Bones, joints, & soft tissue (slides 1-65)

Question 0

smooth muscle tumors particularly affect what demographic

Answer 0

women of child bearing age

Question 1

what is osteomyelitis

Answer 1

infection of bone marrow

Question 2

true or false; blood is connective tissue

Answer 2

true

Question 3

What is dysostosis

Answer 3

development anomaly of bone

• abnormal mesenchymal migration
• defective ossification of fetal cartilage

Question 4

What is aplasia

Answer 4

absent or incomplete development of organ tissues/system

Question 5

true or false; dysostosis (development anomaly of bone) is associated with aplasia

Answer 5

true

Question 6

What is dysplasia? What is it associated with?

Answer 6

Mutations interfere with growth

Associated with dwarfism

Question 7

True or false; Dysplasia (mutations interfering with growth) can cause dwarfism via bone or cartilage mutations

Answer 7

true

bone-osteodysplasia
cartilage- chondrodysplasia

Question 8

What is Sprengel’s deformity? What is it associated with?

Answer 8

Undescended scapula

Klippel-Feil syndrome (form of dysostosis)

Question 9

What is Klippel-Feil syndrome

Answer 9

An idiopathic congenital fusion (any 2 cervical vertebrae) form of dysostosis

-Sprengel’s deformity - undescended scapula

Question 10

What is the MC congenital malformation of the limbs?

Answer 10

Syndactyly (fusion of digits)

Question 11

Autosomal dominant disorders typically effect what?

Answer 11

structural proteins

Question 12

Autosomal recessive disorders typically effect what?

Answer 12

Enzymatic proteins

Question 13

What is another name for osteogenesis imperfecta

Answer 13

brittle bone disease

Question 14

osteogenesis imperfecta (brittle bone disease) causes mutations of what structural protein

Answer 14

collagen type 1

autosomal dominant

Question 15

What disease causes bluish discoloration of sclera

Answer 15

Osteogenesis imperfecta (brittle bone disease)

Question 16

What are the types of osteogenesis imperfecta (brittle bone disease)

Answer 16

Type 1 - normal lifespan
Type 2 - lethal in utero (cerebral hemorrhage)

Both involve type 1 collagen mutations

Question 17

True or false; osteogenesis imperfecta is a contraindication to extremity adjusting

Answer 17

true (brittle bone disease)

Question 18

What is the MC form of dwarfism

Answer 18

Achondroplasia

Question 19

True or false; achondroplasia (MC form of dwarfism) is caused by the FBFR3 gene mutation

Answer 19

true

Question 20

What disease is commonly associated with bullet vertebrae, scoliosis, and spinal stenosis

Answer 20

achondroplasia

Question 21

What is thanatophoric dwarfism?

Answer 21

fatal form of achondroplasia

Question 22

What does osteopetrosis cause in osteoclast activity

Answer 22

decreases osteoclast-mediated bone reabsorption

Question 23

True or false; osteopetrosis causes “stone-like” bones making them harder but not stronger (increasing risk of fractures)

Answer 23

true

Question 24

True or false; osteoporosis is commonly associated with hepatoslenomegaly

Answer 24

false; common in osteopetrosis (due to increased blood production because medullary cavity of bone is being filled with bone cells)

Question 25

Along with Gaucher disease what pathology can cause erlenmeyer flask deformity

Answer 25

osteopetrosis

Question 26

What is the most important form of osteopenia

Answer 26

osteoporosis

Question 27

What is osteopenia

Answer 27

the subtle reduction of bone mineral density - (not full blown osteoporosis)

Question 28

What is the MC type of osteoporosis

Answer 28

Senile, post-menopausal

Question 29

What are some examples of secondary causes of osteoperosis

Answer 29

hyperparathyroidism Nutrient deficiency drug exposure - alcohol, smoking

Question 30

How could hyperparathyroidism cause osteoporosis

Answer 30

As PTH goes up so dose calcium - this calcium comes from bone

Question 31

True or false; osteoporosis MC impacts trabecular (spongy) bone

Answer 31

true

Question 32

What are the 2 MC areas you'll find osteoporosis

Answer 32

``` Vertebral body (old people shrinking) Femoral neck (fractured hip) ```

Question 33

When does loss of bone density begin?

Answer 33

mid 20s (.05% per year)

Question 34

True or false; senile or post-menopausal osteoporosis is caused by decreased growth factors and decreased osteoblast activity

Answer 34

true

Question 35

What is Dowager's hump? What are some complications of it?

Answer 35

Vertebral compression (kyphosis) due to senile osteoporosis Can lead to issues with pneumonia

Question 36

Why is it that a femoral neck fracture often leads to death in the next year

Answer 36

Due to immobilization - collection of blood clots in lower extremity - pulmonary embolism

Question 37

True or false; osteoporosis can be diagnosed following an X-ray

Answer 37

False; you can see the effects of osteoporosis (loss of bone density) but patient would need to complete a T-score exam or DEXA scan

Question 38

Regular exercise prior to age 30, dietary calcium and Vitamin D supplementation, bisphosphates consumption are all preventative measures for what disease?

Answer 38

Osteoporosis

Question 39

What disease is associated with a lytic phase - mixed lytic and blastic phase - exhaustion of cellular activity causing a "shaggy" bone appearance

Answer 39

paget disease

Question 40

What is paget's disease?

Answer 40

Excessive bone formation - disorganized - "shaggy" bone appearance - excessive osteoclastic activity

Question 41

True or false; 70-90% of Paget disease causes pain and discomfort

Answer 41

false; 70-90% of cases are asymptomatic

Question 42

If a patient with Paget's disease did show pain symptoms where is the MC area?

Answer 42

Bone pain in neck and back

Question 43

80% of cases of Paget's disease involve what part of skeleton?

Answer 43

axial skeleton or femur

Question 44

At what age is Paget disease MC diagnosed

Answer 44

70

Question 45

The Mosaic pattern or "jigsaw puzzle" appearance in histological sections of bone is associated with what disease

Answer 45

paget disease

Question 46

The "ivory vertebra sign" is associated with what disease?

Answer 46

paget disease

Question 47

What is the difference between rickets and osteomalacia

Answer 47

Rickets - vitamin D deficiency in children Osteomalacia - vitamin D deficiency in adults - associated with hyperparathyroidism

Question 48

What are the 2 types of hyperparathyroidism

Answer 48

Primary- autonomous PTH production Secondary- renal failure - mild

Question 49

What is the most common form of non-malignant cause of hypercalcemia

Answer 49

Hyperparathyroidism

Question 50

True or false; >50% of hyperparathyroidism is asymptomatic

Answer 50

true (MC in women)

Question 51

A "salt and pepper skull" on X-ray and a brown "tumor" (not actual neoplasm - replaced bone with loose connective tissue) are signs of what?

Answer 51

Hyperparathyroidism

Question 52

True or false; complete fractures are MC in children

Answer 52

false; Incomplete are most common in children

Question 53

infections are most common in what kind of fracture?

Answer 53

compound

Question 54

True or false; subchondral areas including: hip, knee, shoulder, wrist, and ankle are all areas especially susceptible to avascular necrosis

Answer 54

true (especially rounded areas)

Question 55

What is osteomyelitis? Is acute or chronic more common?

Answer 55

Bone-marrow inflammation Chronic is MC

Question 56

What is the MC mode of infection in osteomyelitis (bone marrow inflammation)

Answer 56

Hematogenous (sepsis)

Question 57

What is the MC cause of pyogenic infections in Osteomyelitis (bone marrow infection)

Answer 57

Staph aureus (E. coli & Group B stept - neonates) (Salmonella - sickle cell disease)

Question 58

Why would a patient with Sickle cell disease be very susceptible to a Salmonella infection

Answer 58

Sickle cell disease causes spleen to be over-worked and spleen protects us from salmonella infections

Question 59

What is the name for the reactive woven bone surrounding infected bone in pyogenic osteomyelitis

Answer 59

involucrum

Question 60

What is the name of the dead bone at the site of infection in pyogenic osteomyelitis

Answer 60

sequestrum

Question 61

What is the name for the ruptured periosteum leads to an abscess in the surrounding soft tissue in a pyogenic osteomyelitis infection

Answer 61

Draining sinus

Question 62

Tuberculous osteomyelitis is MC spread how?

Answer 62

Hematogenous spread

Question 63

Pott disease is common which kind of osteomyelitis

Answer 63

Tuberculous osteomyelitis

Question 64

True or false; primary bone tumors are more common than secondary

Answer 64

false; secondary are more common (spread from somewhere else)

Question 65

What does pyrexia mean? What about cachexia?

Answer 65

Pyrexia - fever Cachexia - wasting syndrome

Question 66

Osteosaroma, chondrosarcoma, and ewing sarcoma are all examples of what?

Answer 66

Primary bone cancers

Question 67

True or false; benign bone tumors are MC than malignant

Answer 67

true

Question 68

What is the MC bone tumor

Answer 68

osteochondroma

Question 69

True or false; RB or TP53 gene mutations are associated with bone tumors

Answer 69

true

Question 70

True or false; bone tumors MC develop early and are malignant and painful

Answer 70

False; develop early BUT are benign and asymptomatic

Question 71

Where are osteosarcomas most commonly found

Answer 71

>50% at knee

Question 72

Osteoma are MC where? What are they?

Answer 72

MC on head Completely benign, non-invasive superficial mass

Question 73

What is the main location difference between osteoid osteoma and osteoblastoma

Answer 73

Osteoid osteoma - smaller and on proximal femur Osteoblastoma - larger usually found on vertebrae

Question 74

Osteoid osteoma are associated with what kind of pain? What relieves it?

Answer 74

Well-localized nocturnal pain, aspirin relieves (smaller tumor)

Question 75

Osteoblastomas are associated with what kind of pain? Does aspirin relieve it?

Answer 75

Larger tumor - mild/poorly-localized pain - unrelieved by aspirin