Bone Pathology Flashcards

1
Q

What are the main regulators of bone remodelling?

A

Mechanical stimuli

Hormones:
- Parathyroid hormone
- Vit D3
- Oestrogen

Cytokines
- Perio
- Inflammatory diseases
- Pathological processes

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2
Q

What special tests can be done to investigate bone pathology?

A

Serum calcium

Serum alkaline phosphatase (Osteoblastic activity)

Collagen in urine and blood (osteoclastic activity)

Parathyroid hormone levels

Vit D assays

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3
Q

What are the main types of developmental bone defect?

A

Tori
Osteogenisis imperfecta
Achondroplasia
Osteoporosis
Fiberous dysplasia

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4
Q

What is osteogenesis imperfecta?

A

Type 1 collagen defect

Inherited variance

Clinical features - weak bones, multiple fractures, sometimes associated with dentiogenisis imperfecta

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5
Q

What is achondroplasia?

A

Autosomal dominant abnormality, causing poor endochondral ossification (dwarfism)

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6
Q

What is osteopetrosis?

A

Lack of osteoclastic activity, failure of resorption, marrow obliteration.

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7
Q

What is fiberous dysplasia?

A

Gene defect

Slow growing asymptomatic bony swelling (bone is replaced by fiberous soft tissue)

Stops growing after active growth period

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8
Q

What is rarefying osteitis?

A

Localised loss of bone in response to inflammation

Always secondary to other pathology.

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9
Q

What is sclerosing osteitis?

A

Localised increase in bone density in response to low grade inflammation.

Most common around apex of tooth, poorly defined, and may lead to ERR if chronic.

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10
Q

What is idiopathic osteosclerosis?

A

A localised increase in bone density of unknown cause. Little effect on tooth structures.

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11
Q

How do you determine whether its idiopathic osteosclerosis or sclerosing osteitis?

A

Sensibility testing. Sclerosing will occur in response to pulpal necrosis.

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12
Q

What is osteomyelitis?

A

A rare endogenous infection, which can be acute or chronic.

Suppuration is rare, but can result in sequestrum, actinomycosis, or other complications.

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13
Q

Describe the aetiology of bone necrosis.

A

Osteomyelitis (acute or chronic)

Avascular necrosis (age related ischaemia or medication related)

Irradiation (ORN)

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14
Q

What are anti-resorbative medications used for?

A

Osteoporosis
Paget’s
Bone metastases

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15
Q

Describe the aetiology of osteoporosis?

A

Sex hormone imbalance

Age

Calcium status/physical activity

Secondary to:
- Hyperparathyroidism
- Cushing’s
- Thyrotoxicosis
- Diabetes mellitus

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16
Q

Whta is osteoporosis?

A

Bone atrophy, resorption > formation.

Symptomless, but weak bone and an enlarged antrum.

17
Q

What is Rickets/osteomalacia?

A

Vit D deficiency

Osteoid forms but fails to calcify

Poor endochondral bone

18
Q

What is hypoparathyroidism?

A

Calcium mobilised from bones, causing osteoporosis.

Primary associated with parathyroid adenoma.

Hypercalcaemia and increased bone turnover.

19
Q

What are the two types of giant cell lesion?

A

Peripheral (soft tissue)
Central (bone related)

20
Q

What is cherubism?

A

Rare autosomal dominant disorder

Multicystic/locular lesions in multiple quadrants

Regress after puberty.

21
Q

What is Paget’s syndrome?

A

Bone swelling, pain, nerve compression - unknown aetiology

22
Q

Give three exampled of bone tumours?

A

Osteoma (slow growing, cortical)

Osteoblastoma (rapid, osteoid)

Osteosarcoma (destruction of local tissues)