bone things

Question 1

osteopetrosis

Answer 1

• defective osteoClasts caused by increased osteoblast activity –> dense bones
• fill marrow space –> pancytopenia, extramedullary hematopoiesis
• Mutation= CAHII
• nerve impingment –> narrowed foramina
• erlenmyer flask bone

Question 2

osteomalacia/rickets lab values

Answer 2

decreased vit d causes decrease Ca++
decreased Ca++ causes inc PTH
increased PTH causes dec PO4 and inc ALP

Question 3

pagets dz of bone labs and findings

Answer 3

INC osteoclast and osteoblast activity
INC ALP
mosaic pattern and long bone chalk stick fracture
“picture frame” vertebrae on XRAY

Question 4

two bad outcomes of Pagets + 2 potential physical exam findings

Answer 4

BAD: AV shunts –> high output heart failure
PE: hat doesn’t fit, hearing loss (narrowing of foramen)

Question 5

things that lead to osetonecrosis

Answer 5

CAST Bent LEGS
corticosteroids
alcoholism
sickle cell
trauma
bends
gaucher

Question 6

osteitis fibrosa cystica

Answer 6

primary vs secondary hyperPTH

brown tumors

Question 7

secondary hyperPTH

Answer 7

CKD/ vit D deficiency
decreased Ca and increased PO4 (problem at tubule)
INCREASED PTH, ALP

Question 8

do osteoporosis/ osteopetrosis have abnormal lab values?

Answer 8

no

Question 9

whats the only abnormal lab value in pagets?

Answer 9

increased ALP

Question 10

age bracket for giant cell tumor of bone?

Answer 10

older (20-40), female

locally agressive, benign

Question 11

osteosarcoma

Answer 11

sunburst
risks: pagets, bone infarcts, radiation, rb, li fraumeni
metaphysis of long bones

Question 12

ewing sarcoma: what cells do you see on path? what else do you see them in?

Answer 12

small blue cells

retinoblastoma
medullablastoma
neuroblastoma
wilms tumor

Question 13

reaction seen in bone in Ewings?

Answer 13

e-wings with onion rings

perisoteal inion skinning

Question 14

how do you treat oseosarcoma and ewing sarcoma?

Answer 14

ewing responds excellent to chemo

osteo–> surgical en bloc and chemo