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AAW - musc/skele Week 5 > Thursday 2 - Witrak - Bone pathology > Flashcards

Thursday 2 - Witrak - Bone pathology Flashcards

1
Q

Osteoporosis

A

Post menopausal (usually) bone resorption

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2
Q

Osteomalacia

A

osteois matrix insufficient from G.I mal-absorption

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3
Q

Osteomyelitis

A

Staph A. usually, subtle, nonspecific and hard to eradicate.

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4
Q 
Paget's disease
what is it 
Who does it effect and to what extent?
symptoms?
lab findings?
A

excessive breakdown and reformation of bone possibly from virus in osteoclasts. (widens bones, long bones)
up to 10-15 % in older patients usually ango-saxon
pain due to fractures
^ alkaline phosphatase, normal serum Ca, no hepatobiliary disease

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5
Q

Osteopenia

3 types

A

Generalized decrease in bone mineralization

can be:
Osteoporosis
Osteomalacia
Malignancy

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6
Q

Hyperparathyroidism can do what to bone?

A

increase the resorption of the bone, increasing serum Ca

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7
Q

Pathological fracture

A

fracture through deseased bone – usually refers to fracture through tumorous or tumor-like bone

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8
Q

What type of bone tissue cell produces alkaline phosphotase?

A

active osteoblasts, signals that there is active bone formation going on.

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9
Q

What event coincides with the fusing of the epiphyseal plate during puberty?

A

blood vessels entering into the epiphyseal plate

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10
Q

How do you get the active form of vit D

A

Vit D —-liver—-> Vid D (OH)1

Vit D (OH)1 —-PTH (kidney)—-> Vit D (OH)2

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11
Q

synth of active vit d inhibited by what

A

Phosphate and Vit D (OH)2 (that IS the active form)

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12
Q

Three things parathyroid hormone (PTH) does to bones and calcium

A

synthesizes the last step in activating Vit D (1 OH to 2 OHs)

stimulates osteoblasts to release osteoclast stimulating factor, which resorbs bone calcium.

stimulates uptake of calcium from the intestine to the blood.

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13
Q

Steps in forming new bone in a fracture?

A

Fibroblasts come in and morph into osteocartilagenous matrix, which goes on to form bone

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14
Q

Heterotopic ossification

A

ossification happening where it is not supposed to.

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15
Q

This is a joint that is formed from a break in bone

A

pseudoarthrosis

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16
Q

This fracture of the spine is usually painless and can cause kyphosis

A

wedge fracture

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17
Q

What doesn’t make sense about PTH with regards to osteoporosis?

A

there is a dimineshed PTH secretion, but still too much bone resorption.

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18
Q

Best prevention of osteoporosis

A

maximize peak bone mass in young adult hood

weight-bearing exercise and Ca supplementation

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19
Q

Hypercalcemia.

differential?

A

hyperparathyroidism or cancer until proven otherwise

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20
Q

What is in excess in rickets?

A

osteoid. not enough Ca co calcify the bone

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21
Q

Four examples of ways to get osteomalacia

A

Environmental
intestinal malabsorption (common in US)
liver or renal disease (impaired Vit D hydroxylation(second step in synth))
Rare congenital

22
Q

Main lab finding for osteomalacia

A

^serum alkaline phosphatase

23
Q

Patients with sickle cell tend to get what type of bacteria that causes osteomyelitis?

A

Salmonella

24
Q

Where does most of pyogenic osteomyelitis begin?

A

metaphyseal marow space

25
Q

Treatment for suppurative (purulent) osteomyelitis?

A

Early, aggressive IV antibiotics

surgical drainage

amputation in chronic cases

26
Q

Pott’s disease

A

tuberculous osteomyelitis of the spine

27
Q

Blastomycosis and coccidioidomycosis

A

Fungal forms of osteomyelitis

28
Q

Avascular bone necrosis/infarction
causes?
What usually causes multiple infarcts?
best way to image?

A

Fractures, corticosteroids, alcoholism
corticosteroids
MRI

29
Q

Unilateral hip hypercalcification. main thought in differential?

A

Paget’s

30
Q

Osteogenesis imperfecta
clinical findings
congenital disorder of what

A

Smaller, bent bones

type 1 collagen

31
Q

Classic example of purely osteolytic malignancy

A

Myeloma (cancer of plasma cells, effector B cells)

32
Q

Classic example of purely osteoblastic malignancy

A

prostate cancer

33
Q

Most common sources of metastatic tumor that involve the skeleton

A

Lung, Breast, Prostate

34
Q

What is usually the first clinical finding of bone malignancy

A

Pathological fracture

35
Q

Most common malignancy involving bone?

A

METASTATIC TUMORS i.e. cancer that came from a different type of tissue.

36
Q

Most common type of bone tumors for kids?

for adults?

A

Kids: osteosarcoma
Adults: Chondrosarcoma

37
Q

Osteochondroma. mostlikely benign or malignant?

A

benign

38
Q

3 common malignant bone tumors

A

osteosarcoma
chondrosarcoma
ewing’s sarcoma

39
Q

Common bone lesion in children (1 in 3) that looks like a mushroom

Where is it most common in the body?

A

metaphyseal fibrous defect (a non-ossifying fibroma)

Knees

40
Q

Pain at night, Throbbing finger, bone deformity, young.
Asprin releaves pain

top of differential?

A

osteoid osteoma**

41
Q

Soft, jello crud in epyphysis of bone.

Inbetween tumor, might be malignant might not be

A

Giant cell tumor.

42
Q

Shepard’s crypt deformaty

A

congenital focal bone disorder of the trochantor of the femur

43
Q

Characteristics of a bone x-ray that would make you think malignancy

A

not well circuscribed.
cortex is lytically destroyed
elevated pariostium (irregular osteoblastic change)
calcification in soft tissue.

only other thing in differential is severe osteomyelitis

44
Q

Most feared primary bone cancer in young people.

Where does it usually occur?

A

osteogenic sarcoma.

sporatic, loves the knee

45
Q

histology of osteosarcoma

A

some nuclii bigger than others, osteoblastic tumor cells making too much pink osteoid. (H&E stain)

46
Q

Where can osteosarcoma metastasize in the example from class?

A

Lung

47
Q

This type of tumor is often one of the largest

A

Chondrosarcoma.

48
Q

Most aggressive and lethal primary bone tumors

often found where?

Histology?

who?

metastases?

A

Ewing’s sarcoma

Shafts of long bone

Wall to wall nucleii

young

often lung

49
Q

Metaphyseal refers to what?

A

metaphysis of the bone, between the epiphysis and diaphysis

50
Q

Myeloma

age group?

A

cancer of plasma cells (b cells)

older people

51
Q

Osteiod osteoma gender ratio

A

M:F
3:1

AAW - musc/skele Week 5 (12 decks)

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