysis patient
Osteodystrophy causes deposits of what two substances?
Aluminium & amyloid (derived from beta-2-microglobulin)
Osteonecrosis can be caused by?
mechanical vascular interruption (fracture, corticosteroids, thrombosis & embolism, vessel injury, increased interrosseous pressure, venous hypertension
These type of infarcts cause chronic pain
Subchondral infarcts
These type of infarcts are silent except for large ones
Medullary infarcts
Results from bacterial seeding of bone by hematogenous spread, extension from contiguous infection, & open fx of surgical procedure
Pyogenic Osteomyelitis
Organism that usually causes Pyogenic Osteomyelitits?
Staph. Aureus
Patients w/ sickle cell anemia are prone to what type of infection?
Salmonella infection
TB osteomyelitis of the spine is known as what?
Potts Disease
Congenital form of syphilitic bone disease appears at birth & is marked by what?
Periostitis
Congenital form of syphilitc bone disease gives what appearance on xray?
Crew-haircut like appearance & new bone formation on cortex
Saber shin of the tibia is seen with which type of Syphilitic bone disease?
Congential
The acquired form of syphilitic bone disease appears in what form & is manifested by what in the bone?
Tertiary form; gummas
Results from incompletely healed or persistent suppurative acute infection (draining sinus tract has developed)
Chronic osteomyelitis
Lytic enzymes from the inflammatory cells cut channels through the bone leading to the formation of bone fragments that ultimately detach from the main bone. This is known as what?
Sequestrum
Wall of the abscess cavity is composed of newly formed bone which is known as?
Involucrum
Hat size may increase with this disease?
Paget Disease (Osteitis Deformans)
Paget’s is characterized by what?
“Collage of matrix madness”; periods of severe osteoclastic activity followed by hectic bone formation which is laid down in a disorderly fashion which is architecturally unsound
Paget’s disease may lead to what?
Severe secondary osteoarthritis
Paget’s disease increases the risk for what?
Osteosarcoma
Paget’s Disease (Osteitis Deformans) is caused by a slow viral infection by what virus?
Paramyxovirus
How does paramyxovirus affect osteoclasts?
Enters cytoplasm & nucleus increasing their resorptive activity
High-output cardiac failure in Paget’s results from what?
Multiple functional arteriovenous shunts w/i highly vascular early lesions
Hearing loss in Paget’s is caused by what?
Narrowing of the auditory foramen or direct involvement of the bones of the middle ear
Paget’s increases what enzyme’s activity?
serum alkaline phosphatase
Osteopetrosis is AKA what?
Marble bone disease, Albers-Schonberg disease
What is osteopetrosis?
Genetic disorder characterized by abnormal thickening of bones
What is the cause of osteopetrosis?
Unidentified defect in the function of osteoclasts causing them to not reabsorb bone
How does osteopetrosis cause anemia?
Bones grow but don’t remodel which lead to obliteration fo bone marrow spaces resulting in anemia
Fibrous replacement of resorbed bone may lead to formation of non-neoplastic tumor-like masses known as?
Brown tumor
Brown tumors are due to what?
Hyperthyroidism; high levels of PTH leads ot cystic changes in bone due to osteoclastic resorption
The brown color of a brown tumor is due to what?
Vascularity, hemorrhage, & hemosidirin deposition
Hyperparathyroidism is AKA?
Osteitis fibrosa cystica & Von Recklinghausen disease of bone
Almost all joint arthropathies are assoc. w/ what?
Inflammation
Two types of osteoarthritis AKA DJD
Primary DJD & Secondary DJD
This type of DJD most often occurs after 50 years of age w/o an obvious cause
Primary DJD
This type of DJD occurs in joints damaged by known mechanisms, including mechanical factors (trauma), congenital malformation, metabolic injury of chondrocytes (cartilage cells)
Secondary DJD
Fragmented cartilage which may float freely in the articular cavity
Joint mice
The biochemical changes in DJD mainly involve what?
Proteoglycans (mucopolysaccharides)
Bone that appears like ivory
Bone eburnation
These are produced by reactive bone formation at the margins of the joint
Osteophytes
Osteoblasts develop when the mysenchymal tissue of the synovium does what?
Differentiates into osteoblasts & chondroblasts to form a mass of cartilage & bone
Osteophytes may cause compression of?
Cervical & lumbar nerve roots causing pain, muscle spasms, & neurological deficit
Osteophytes are the base of the distal interphalangeal joints are called?
Heberden nodes
Osteophytes at the proximal interphalangeal joints are called?
Bouchard nodes
Clinical features of osteoarthritis
Deep aching pain w/ movement of joints along w/ stiffness
Morning joint stiffness for less than 30 mins
Joint pain is often worse later in the day w/ activity
Pain relieved by rest
Restricted joint motion
Crepitations
Reactive bone formation at the margins of the joints produces osteophytes
This is a systemic disease of unknown etiology that is assoc. w/ chronic inflammatory disorder primarily affecting the synovial joints but other organs of the body can be affected as well
Rheumatoid arthritis
Joints that are typically involved in RA
Small hand joints, especially prox. interphalangeal & metacarpophalangeal joint, foot joints, especially the metatarsophalangeal joint, wrist & elbows