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Tri 6 - Tumors > 6. Nutritional/Metabolic/Endocrine > Flashcards

6. Nutritional/Metabolic/Endocrine Flashcards

(92 cards)

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1
Q

most common metabolic bone

disorder

A

Osteoporosis

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2
Q

low bone mass
and microarchitectural deterioration of bone tissue, with a
consequent increase in bone fragility and susceptibility to fracture”

A

Osteoporosis

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3
Q

Reduction of bone

quantity of otherwise normal bone

A

Osteoporosis

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4
Q

poverty of
bone with increased
radiolucency

A

Osteopenia

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5
Q

decreased bone

density in majority of skeleton, especially axial and proximal long bones

A

Generalized Osteoporosis:

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6
Q

Complex Regional Pain Syndrome and Reflex Sympathetic Dystrophy
Syndrome is also called

A

Sudeck’s atrophy

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7
Q

T1 -MR of hips
shows a diffuse zone of low signal intensity in the femoral
head and neck consistent with
marrow edema

A

Transient Osteoporosis of Hip (TOH)

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8
Q

Localized Osteoporosis

A

focal loss of bone density affecting

a small area of bone

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9
Q

bone mass decreases at what age

A

35 yo

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10
Q

Complications of osteoporosis include

A

Spinal compression fractures, Increasing thoracic kyphosis and other fractures

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11
Q

effective to restore AS posture

A

spine osteotomy

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12
Q

Subtrochanteric

femoral fractures are a complication of

A

Bisphosphonates

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13
Q

According to a 2009 Swedish study by
Aspberger, the incidence of mid femur stress
fracture is 50 times higher for patients on
_________ compared to untreated women

A

Bisphosphonates

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14
Q

Fosamax

and Actonel are

A

bisphosphonate drugs

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15
Q

if patient presents

with pain upon coughing, sneezing or straining, suspect

A

acute compression fracture

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16
Q

Progressive angular kyphotic deformity within 1 year of spinal compression fracture may result in

A

spinal

stenosis

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17
Q

are neurological abnormalities common with spinal compression fracture?

A

NO

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18
Q

Cement injected into vertebral body which usually provides
immediate/substantial
results in pain and function

A

Vertebroplasty

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19
Q 
procedure consists of an image-guided
injection of polymethylmethacrylate
(PMMA), which is an acrylic bone cement
meant to stabilize and strengthen a
collapsing vertebral body
A

Percutaneous Vertebroplasty

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20
Q

uses balloon dilatation of vertebral body,

with subsequent instillation of polymethylmethacrylate.

A

Kyphoplasty

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21
Q

In Weightbearing Bones (vertebrae) there is preferential resorption of non-essential supporting
trabeculae and relative sparing of the major, ______
oriented stress trabeculae

A

vertical

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22
Q

why is Single Photon Absorptiometry unreliable?

A

High false negative rates

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23
Q

DEXA stands for

A

Dual Energy X-ray Absorptiometry

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24
Q

Dual Photon Absorptiometry is applied to the

A

spine and prox femur

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25
DEXA scores are reported as
"T-scores" and "Z-scores."
26
comparison of a person's bone density with that of a healthy 30-year-old of the same sex.
T-score
27
comparison of a person's bone density with that of an average person of the same age and sex
Z-score
28
T-score of -1 and above
normal bone density
29
T-score of -1 to -2.5
osteopenia
30
T-score of -2.5 and below
osteoporosis.
31
may suggest that something other than aging is causing abnormal bone loss.
Z-score of -2 or less
32
Most commonly used to assess the strength of vertebrae in assessment of fracture risk
Quantitative CT
33
200-250 mRad
Quantitative CT
34
Dual photon beam is passed through a vertebral body
Quantitative CT
35
Advantages of quantitiative CT over DEXA for Dx osteopororsis
1. Ability to separate cortical and trabecular bone 2. Provides true volumetric density in units of mg/cc 3. No errors due to spinal degenerative changes or aortic calcification 4. Information on bone morphometry
36
Roentgen Signs of Osteoporosis
Cortical Thinning and Altered Trabecular Patterns
37
Pencil thin cortices and | Endosteal scalloping
Cortical Thinning seen in Osteoporosis
38
Trabecular resorption with accentuation of remaining trabeculae especially in weight bearing regions of bone and Washed-out appearance of bone in severe stages
Altered Trabecular Patterns seen in Osteoporosis
39
During resorption of trabeculae, typically the transverse vertebral body trabeculae are resorbed first which gives a
Pseudohemangioma appearance
40
compression of anterior and posterior portions of | vertebral body
Vertebra Plana (Pancake Vertebra)
41
Loss of anterior vertebral body height most common in mid T and TL regions
Wedge Vertebra
42
Magnetic resonance imaging of the thoracic cord shows a wedgeshaped deformity with increased signal intensity of T7 indicating an acute
severe compression | fracture
43
Due to pressure of nucleus pulposus | upon weakened endplates (Hourglas/Fish vertebrae)
Biconcave Deformities:
44
present with marked | sacral tenderness on physical examination
Sacral Insufficiency Fractures
45
present with pain in the low back, groin, or hip
rami fractures
46
characteristic “H pattern” or Honda sign may be seen with a
sacral insufficiency fracture
47
stress fractures on nuclear bone scans show ares of increased or decreased tracer uptake?
increased
48
Acute onset of painful regional osteoporosis | usually following trivial trauma
Reflex Sympathetic Dystrophy Syndrome (RSDS)
49
Progressive pain, stiffness, swelling, atrophy, contracture usually in hand and shoulder region 50 + yo
Reflex Sympathetic Dystrophy Syndrome (RSDS) Aka Complex Regional Pain Syndrome (CRPS)
50
Hyperemia of bone augments osteoclastic resorption resulting in rapid osteoporosis with slow recovery and may never recover fully
Reflex Sympathetic Dystrophy Syndrome (RSDS) Aka Complex Regional Pain Syndrome (CRPS)
51
Rapid progressive osteoporosis with normal Joint spaces and margins
Reflex Sympathetic Dystrophy Syndrome (RSDS)
52
Severe osteoporosis especially of femoral head with sudden pain, antalgia and limp
Transient Osteoporosis of Hip
53
Full recovery of Transient Osteoporosis of Hip expected in
3-12 months
54
Transient Osteoporosis of Hip may be associated with
pregnancy
55
In Disuse and Immobilization Osteoporosis X ray changes begin after ___ days and are most pronounced by ___ months
7-10, 2-3
56
4 patterns of Disuse Osteoporosis
* Uniform * Spotty * Bands * Cortical
57
Lack of calcium deposited in osteoid altered quality of bone
Osteomalacia (“soft bones”
58
Bilateral and symmetrical fractures at right angles to cortex seen in Osteomalacia
Pseudofractures, aka Looser or Milkman Lines
59
Radiographic Findings of osteomalacia
* Osteopenia * Pseudofractures * Bone deformities
60
unmineralized osteoid along anterior rib cage
Rachitic Rosary
61
In there will be soft tissue swellings around growth plates due to
hypertrophied | cartilage
62
With rickets at the physis, cartilage cells grow normally, but fail to
calcify
63
- Absent zone of provisional calcification - Widening of growth plates due to accumulation of osteoid - Irregular, frayed, cupped metaphyseal margins - “Paint brush” frayed zones of provisional calcification
Rickets
64
Bowing deformities, fractures, osteopenia, scoliosis, | pseudofractures, abnormal bone length
Rickets
65
“Paint brush” frayed zones of provisional calcification
Rickets
66
suppression of osteoblastic activity; decreased production of collagen and osteoid
scurvy
67
in scurvy you need at least __ months avitaminosis C before symptoms and skeletal changes occur
4
68
Clinical Hallmark of scurvy
spontaneous hemorrhages from | capillary fragility
69
- Generalized osteopenia - White Line of Frankel - Wimberger’s Ring - Corner Sign - Pelken’s Spurs - Scorbutic Zone (Trummerfeld Zone) - Subperiosteal Hemorrhage
scurvy
70
dense zone of provisional | calcification
White Line of Frankel
71
dense peripheral ring epiphysis
Wimberger’s Ring
72
infractions of the epiphyseal—metaphyseal | margins
Corner Sign
73
spurs at metaphyseal margins extending | perpendicular to cortex
Pelken’s Spurs
74
poor osteoid formation located along metaphyseal side of ZOPC which appears as a radiolucent band
Scorbutic Zone (Trummerfeld Zone)
75
Osteoclastic resorption with fibrous tissue replacement
Osteitis Fibrosa Cystica
76
Accumulation of fibrous tissue produces localized cyst like destructive bone lesions that are brown in color
Brown Tumors in Hyperparathyroidism
77
Pathologic Hallmark of hyperparathyroidism and occurs along outer cortex at insertional points of ligaments and tendons
Subperiosteal Bone Resorption
78
- Radial margins 2nd and 3rd digits of hand - Lacelike appearance - SI erosion
Subperiosteal Bone Resorption in Hyperparathyroidism
79
Salt and Pepper Skull
Hyperparathyroidism
80
Erosion of Lamina Dura
Hyperparathyroidism
81
Rugger Jersey Spine and Aortic Calcification
Hyperparathyroidism
82
Subperiosteal Resorption, | Osteopenia, and Rugger Jersey Spine
Hyperparathyroidism
83
Calcification within subcutaneous, articular, muscular, vascular and visceral organs is common in
Hyperparathyroidism
84
disease of medium-sized muscular arteries
Monckeberg medial calcific sclerosis
85
Calcium deposits in media portion of artery of people over 50
Monckeberg medial calcific sclerosis
86
- Hepatosplenomegaly - Yellowing of skin - Dermatitis - Pruritis - Alopecia
Hypervitaminosis A
87
Solid periosteal reactions on | shafts of long bones:
Hypervitaminosis A
88
Secretory Eosinophilic Adenoma of anterior pituitary gland produces intramembranous bone tissue growth, and subcutaneous tissue hypertrophy
Acromegaly
89
- Enlarged sella turcica - Widened mandibular angle - Sinus overgrowth - Prominent ungual tufts
Acromegaly
90
Spade like appearance of ungual tufts
Acromegaly
91
Dense metaphyseal bands
Lead Poisoning, or Plumbism (Pb)
92
In children, lead deposition affects the
distal femur, both ends of the tibia, and distal radii

Tri 6 - Tumors (12 decks)

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