Nutritional, Metabolic and Endocrine Disorders Flashcards

1
Q

What is the most common metabolic bone disorder described as a skeletal disease, characterized by 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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2
Q

After the age of 35, how much cortical bone is lost per year? Trabecular bone?

A

Cortical bone: 1% per year

Trabecular bone: 2% per year

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3
Q

At menopause, how much does this loss accelerate? Lumbar spine?

A
10 fold
20 fold (6% per year)
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4
Q

At what age does sex ratio or bone loss equalize between male:female?

A

80 years old

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5
Q

How likely is someone to get a mid femur stress fracture for patients taking Bisphosphonates compared to untreated women?

A

50x

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6
Q

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

A

Spinal Stenosis

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7
Q

What is an effective and minimally invasive procedure in which acrylic bone cement is injected to stabilize and strengthen a collapsing vertebral body?

A

Vertebroplasty

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8
Q

What percent of patients with osteoporotic compression fracture will experience another fracture within 1 year?

A

20%

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9
Q

What uses a balloon dilatation of vertebral body, with subsequent instillation of polymethylmethacrylate?

A

Kyphoblasty

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10
Q

What DEXA score is a comparison of a person’s bone density with that of a healthy 30-year-old of the same sex?

A

T-score

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11
Q

What DEXA score is a comparison of a person’s bone density with that of an average person of the same age and sex?

A

Z-score

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12
Q

What is a normal T-score?

A

> -1

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13
Q

What T-score indicates osteoporosis?

A
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14
Q

What is most commonly used to assess the strength of vertebrae in assessment of fracture risk?

A

Quantitative CT

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15
Q

How much percent loss of bone mass is needed to indicate osteoporosis?

A

30-50%

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16
Q

What are 2 Roentgen signs of osteoporosis?

A

cortical thinning

altered trabecular pattern

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17
Q

What is the Vertebral body shape of osteoporosis?

A

Vertebra Plana (compression of anterior and posterior portions of vertebral body)

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18
Q

What is a Loss of anterior vertebral body height called?

A

Wedge vertebra

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19
Q

Where are wedge vertebra most commonly seen?

A

mid thoracic and TL junction

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20
Q

What is a Hour-glass or fish vertebrae and is Due to pressure of nucleus pulposus upon weakened endplates?

A

Biconcave vertebra

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21
Q

What do vertebra plana’s have inside the vertebral body?

A

GAS

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22
Q

What presents with marked sacral tenderness on physical examination, and rami fractures present with pain in the low back, groin, or hip?

A

Sacral Insufficiency Fractures

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23
Q

What is the characteristic sign of a Sacral Insufficiency Fracture?

A

H-pattern/Honda sign

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24
Q

What 2 parts of the body does Reflex Sympathetic Dystrophy Syndrome (RSDS) (rapid progressive osteoporosis) usually affect?

A

hand and shoulder

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25
Q

Who does Reflex Sympathetic Dystrophy Syndrome (RSDS) usually affect?

A

> 50yo

26
Q

Which hip of females does Transient Osteoporosis of Hip typically affect?

A

Left hip

27
Q

What may Transient Osteoporosis of Hip be associated with?

A

pregnancy

28
Q

What age group does Transient Osteoporosis of Hip affect?

A

20-40 year olds

29
Q

When would you expect a full recovery from Transient Osteoporosis of Hip?

A

3-12 months

30
Q

What does Transient Osteoporosis of Hip affect?

A

Bone marrow edema in the femoral head and neck

31
Q

In regards to Immobilization Osteoporosis, what does immobilization do to osteoblastic activity?

A

inhibit

32
Q

In regards to Immobilization Osteoporosis, what does immobilization do to osteoclastic activity?

A

accelerate

33
Q

There are 4 patterns to Disuse Osteoporosis, which one has all bones involved have similar degree of bone loss and is the most common form?

A

Uniform

34
Q

There are 4 patterns to Disuse Osteoporosis, which one is localized circular lucencies predominate, especially in the epiphyseal regions?

A

Spotty

35
Q

There are 4 patterns to Disuse Osteoporosis, which one is linear transverse subchondral or metaphyseal Lucent zones?

A

Bands

36
Q

There are 4 patterns to Disuse Osteoporosis, which one is lamination or scalloping loss of definition in the outer and inner cortical margins?

A

Cortical

37
Q

What means soft bones and is also known as adult rickets and has a Lack of calcium deposited in osteoid?

A

Osteomalacia

38
Q

What are characteristic features of pseudofractures (looser lines) of Osteomalacia?

A

Fractures at right angles to cortex
Uncalcified osteoid
Bilateral and Symmetrical

39
Q

What minerals are deficient in rickets?

A

Vitamin D, calcium, or phosphate

40
Q

What kind of drugs can cause rickets?

A

anticonvulsant drugs (Dilantin)

41
Q

What age does rickets usually develop?

A

6-12 months old

42
Q

What are unmineralized osteoid along anterior rib cage for rickets known as?

A

Rachitic Rosary

43
Q

Do growth plates widen or narrow with rickets?

A

Widen

44
Q

How many months of vitamin C need to be administered before symptoms and skeletal changes occur with scurvy?

A

4 months

45
Q

What is a clinical hallmark of scurvy?

A

spontaneous hemorrhages from capillary fragility

46
Q

What are all the radiographic features of scurvy?

A
osteopenia
white line of Frankel
Wimberger's Ring
Corner Sign
Pelken's Spurs
Trummerfield Zone
Subperiosteal hemorrhage
47
Q

What is an accumulation of fibrous tissue produces localized cyst like destructive bone lesions that are brown in color?

A

Brown Tumors

48
Q

What is a brown tumor associated with?

A

Hyperparathyroidism

49
Q

What is the Pathologic Hallmark of Hyperparathyroidism?

A

Subperiosteal Bone Resorption

50
Q

What is a radiographic feature involving the skull with hyperparathyroidism?

A

Salt and Pepper Skull

51
Q

What is a radiographic feature involving the spine with hyperparathyroidism?

A

Rugger Jersey Spine

52
Q

What kind of arteries do Monckeberg medial calcific sclerosis affect?

A

medium-sized muscular arteries

53
Q

Is there vascular narrowing with Monckeberg medial calcific sclerosis?

A

No

54
Q
What is your diagnosis?
These are the clinical findings:
--Hepatosplenomegaly
– Yellowing of skin
– Dermatitis
– Pruritis
– Alopecia
A

Hypervitaminosis A

55
Q

What is a secretory Eosinophilic Adenoma of anterior pituitary gland produces intramembranous bone tissue growth, and subcutaneous tissue hypertrophy?

A

Acromegaly

56
Q

If the above occurs prior to closure of the growth plates, what is it called?

A

Gigantism

57
Q

What does the heel pad thickness have to be in order for it to be labeled as acromegaly?

A

> 20mm

58
Q

What part of the bone does lead primarily affect?

A

Metaphysis

59
Q

Why does lead mostly affect the distal femur, both ends of the tibia, and distal radii in children?

A

they’re the most rapidly growing bones

60
Q

What is the radiographic feature of lead poisoning?

A

dense metaphyseal bands