Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Musculoskeletal/Rheum > Acquired Bone Diseases > Flashcards

Acquired Bone Diseases Flashcards

(87 cards)

Start Studying
1
Q

What is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk?

A

Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of physical activity best stimulates bone remodeling?

A

Resistance exercises (load magnitude influences bone density more than the number of load cycles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are menopause and osteoporosis connected?

A

Decreased estrogen appears to increase secretion of inflammatory cytokines such as TNF-alpha, IL-1 and IL-6, which stimulate osteoclast recruitment and activity by increasing the levels of RANKL, diminishing the expression of OPG, decreasing osteoclast proliferation and preventing osteoclast apoptosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the histological hallmark of osteoporosis?

A

bone that is histologically normal, but decreased in quantity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

At what DEXA scan score can you diagnose osteoporosis?

A

T-score of −2.5 or lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do biphosphates treat osteoporosis?

A

decrease bone resorption by retarding dissolution of hydroxyapatite crystals, decrease osteoclast formation, increase osteoclast apoptosis and module crosstalk from osteoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are adverse effects of biphosphates?

A

osteonecrosis of the jaw and atypical subtrochanteric femoral fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the adverse effects of estrogen receptor modulators (raloxifene and basedoxifene)?

A

venous thromboembolism and stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are adverse effects of estrogen replacement?

A

myocardial infarction and cerebral infarction as a complication of atherosclerosis (due to thrombosis); promotion of carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drug is a human monoclonal antibody that inhibits RANKL?

A

Denosumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does denosumab work?

A

inhibits the RANKL to inhibit osteoclast formation, function, and survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Administration of PTH in women will help reduce the risk of what fractures?

A

vertebral fractures (but NOT hip fractures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is cathepsin K?

A

lysosomal cysteine protease with high collagenase activity expressed predominantly in osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drug is directed against cathepsin K?

A

odanacatib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What affect does odanacatib have on osteoclasts?

A

suppress osteoclast function without impairing osteoclast viability and thus maintain bone formation by preserving the osteoclast-osteoblast crosstalk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a simple, complete fracture?

A

full thickness

not displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a simple, incomplete fracture?

A

NOT full thickness

NOT displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a closed fracture?

A

fracture with intact overlying skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an open fracture?

A

fracture with broken skin over broken bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a compound fracture?

A

displacement with penetration of the skin surface, a broken bone compounded by a break in the overlying skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a comminuted fracture?

A

complex fracture, with multiple fragments of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a stress fracture?

A

slowly developing fracture that follows a period of increased physical activity in which the bone is subjected to repetitive loads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a “greenstick” fracture?

A

fracture of a long bone extends only partially through the shaft, is common in infants when bones are soft and heals rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a “pathologic” fracture?

A

fracture due to intrinsic disease of the bone, from a force that would not have broken a normal bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the role of the hematoma in fracture healing?
seals off the fracture site, provides a fibrin mesh, and creates a framework for the influx of inflammatory cells and ingrowth of fibroblasts and new capillaries
26
What is the funciton of the procallus?
provides some anchorage between the ends of the fractured bones, but not structural rigidity sufficient for weight bearing
27
How long does it take the soft tissue callus to become the bony callus?
two weeks
28
When does the bony callus reach its maximal girth?
end of the 2nd or third week
29
How does the bony callus form?
Cartilage is formed along the fracture line and undergoes endochondral ossification, forming a contiguous network of bone with newly deposited bone trabeculae in the medulla and beneath the periosteum
30
What is the name of the pathological form of bone healing, which occurs when the ends of fractured bones are not closely enough aligned with each other to form callus and to continue the remodeling process to make a perfectly healed bone?
Fibrous nonunion
31
What happens with fibrous nonunion?
Fibrous replacement of tissue between the two ends that undergoes cystic degeneration and the bone becomes lined by synovial like cells that create a false joint
32
What is the most important cause of delayed, distorted or aborted bone fracture healing?
Infection (especially common in open fractures)
33
Most cases of bone infarcts are due to what?
fractures or corticosteroid therapy
34
Medullary infarcts involve what part of bone?
trabecular bone and marrow, usually sparing cortex because it has collateral blood flow
35
What part of bone is involved with subchondral infarcts?
triangular or wedge-shaped segment of tissue that has the subchondral bone plate as its base undergoes necrosis.
36
Why is overlying cartilage not affected by subchondral infarcts?
it can get nutrients from synovial fluid
37
What is creeping substitution?
In the healing response, osteoclasts resorb necrotic trabeculae. Trabeculae that remain act as scaffolding for the deposition of new bone.
38
What type of bone infarct undergoes creeping substitution?
medullary infarcts (too slow for subchondral infarcts)
39
What surgery is highly related to osteonecrosis complications?
joint replacement
40
Where is spongy bone most commonly infarcted?
near the convex surfaces of joints
41
Why is infarction and necrosis of a bone shaft more difficult?
it has collateral circulation
42
Osteonecrosis of what location is a complication of sickle cell disease or glucocorticoid use?
femoral head (called avascular necrosis)
43
Why are adverse skeletal events the most common glucocorticoid-related complication associated with successful litigation?
Patients are rarely warned about the common skeletal side effects of steroid therapy (fractures in up to 50% of chronic users and osteonecrosis in up to 40%)
44
What is the major cause of osteomyelitis?
pyogenic bacterial infection (ex. staph aureus)
45
What is osteomyelitis?
inflammation of bone and marrow
46
How do infectious organisms reach the bone in osteomyelitis?
(1) hematogenous spread (2) extension from a contiguous site (3) direct implantation
47
What type of osteomyelitis occurs in children? Where?
osteomyelitis is hematogenous and develops in long bones, typically in the metaphysis
48
Why does osteomyelitis occur in adults?
occurs as a complication of open fractures, surgical procedures or diabetic infections of the feet
49
Waht are risk factors for osteomyelitis?
presence of foreign material from orthopedic surgery, peripheral vascular disease, sickle cell disease and congenital phagocyte function defects
50
How does staph aureus bind to bone?
express cell wall proteins that bind to bone matrix components such as collagen, which facilitates adherence of the bacteria to bone
51
Where does osteomyelitic occur in adults? Why is this different from children?
epiphyses and subchondral regions (because growth plate is closed and the metaphyseal blood vessels reunite with epiphyseal counterparts)
52
What occurs in the acute phase of osteomyelitis?
bacteria proliferate and induce a neutrophilic inflammatory reaction.
53
How long does it take bone cells and marrow to become necrotic in osteomyelitis?
Necrosis of bone cells and marrow ensues within the first 48 hours after bacterial proliferation
54
What complication of osteomyelitis may be seen in children due to their loosely attached periosteum?
Subperiosteal abscesses may form that can dissect for long distances along the bone surface
55
What is dead bone called?
a sequestrum
56
What occurrence in osteomyelitis leads to a soft tissue abscess which can channel to the skin as a draining sinus?
rupture of the periosteum
57
What complication of osteomyelitis is seen in infants due to epiphyseal infection spreading along the articular surface or along tendons into a joint?
septic or suppurative arthritis
58
During the healing process of osteomyelitis, what is the term for the newly deposited bone that forms a "shell of living tissue" around the necrotic bone?
involucrum
59
What is a small intraosseous abscess that frequently involves the cortex and is walled off by reactive bone?
Brodie abscess
60
What morphological variant of osteomyelitis typically develops in the jaw and is associated with extensive new bone formation that obscures much of the underlying osseous structure?
Sclerosing osteomyleitis of Garré
61
What type of infection is produced by the organisms that cause osteomyelitis? What are the major cell types in the infection?
continuously suppurative infection with a predominance of neutrophils throughout the time course
62
What is the characteristic radiologic finding of osteomyelitis?
lytic focus of bone destruction surrounded by a zone of sclerosis
63
How do you treat osteomyelitis?
antibiotics and surgical drainage is usually curative
64
Mycobacterial osteomyelitis is a rare complication of what disease?
Tuberculosis
65
What part of the body is typically involved with mycobacterial osteomyelitis?
spine (40%)
66
What is another name for Tb spondylitis?
Pott Disease
67
What are the complications of Pott Disease?
permanent compression fractures that produce scoliosis or kyphosis and neurologic deficits secondary to spinal cord and nerve compression
68
What is the most common mutation in Paget Disease of Bone?
mutations in the SQSTM1 gene
69
What do the mutations in the SQSTM1 gene do?
increase the activity of NF-kB, which increases osteoclast activity
70
What is Paget Disease of bone?
a disorder of unbalanced and excessive osteoclast and osteoblast function leading to increased bone turnover and increased, but disordered and structurally unsound bone mass
71
What mutations can be seen in some juvenile cases of Paget Disease of Bone?
Activating mutations in RANK and inactivating mutations in OPG
72
What may also (other than genetics) play a role in Paget Disease of Bone?
Chronic infection of osteoclast precursors by measles or other RNA viruses
73
What are the three phases of Paget Disease of Bone?
(1) an initial osteolytic stage, (2) a mixed osteoclastic-osteoblastic stage, which ends with a predominance of osteoblastic activity and evolves ultimately into (3) a final burned-out quiescent osteosclerotic stage
74
What causes osteomalacia and rickets?
vitamin D deficiency or its abnormal metabolism
75
What is the fundamental defect in osteomalacia/rickets?
impairment of mineralization and a resultant accumulation of unmineralized matrix
76
What is the difference between Rickets and Osteomalacia?
Rickets refers to the disorder in children, in whom it interferes with the deposition of bone in the growth plates. Adults get osteomalacia which predisposes them to fractures.
77
What does PTH do to bone?
activates osteoclasts, increasing bone resorption and calcium mobilization
78
Does PTH directly act on osteoclasts?
NO- mediates these effects indirectly by increased RANKL expression on osteoblasts
79
What does PTH do to the kidney/gut?
increased resorption of calcium by the renal tubules, increased urinary excretion of phosphates and increased synthesis of active vitamin D by the kidneys, which in turn enhances calcium absorption from the gut
80
What diseases can occur due to symptomatic, untreated primary hyperparathyroidism?
osteoporosis, brown tumors and osteitis fibrosa cystica
81
Where is osteoporosis due to hyperparathyroidism most generalized?
phalanges, vertebrae and proximal femur
82
What is it called when osteoclasts tunnel into and dissect centrally along the length of the trabeculae, creating the appearance of railroad tracks?
dissecting osteitis (occurs in hyperparathyroidism)
83
What happens to the marrow space in dissecting osteitis?
replaced by fibrovascular tissue
84
What occurs as a result of microfractures and secondary hemorrhages associated with dissecting osteitis?
brown tumor
85
What is osteitis fibrosa cystica?
combination of increased bone cell activity, peritrabecular fibrosis, and cystic brown tumors
86
What is the bone disease due to secondary hyperparathyroidism in patients with renal failure?
Renal osteodystrophy
87
Why does osteodystrophy occur in chronic renal failure?
inadequate synthesis of active vitamin D, which ultimately affects gastrointestinal calcium absorption

Musculoskeletal/Rheum (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions