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Clin Med II MHM - FINAL > Bone Pathology Duval > Flashcards

Bone Pathology Duval Flashcards

1
Q

What is a major cause of dwarfism?

A

Achondroplasia

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2
Q

What is the MC congenital disorder of the growth plate?

A

Achondroplasia

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3
Q

Achondroplasia genetic factor

A

Only 20% have family history, so 80% of cases are sporadic mutations

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4
Q

Pathophys of achondroplasia

A
  • Impaired maturation of cartilage in the growth plate
  • Hypoplastic disorganized chondrocyte aggregations
  • Affects all bones that form from cartilage (endochondral formation)
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5
Q

Pathophys of osteogenesis imperfecta

A

Abnormal development of type I collagen

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6
Q

Describe osteopetrosis (pathology)

A
  • Group of rare genetic disorders (4 variants)

- Reduced osteoclast mediate bone resorption resulting in defective bone remodelling (dense stone-like bone)

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7
Q

Describe osteoporosis (pathology)

A
  • Increase in bone fragility due to a reduction in bone mass

- Localized or generalized

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8
Q

What causes age related bone loss? (pathology)

A

Decreased osteoblast activity

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9
Q

Morphology of osteoporosis

A
  • Affects vertebral bodies, femoral neck
  • Thin, widely separated bony trabeculae
  • Normal mineral content though
  • Normal osteoclast activity
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10
Q

How does hyperPTH affect bones?

A
  • Increases serum Ca
  • Activates osteoclasts
  • Excessive osteoclastic activity
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11
Q

Morphology of hyperPTH (pathology)?

A
  • Increased osteoclast activity (bone erosion)
  • Reduced cortical bone and increased loose CT
  • Hemosiderin deposits from previous fractures
  • Brown tumor (hemosiderin, osteoclasts clump)
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12
Q

What factors can disrupt fracture repair? (pathology)

A
  • Delayed healing from needing extensive remodeling (displaced/comminuted fx)
  • Delayed union or non-union (from inadequate immobilization)
  • Pseudarthrosis (false joint from non-union)
  • Infection
  • Health status (comorbidities)
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13
Q

Morphology of osteonecrosis (pathology)

A
  • Dead bone w/empty lacunae, fat necrosis, Ca soaps
  • Cortical bone and articular cartilage spared
  • Necrotic bone acts as scaffold for new bone
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14
Q

MC organisms causing pyogenic osteomyelitis

A
  • S aureus
  • E coli, group B strep (neonates)
  • Salmonella (sickle cell)
  • Mixed flora (trauma)
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15
Q

What is Brodie’s abscess?

A
  • Formed in chronic pyogenic osteomyelitis
  • Residual necrotic bone (sequestrum)
  • Surrounding reactive bone (involucrum)
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16
Q

Pathology of TB osteomyelitis: what areas affected?

A
  • Synovium/epiphyses of long bones

- Vertebrae (Pott’s disease, psoas abscess)

17
Q

Paget’s disease of bone (pathology)

A
  • Skeletal deformities d/t intermittent exuberant osteoclast/blast activity
  • Uncommon under 40 yo
  • Males mainly
18
Q

Pathogenesis of Paget’s disease

A
  • Paramyxovirus-like particle in osteoclasts
  • Cytokine induced osteoclast activation
  • Hyper responsive osteoclasts
19
Q

Morphologic phases of Paget’s disease

A
  • Osteoclastic/lytic phase
  • Mixed proliferation
  • Osteosclerotic “jigsaw puzzle”
20
Q

Which cancers MC metastasize to bone?

A

Prostate, breast, lung

21
Q

What is the MC type of bone tumor?

A

Mets from a primary tumor

22
Q

What are primary tumors of the bone?

A
  • Osteoma
  • Osteoblastoma
  • Osteosarcoma (malignant)
23
Q

Osteoma features (pathology)

A
  • Head and neck
  • Localized, solitary
  • No malignant transformation
24
Q

Osteoid osteoma/osteoblastoma features (pathology)

A
  • Femur, tibia/vertebrae
  • Young adult males
  • Circumscribed, cortex
25
Q

What is the MC malignant primary bone tumor?

A

Osteosarcoma

26
Q

Classic features of osteosarcoma (pathology)

A
  • Adolescent males
  • Distal femur, proximal tibia
  • Sporadic or hereditary mutation
27
Q

Morphology of classic osteosarcoma

A
  • Large, ill-defined
  • Destructive
  • Elevates periosteum (Codman’s triangle)
  • Islands of primitive bony trabeculae (osteoid) rimmed by malignant osteoblasts
28
Q

Describe osteochondroma (pathology)

A
  • Cartilagenous tumor
  • Mature bone w/cartilagenous cap
  • Metaphysis of long bones
29
Q

Describe chondroma (pathology)

A
  • Benign proliferation of mature hyaline cartilage
  • Small bones of hands, feet
  • Young to middle aged adults
30
Q

Describe chondrosarcoma (pathology)

A
  • Older males, axial skeleton
  • 2nd MC malignant bone tumor
  • Glistening expansile mass in medullary cavity eroding cortex
31
Q

Describe giant cell tumor of bone (pathology)

A
  • Benign
  • Proliferation of reactive osteoclast-like giant cells
  • Young to middle aged females
  • Epiphysis of long bones
32
Q

Morphology of giant cell tumor of bone (gross vs. micro)

A
  • Gross: solitary, dark brown (vascular), necrotic, cystic

- Micro: 2 cell types (MNGC, mononuclear)

33
Q

Describe Ewing sarcoma (pathology)

A
  • Highly aggressive tumor of children/adolescents
  • Chromosomal translocation
  • Diaphysis of femur, tibia, pelvis
34
Q

Describe fibrous dysplasia (pathology)

A
  • Uncommon, benign, tumor-like

- MC type is monostotic (70%)

35
Q

McCune Albright syndrome (pathology)

A
  • Part of syndrome is fibrous dysplasia
  • Unilateral bone lesions
  • Ipsilateral cafe au lait spots
  • Precocious puberty
36
Q

Morphology of fibrous dysplasia

A
  • Circumscribed, radiolucent, sclerotic rim

- Trabecular bone replaced by fibrous tissue w/disorderly islands of malformed woven bone

37
Q

What type of benign tumor can transform to malignant?

A

Giant cell tumor of the bone

Clin Med II MHM - FINAL (16 decks)

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