Bone Pathology Duval Flashcards Preview

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

Flashcards in Bone Pathology Duval Deck (37):
1

What is a major cause of dwarfism?

Achondroplasia

2

What is the MC congenital disorder of the growth plate?

Achondroplasia

3

Achondroplasia genetic factor

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

4

Pathophys of achondroplasia

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

5

Pathophys of osteogenesis imperfecta

Abnormal development of type I collagen

6

Describe osteopetrosis (pathology)

-Group of rare genetic disorders (4 variants)
-Reduced osteoclast mediate bone resorption resulting in defective bone remodelling (dense stone-like bone)

7

Describe osteoporosis (pathology)

-Increase in bone fragility due to a reduction in bone mass
-Localized or generalized

8

What causes age related bone loss? (pathology)

Decreased osteoblast activity

9

Morphology of osteoporosis

-Affects vertebral bodies, femoral neck
-Thin, widely separated bony trabeculae
-Normal mineral content though
-Normal osteoclast activity

10

How does hyperPTH affect bones?

-Increases serum Ca
-Activates osteoclasts
-Excessive osteoclastic activity

11

Morphology of hyperPTH (pathology)?

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

12

What factors can disrupt fracture repair? (pathology)

-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)

13

Morphology of osteonecrosis (pathology)

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

14

MC organisms causing pyogenic osteomyelitis

-S aureus
-E coli, group B strep (neonates)
-Salmonella (sickle cell)
-Mixed flora (trauma)

15

What is Brodie's abscess?

-Formed in chronic pyogenic osteomyelitis
-Residual necrotic bone (sequestrum)
-Surrounding reactive bone (involucrum)

16

Pathology of TB osteomyelitis: what areas affected?

-Synovium/epiphyses of long bones
-Vertebrae (Pott's disease, psoas abscess)

17

Paget's disease of bone (pathology)

-Skeletal deformities d/t intermittent exuberant osteoclast/blast activity
-Uncommon under 40 yo
-Males mainly

18

Pathogenesis of Paget's disease

-Paramyxovirus-like particle in osteoclasts
-Cytokine induced osteoclast activation
-Hyper responsive osteoclasts

19

Morphologic phases of Paget's disease

-Osteoclastic/lytic phase
-Mixed proliferation
-Osteosclerotic "jigsaw puzzle"

20

Which cancers MC metastasize to bone?

Prostate, breast, lung

21

What is the MC type of bone tumor?

Mets from a primary tumor

22

What are primary tumors of the bone?

-Osteoma
-Osteoblastoma
-Osteosarcoma (malignant)

23

Osteoma features (pathology)

-Head and neck
-Localized, solitary
-No malignant transformation

24

Osteoid osteoma/osteoblastoma features (pathology)

-Femur, tibia/vertebrae
-Young adult males
-Circumscribed, cortex

25

What is the MC malignant primary bone tumor?

Osteosarcoma

26

Classic features of osteosarcoma (pathology)

-Adolescent males
-Distal femur, proximal tibia
-Sporadic or hereditary mutation

27

Morphology of classic osteosarcoma

-Large, ill-defined
-Destructive
-Elevates periosteum (Codman's triangle)
-Islands of primitive bony trabeculae (osteoid) rimmed by malignant osteoblasts

28

Describe osteochondroma (pathology)

-Cartilagenous tumor
-Mature bone w/cartilagenous cap
-Metaphysis of long bones

29

Describe chondroma (pathology)

-Benign proliferation of mature hyaline cartilage
-Small bones of hands, feet
-Young to middle aged adults

30

Describe chondrosarcoma (pathology)

-Older males, axial skeleton
-2nd MC malignant bone tumor
-Glistening expansile mass in medullary cavity eroding cortex

31

Describe giant cell tumor of bone (pathology)

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

32

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

-Gross: solitary, dark brown (vascular), necrotic, cystic
-Micro: 2 cell types (MNGC, mononuclear)

33

Describe Ewing sarcoma (pathology)

-Highly aggressive tumor of children/adolescents
-Chromosomal translocation
-Diaphysis of femur, tibia, pelvis

34

Describe fibrous dysplasia (pathology)

-Uncommon, benign, tumor-like
-MC type is monostotic (70%)

35

McCune Albright syndrome (pathology)

-Part of syndrome is fibrous dysplasia
-Unilateral bone lesions
-Ipsilateral cafe au lait spots
-Precocious puberty

36

Morphology of fibrous dysplasia

-Circumscribed, radiolucent, sclerotic rim
-Trabecular bone replaced by fibrous tissue w/disorderly islands of malformed woven bone

37

What type of benign tumor can transform to malignant?

Giant cell tumor of the bone