Bones & Joints Flashcards
(163 cards)
1
Q
the condition seen in the image can lead to a ___ abscess
A
the condition seen in the image can lead to a psoas abscess
cold abscess d/t minimal inflammatory response; no spiking fevers seen in normal abscesses
2
Q
the condition seen in the image affects the ___ skeleton
A
the condition seen in the image affects the axial skeleton
3
Q
how can the condition seen in the image can be contrasted with GH deficiency dwarfism?
A
GH deficiency (dwarfism) = proportionally shortened limbs
4
Q
chronic osteomyelitis can lead to Brodie abscess, which is an _____
A
chronic osteomyelitis can lead to Brodie abscess, which is an intracortical abscess (abscess within the bone)
5
Q
the condition seen in the image can cause ___ anemia; explain how
A
the condition seen in the image can cause myelophthisic anemia
metastasis to bone → caseating granulomas replacing normal bone marrow → inadequate cell formation
6
Q
osteomyelitis can lead to sequestrum, which is progressive ____ leading to segmental ____ surrounded by viable new bone (____)
A
osteomyelitis can lead to sequestrum, which is progressive ischemia leading to segmental bony necrosis surrounded by viable new bone (involucrum)
7
Q
$$ what is a complication of the condition seen in the image? $$
A
chondrosarcoma
8
Q
$$ describe the invasiveness of the condition seen in the image $$
A
LOCALLY invasive
9
Q
the condition seen in the image is caused by dysfunction in _____
how does this lead to the condition?
A
the condition seen in the image is caused by dysfunction in carbonic anhydrase
without acidic environment → osteoclastic activity is impaired → primary spongiosa layer which is normally broken down by osteoclasts is retained → narrowed medullary cavity → no hematopoiesis → pancytopenia
10
Q
in the condition seen in the image, there is progressive joint destruction due to formation of a ____
explain this
A
in the condition seen in the image, there is progressive joint destruction due to formation of a pannus
pannus = synovial cell hyperplasia, organizing fibrin, CD4 T cells which form lymphoid aggregates, neutrophils (b/c acute on chronic inflammation), granulation tissue (col. III) → col. 1
11
Q
chronic osteomyelitis can lead to sclerosing OM of Garre, which is when _____
A
chronic osteomyelitis can lead to sclerosing OM of Garre, which is when extensive new bone obscures the underlying bone
12
Q
in scurvy, there are fragile ___ and ___ which can lead to ___
A
in scurvy, there are fragile capillaries and venules which can lead to subperiosteal hemorrhages
13
Q
the condition seen in the image arises from the ___ (part of bone?)
A
the condition seen in the image arises from the the epiphysis
14
Q
list the viral organism (1) that can cause infectious arthritis
A
Parvovirus B19
15
Q
in the condition seen in the image, there is leakage of ____ which leads to ____
A
in the condition seen in the image, there is leakage of synovial fluid which leads to subchondral cysts
16
Q
____ is an important predictor of behavior in bone tumors
A
histologic grade is an important predictor of behavior in bone tumors
17
Q
the condition seen in the image affects the:
____ vertebrae in children
____ vertebrae in adults
A
the condition seen in the image affects the:
thoracic vertebrae in children
lumbar vertebrae in adults
18
Q
osteomyelitis begins in ___ because ____ terminate int he venous sinusoids and eventually leads to the formation of ____
A
osteomyelitis begins in the metaphysis because nutrient arteries terminate in the venous sinusoids and eventually leads to the formation of abscesses within medulla & under periosteum and bone necrosis
19
Q
the condition seen in the image has a predilection for sites around ____ (where on the body?)
A
the condition seen in the image has a predilection for sites around the knee (distal femur, prox. tibia)
20
Q
name the 2 translocations associated with the condition seen in the image
A
t(11,22)
t(21,22)
21
Q
summarize the differences between RA and OA
A
22
Q
the most common cause of death in the condition seen in the image is from ____
A
the most common cause of death in the condition seen in the image is from recurrent infections (due to the pancytopenia)
23
Q
osteomalacia & rickets is characterized by abnormal ____
A
osteomalacia & rickets is characterized by abnormal mineralization
24
Q
in the condition seen in the image, the ___ layer, which is normally broken down by ___, is retained
A
in the condition seen in the image, the primary spongiosa layer, which is normally broken down by osteoclasts, is retained
25
the condition seen in the image is also called \_\_\_\_
the condition seen in the image is also called **primitive neuroectodermal tumor (PNET)**
26
what are other predisposing factors that can lead to the condition seen in the image?
smoking
infections (EBV, E. coli)
stress
27
list the bacterial organisms that can cause infectious arthritis
* bacteria: rapid joint destruction
* S. aureus (children)
* N. gonococcus (adults)
* Mycobacteria
* Borrelia (Lyme disease)
28
the condition seen in the image can occur due to \_\_\_\_
the condition seen in the image can occur due to **Paget's disease**
29
in the beginning stages of the condition seen in the image, there are changes in ____ which release ____ that break down the matrix and inhibit ____ synthesis
in the beginning stages of the condition seen in the image, there are changes in **chondrocytes (proliferation)** which release **IL-1 and TNF-a** that break down the matrix and inhibit **type II collagen synthesis**
30
presentation of the condition seen in the image shows ____ nodes in the DIP and ___ nodes in the PIP
presentation of the condition seen in the image shows **Haberden's** nodes in the DIP and **Bouchard's** nodes in the PIP
31
list the **GI** disorders that can lead to the condition seen in the image
* malnutrition
* hepatic insufficiency
* vit. D or vit. C def.
* malabsorption
32
in rickets, there is:
frontal bossing due to ___ on the skull
rachitic rosary due to ___ at the costochondral junction
frontal bossing due to **osteoid deposition** on the skull
rachitic rosary due to **osteoid deposition** at the costochondral junction
33
in the condition seen in the image, there is bone loss due to ____ and \_\_\_\_
in the condition seen in the image, there is bone loss due to **defective osteoblasts** and **increased activity of osteoclasts**
34
list 4 causes of the secondary form of the condition seen in the image
hyperparathyroidism
vit. D deficiency
vit. C deficiency
corticosteroids
35
\_\_\_ is the most common cause of death in the condition seen in the image
**hypercalcemia → arrhythmias**
36
the condition seen in the image arises from the ___ (part of bone) and is a tumor of ____ (cells)
the condition seen in the image arises from the **metaphysis** and is a tumor of **osteoblasts → imperfect laying of the osteoid**
37
the condition seen in the image can lead to deeper cracks in the bones that dislodge as \_\_\_\_
the condition seen in the image can lead to deeper cracks in the bones that dislodge as **joint mice (have a central core of necrotic bone)**
38
list the clinical features of EDS
* hyperextensibility of skin
* easy bruising
* hypermobile joints
* blue sclerae may be present
39
chronic osteomyelitis can lead to renal and heart failure due to \_\_\_\_
chronic osteomyelitis can lead to renal and heart failure due to **secondary amyloidosis (**_A_**ssociated **_A_**myloid, AA)**
40
the condition seen in the image can occur sporadically and arise from the ____ (part of bone?)
the condition seen in the image can occur sporadically and arise from the **dia****physis**
41
in the condition seen in the image, ____ engulf uric acid crystals and activate the ____ pathway that brings in \_\_\_\_
in the condition seen in the image, **macrophages** engulf uric acid crystals and activate the **complement pathway** that brings in **neutrophils**
42
osteomyelitis commonly occurs in (bone location):
\_\_\_ in children
\_\_\_\_ in adults
osteomyelitis commonly occurs in (bone location):
**metaphysis** in children
**diaphysis (shaft)** in adults
43
the condition seen in the image is rheumatoid factor positive or negative?
**rheumatoid factor POSITIVE = IgM directed at the Fc portion of IgG**
44
how can the condition seen in the image can be contrasted with dwarfism seen in cretinism (hypothyroidism)?
short stature with **mental retardation**, protruding belly and protruding tongue
45
osteomas have a predilection for \_\_\_\_
osteomas have a predilection for **craniofacial bones**
46
describe the pathogenesis of the condition seen in the image
**increased PTH →** acts on osteoblasts **→** increased interaction between RANK + RANKL **→ activates osteoclasts → demineralization of bone → lose calcium and phosphate from bone**
47
list the causes of osteomalacia & rickets
* lack of exposure to sun
* malnutrition
* malabsorption
* liver & renal failure
* when caused by renal failure, phosphate is HIGH in blood
48
in the condition seen in the image, in post-menopausal women, there is decrease in serum ____ which leads to increased ___ (3 cytokines) levels and therefore activates osteoclasts
in the condition seen in the image, in post-menopausal women, there is decrease in serum **estrogen** which leads to increased **IL-1, IL-6, TNF** levels and therefore activates osteoclasts
49
\_\_\_\_ are the genitourinary infections that can cause osteomyelitis
**E. coli and Klebsiella** are the genitourinary infections that can cause osteomyelitis
50
on x-ray investigation of the condition seen in the image, there is an incidental finding of ____ sign
on x-ray investigation of the condition seen in the image, there is an incidental finding of **"O-ring"** sign
51
\_\_\_\_ is the bacteria that can cause osteomyelitis in sickle-cell patients
**Salmonella** is the bacteria that can cause osteomyelitis in sickle-cell patients
52
$$ "pt has pain in joints that gets better throughout the day; what is found in the joints?" $$
(talking about RA)
## Footnote
**IgG in joints**
53
"a woman has a history of rheumatoid arthritis and has been on corticosteroids--which condition is she at increased risk for?"
**osteoporosis**
54
the condition seen in the image can follow Ollier's or Mafucci and arise from the ____ (part of bone?)
the condition seen in the image can follow Ollier's or Mafucci and arise from the **metaphysis**
55
describe the pathogenesis of renal osteodystrophy
chronic renal failure → hyperphosphatemia → hypocalcemia → secondary increase in PTH
56
\_\_\_\_ is the most common cause of death in the condition seen in the image
**high output congestive cardiac failure** d/t mixed phase → high osteoblastic activity and angiogenesis → AV shunts (volume overload)
57
RANKL is expressed on ___ and is upregulated by which 2 hormones?
RANKL is expressed on **osteoblasts** and is upregulated by:
PTH
vitamin D3
58
since the condition in the image causes pancytopenia, there is _____ caused by ____ hematopoiesis
since the condition in the image causes pancytopenia, there is **hepatosplenomegaly** caused by **extramedullary** hematopoiesis
59
what serum levels are increased in the condition seen in the image?
**increased ANA, CRP, ESR and neutrophils**
60
the condition seen in the image arises from the ___ (part of bone?)
the condition seen in the image arises from the **diaphysis**
61
describe what is seen on **biopsy** of the condition in the image in **immunocompetent vs. immunocompromised**
immunocompetent = caseating granulomas
immunocompromised = AF bacilli in macrophages
62
the condition seen in the image has morning stiffness that lasts for ___ and ___ with activity (because the condition is \_\_\_\_)
the condition seen in the image has morning stiffness that lasts for **15-30 min.** and **worsens** with activity (because the condition is **degenerative**)
63
$$ the condition seen in the image can be caused by ____ failure $$
the condition seen in the image can be caused by **renal** failure
64
on biopsy of the condition seen in the image, a ____ appearance is seen
on biopsy of the condition seen in the image, an **onion-skin** appearance is seen
65
in the condition seen in the image, there is an attempt at new bone formation which forms \_\_\_\_
in the condition seen in the image, there is an attempt at new bone formation which forms **osteophytes**
66
Ehler-Danlos syndrome (EDS) is caused by inappropriate \_\_\_\_
Ehler-Danlos syndrome (EDS) is caused by inappropriate **cleavage of collagen fibers**
67
describe the pathogenesis of the condition seen in the image
**virus stimulates IL-6** → IL-6 and M-CSF activate osteoclasts → **osteoclasts are hyperresponsive to RANKL and** **vit****. D** → abnormal bone remodeling
68
describe what is seen on biopsy of the condition seen in the image
medullary cavity has brown cystic deposit (brown tumor) = osteitis fibrosis cystica (ONLY in primary hyper-PTH)
this is due to angiogenesis needed by osteoblasts to form bone → after 2 weeks, turn to hemosidering
69
in the condition seen in the image, patients are at an increased risk for developing \_\_\_\_
in the condition seen in the image, patients are at an increased risk for developing **secondary osteosarcoma (malignant tumor of osteoblasts)**
70
the condition seen in the image is (symmetric or asymmetric?) and (unilateral or bilateral?)
the condition seen in the image is **symmetric** and **bilateral**
71
the condition seen in the image affects the bones of the ___ and \_\_\_\_
the condition seen in the image affects the bones of the **hands** and **feet**
72
the condition seen in the image most commonly occurs in ___ and \_\_\_\_
the condition seen in the image most commonly occurs in **elderly** and **post-menopausal women**
73
the condition seen in the image causes vasculitis; what can this cause?
* MI
* cerebrovascular disease
* renal failure
* mesenteric and intestinal infarction (watershed area = splenic flexure)
* gangrene
74
list the seronegative spondyloarthropathies
75
in renal osteodystrophy, ___ and ___ accumulation in the bone (from \_\_\_) prevents \_\_\_\_
in renal osteodystrophy, **iron** and **aluminum** accumulation in the bone (from **dialysate**) prevents **further bone deposition**
76
in osteomalacia & rickets, there is under-mineralized matrix which leads to persistent \_\_\_\_
in osteomalacia & rickets, there is under-mineralized matrix which leads to persistent **hyaline cartilage**
77
describe the urine findings in the condition seen in the image
**increased hydroxyproline** due to high collagen turonver
part of type 1 collagen; **signifies osteoclast** **fxn** **(stage 1 of the disease)**
78
the condition seen in the image is caused by a mutation in ____ which \_\_\_\_
the condition seen in the image is caused by a mutation in **FGFR3** which **inhibits chondrocyte proliferation**
79
rarely, chronic osteomyelitis can have malignant complications which can lead to ___ or \_\_\_\_
rarely, chronic osteomyelitis can have malignant complications which can lead to **squamous cell carcinoma of fistula tract** or **sarcoma of infected bone**
80
the most common malignant tumor of the bone is caused by \_\_\_\_
the most common malignant tumor of the bone is **caused by metastasis**
81
in the chronic form of the condition seen in the image, ___ form in the articular cartilage of joints & soft tissue and induces ____ inflammation
in the chronic form of the condition seen in the image, **tophi** form in the articular cartilage of joints & soft tissue and induce **foreign body type of granulomatous** inflammation
82
in osteoid osteoma, there is nocturnal pain that is \_\_\_\_\_
in osteoid osteoma, there is nocturnal pain that is **alleviated by aspirin**
83
list the 3 characteristics of osteoid osteomas
1. small size
2. self-limited growth
3. tendency to cause extensive reactive changes in adjacent tissues
84
describe the presentation of the condition seen in the image
**usually asymptomatic**
* **bone pain, kidney stones, GI pain, confusion**
* "painful bones, renal stones, abdominal groans, and psychic moans"
* **polydipsia and polyuria**
* hypercalcemia causes aquaporin in CD to become insensitive to ADH → nephrogenic diabetes insipidus
85
the condition in the image can be caused by a genetic predisposition with a mutation in \_\_\_\_
the condition in the image can be caused by a genetic predisposition with a mutation in **p62 → increased RANK-RANKL interaction → increased osteoclasts**
86
list the **endocrine** disorders that can lead to the condition seen in the image
**hyperparathyroidism**
hyperthyroidism
diabetes
Addison's disease
pituitary tumors
87
describe the etiology of the condition seen in the image
parathyroid adenoma (most common) or parathyroid hyperplasia
can be part of MEN1 and MEN2a
88
list the **drugs** that can lead to the condition seen in the image
* **corticosteroids**
* chemotherapy
* alcohol
89
describe the blood levels of Ca, PTH, ALP and phosphate in the condition seen in the image
**increased Ca, PTH and ALP**
**decreased phosphate**
90
list predisposing factor for the condition seen in the image
* diabetes
* hemochromatosis
* ochronosis = accumulation of homogentisic acid in connective tissues
* obesity
* congenital deformity
91
list predisposing factors for the condition seen in the image
* obesity
* red wine
* red meat
* leukemia
* alcohol (competes with uric acid in the nephron)
* Lesch Nyhan (HGPRT def.)
* thiazides
92
$$ "pt has 'bamboo spine', which HLA is associated with this?" $$
**HLA-B27**
93
in scurvy, there is defective ____ which can lead to \_\_\_\_
in scurvy, there is defective **osteoid synthesis** which can lead to **microfractures**
94
the condition seen in the image is associated with HLA-\_\_\_ and HLA-\_\_\_\_
the condition seen in the image is associated with HLA-**DR4** and HLA-**DRB1**
95
describe how the condition in the image affects the heart
* heart:
* MI due to accelerated atherosclerosis
* pericarditis → pericardial effusion → pericardial tamponade
* restricted cardiomyopathy due to amyloidosis
96
on biopsy of the condition seen in the image, ___ is seen
on biopsy of the condition seen in the image, **thinning of the trabeculae** is seen
97
describe the blood levels seen in osteomalacia & rickets
**decreased Ca, phosphate, vit. D**
**increased PTH, ALP (measure of osteoblastic activity)**
98
describe what **subarticular osteoporosis** is seen in the condition in the image
99
in the condition seen in the image, there is no ______ at the growth plate and therefore affects all bones with ___ ossification
in the condition seen in the image, there is **no chondrocyte proliferation** at the growth plate and therefore affects all bones with **endochondral ossification (long bones)**
100
in scurvy, which is caused by ___ def., there is failed \_\_\_\_
in scurvy, which is caused by **vit. C def**., there is failed **cross-linking of collagen**
101
Marfan's syndrome is caused by a mutation in ___ gene on chr. \_\_\_\_
Marfan's syndrome is caused by a mutation in **fibrillin-1** gene on **chr. 15**
102
the hereditary form condition seen in the image is associated with mutations in ___ and \_\_\_
the hereditary form condition seen in the image is associated with mutations in **p53 (LiFraumeni)** and **retinoblastoma (Rb)**
103
list predisposing factors for osteomyelitis
* catheter
* trauma
* infection
* underlying disease
* IV drug abuse
104
describe the pathogenesis of hyperparathyroidism
105
osteomas are part of ____ syndrome; what else is found in this?
osteomas are part of **Gardner's** syndrome
DOPES =
**d**esmoid tumors, **o**steomas, **p**apillary thyroid tumor, **e**pidermal cysts, **s**upernumerary teeth
106
the condition seen in the image leads to a \_\_\_-facies due to \_\_\_\_
the condition seen in the image leads to a **lion**-**facies** due to **coarse facial features**
107
\_\_\_\_ is a bacteria that can cause osteomyelitis in patients that are IVDU
**Pseudomonas** is a bacteria that can cause osteomyelitis in patients that are IVDU
108
$$ a complication of the condition seen in the image is ____ due to compression of ___ nerves $$
a complication of the condition seen in the image is **paralysis/paraplegia** due to compression of **spinal** nerves
109
describe the effects of estrogen on osteoblasts and osteoclasts
110
describe the 3 phases of the condition seen in the image
1. osteolytic/osteoclastic phase
* dark and radiolucent on x-ray
2. mixed phase
* requires angiogenesis → warm skin
3. osteosclerotic (burnt-out) phase
* bright and radioopaque on x-ray
111
the condition seen in the image is associated with **Felty syndrome**; explain the symptoms seen
**Felty syndrome** = RA, splenomegaly, neutropenia
112
\_\_\_\_ predicts the clinical outcome of a bone tumor
**tumor stage** predicts the clinical outcome of a bone tumor
113
In Ewing sarcoma, the t(11;22) chromosomal translocation leads to production of \_\_\_\_\_
In Ewing sarcoma, the t(11;22) chromosomal translocation leads to production of **EWS-FLI-1, *an overactive transcription factor***
114
describe the clinical features of Marfan's syndrome
* tall with long extremeities
* hyperflexible joints
* kyphosis
* scoliosis
* pectus excavatum
* subluxation of lens (ectopia lentis)
115
describe how the condition seen in the image can affect the kidney
chronic inflammatory condition → **AA amyloidosis**
116
describe the neurological complications of the condition seen in the image
thick bones → **compress CN 7 & 8** → hearing impairment
117
describe the blood levels in the condition seen in the image
calcium, phosphate and ALP are ALL NORMAL
118
the condition seen in the image destroys the ____ first and then damages the \_\_\_\_
the condition seen in the image destroys the **intervertebral discs** first and then damages the **vertebral bodies**
119
describe how the condition seen in the image is part of Mafucci's disease
Mafucci's disease = multiple enchondromas on BOTH sides
+ 20% chance of developing chondrosarcoma
+ 100% chance of developing extraskeletal malignancies (soft tissue angiomas, CNS gliomas, ovarian carcinomas)
120
describe the blood levels in the condition seen in the image
**Ca, phosphate and PTH are NORMAL**
**increased ALP**
121
\_\_\_\_ is the most common organism that causes osteomyelitis
**S. aureus** is the most common organism that causes osteomyelitis
122
explain how the anatomic location of the condition seen in the image affects the grade
intramedullary = low grade
intracortical = high grade
juxtacortical = low or high grade
123
histologic grade of a bone tumor determines \_\_\_\_
histologic grade of a bone tumor determines **likelihood of adjuvant therapy**
124
the sporadic form of the condition seen in the image is associated with which 3 mutations?
**p53**
**Rb**
**MDM2** (inactivates apoptotic capacity of p53)
125
the most important risk factor for the condition seen in the image is \_\_\_\_
the most important risk factor for the condition seen in the image is **age**
126
the crystals seen in the condition in the image are composed of \_\_\_\_\_, are \_\_\_-shaped and are ____ (color)
the crystals seen in the condition in the image are composed of **monosodium urate**, are **needle**-**shaped** and are **yellow**
127
on x-ray of the condition seen in the image, ____ and ___ is seen
on x-ray of the condition seen in the image, **Codman's triangle (periosteal elevation)** and **reactive bone formation (sunburst appearance)** is seen
128
what is a complication for the condition seen in the image?
hematogenous spread to lungs → hemoptysis, chest pain and breathlessness
129
on biopsy of the condition seen in the image, there is ____ laid down by malignant \_\_\_\_
on biopsy of the condition seen in the image, there is **lace-like osteoid** laid down by malignant **osteoblasts**
130
osteochondromas only occur in bones with \_\_\_\_\_
osteochondromas only occur in bones with **endochondral ossification**
131
the condition seen in the image is associated with **Caplan syndrome**; explain the symptoms seen
Caplan syndrome = RA, pneumoconiosis, rheumatoid nodules in the lung
132
describe the CVS clinical features seen in Marfan's syndrome
**MVP**; aortic dilatation (due to cystic medionecrosis); **aortic regurgitation**
133
direct inoculation leading to osteomyelitis can be caused by \_\_\_\_
direct inoculation leading to osteomyelitis can be caused by **mixed bacteria**
134
the condition seen in the image is caused by a mutation in ____ located on chr. \_\_\_\_
the condition seen in the image is caused by a mutation in **FGFR3** located on **chr**. **4**
135
the condition seen in the image affects small joints but NEVER the \_\_\_\_
the condition seen in the image affects small joints but NEVER the **DIP**
136
describe the histology of the condition seen in the image
sheets of small round blue cells with small amounts of clear cytoplasm
137
list the complications of EDS
* aortic dissection
* osteopenic bone → kyphoscoliosis, spondylolisthesis
138
describe what is seen on biopsy of the condition in the image
**mosaic pattern of lamellar bone w/ cement lines & resorption pits d/t haphazard laying of bone osteoid**
139
"an elderly male comes to the physician complaining that his hat size is getting bigger"
what is he at increased risk of developing?
osteosarcoma
140
the condition seen in the image is a benign tumor made of ___ and \_\_\_
the condition seen in the image is a benign tumor made of **hyaline** and **myxoid cartilage**
141
list the **neoplasias** that can lead to the condition seen in the image
* carcinomatosis
* multiple myeloma
* paraneoplastic syndrome
* hyperPTH caused by squamous cell ca. of the lung
142
the condition seen in the image is (symmetric or asymmetric?) and (unilateral or bilateral?)
the condition seen in the image is **asymmetric** and **unilateral**
143
the crystals seen in the condition in the image are composed of ____ and are (positively or negatively?) birefringent
the crystals seen in the condition in the image are composed of **monosodium urate** and are **negatively** **birefringent**
144
"patient with chronic osteomyelitis develops a new heart murmur"
how?
**endocarditis**
145
describe what is seen on x-ray in the condition in the image
**radiopaque & bright**
normal **demarcation of cancellous (medullary) bone & cortical bone is lost**
**metaphyseal flaring (Erlenmeyer flask deformity)** = more prominent around the knee and hips
146
osteomyelitis is caused by ____ spread (\_\_\_\_ from systemic disease)
osteomyelitis is caused by **hematogenous** spread (**seeding** from systemic disease)
147
\_\_\_ and ____ are the bacteria that can cause osteomyelitis in neonates
**H. influenzae** and **Group B streptococcus (S. agalactiae)** are the bacteria that can cause osteomyelitis in neonates
148
osteoid osteomas have a predilection for \_\_\_\_\_
osteoid osteomas have a predilection for **appendicular skeleton**
**appendicular skeleton =** the portion of the skeleton that consists of the girdles and the **limbs**. The primary function of the pectoral girdle, which is composed of the **clavicle** and the **scapula**, is to attach the upper limbs to the axial skeleton.
149
the condition seen in the image occurs from ____ spread of \_\_\_\_
the condition seen in the image occurs from **hematogenous** spread of **TB**
150
in patients with the condition seen in the image, are other aspects of their life affected?
NO impact on intelligence, life span, and fertility
151
describe what is seen on biopsy (histology) of the condition seen in the image
multinucleated osteoclast-like giant cells (reactive) + neoplastic mononuclear stromal cells
152
the most common cause of death in the condition seen in the image is \_\_\_\_
the most common cause of death in the condition seen in the image is **DVT (due to immobility from fractures) → _pulmonary embolus_**
153
\_\_\_\_ is the most specific antibody found in the condition seen in the image
**anti-CCP (cyclic citrullinated peptide)** is the most specific antibody found in the condition seen in the image
154
describe how the condition seen in the image has bimodal distribution
seen in **teenagers** (who may have had a history of bilateral **retinoblastomas** as a child)
seen in **older patients with Paget's disease**
155
the condition seen in the image is associated with which infection?
associated with **Paramyxovirus (measles) in childhood**
156
on x-ray investigation of the condition seen in the image, what is seen?
**x-ray = narrowing of the joint space & bony erosions**
157
the primary problem in the condition seen in the image is \_\_\_\_\_
the primary problem in the condition seen in the image is **enzymatic breakdown of articular cartilage**
158
describe how the condition seen in the image can lead to hearing loss
**thick bones → press on cranial nerves in skull, *_especially CN VIII_* → hearing loss**
159
describe how the condition seen in the image is related to Ollier's disease
Ollier's disease = multiple enchondromas on **one side of the body** → increased risk of **chondrosarcoma**
160
the function of RANKL is inhibited by \_\_\_
the function of RANKL is inhibited by **osteoprotegrin (TNF family)**
161
on x-ray of the condition seen in the image, a _____ appearance is seen because \_\_\_\_
on x-ray of the condition seen in the image, a **soap bubble** appearance is seen because **it's very cystic and radiolucent**
162
osteochondroma is a benign cartilage tumor of the ___ (part of bone?)
osteochondroma is a benign cartilage tumor of the **metaphysis**
163
in the condition seen in the image, there is morning stiffness which lasts for ____ and ____ as the day progresses
in the condition seen in the image, there is morning stiffness which lasts for **\>1 hour** and **gets better as the day progresses**
