Dougherty Part 2

Question 1

what is rickets

Answer 1

child vitamin D deficiency

Question 2

osteomalacia is what

Answer 2

adult vitamin D deficiency

Question 3

hyperparathyroidism is due to what

Answer 3

PTH excess

Question 4

renal osteodystrophy is due to what

Answer 4

chronic renal disease

Question 5

primary hyperparathyroidsim is most commonly from what

Answer 5

an adenoma

Question 6

in hyperparathyroidism what is the osteoclast and osteoblast activity

Answer 6

increased activity in both OC>OB

Question 7

secondary hyperparathyroidism is often due to what

Answer 7

hypocalcemia

Question 8

what is part of the skeleton is affected in hyperparathyroidism

Answer 8

entire skeleton

Question 9

what is seen in osteitis fibrosa cystica

Answer 9

subperiosteal resorption thins cortices
loss of lamina dura around the teeth
X-ray: bone loss radial aspect of middle phalanges of index and middle finger/ osteopenia

Question 10

what is a brown tumor

Answer 10

bone replaced by fibrovascular tissue
microfractures result in hemorrhage and healing
granulation tissue and hemosiderin

Question 11

what bone disease is caused by hyperparathyroidism

Answer 11

osteitis fibrosa cystica

Question 12

brown tumors are seen in what

Answer 12

hyperparathyroidism (osteitis fibrosa cystica)

Question 13

in renal osteodystrophy what is the osteoclast and osteoblastic activity

Answer 13

increased or decreased

Question 14

in renal osteodystophy what is going on

Answer 14

hyperparathyroidism
decreased vitamin D conversion to 1,25-OH2VitD3
metabolic acidosis (increase release of calcium)

Question 15

mosaic pattern of lamellar bone (jigsaw puzzle-like cement lines) is seen in what

Answer 15

paget disease (osteosclerotic

Question 16

what are the stages of paget disease

Answer 16

osteolytic stage- loss of bone mass
mixed stage- osteolytic and osteoblastic
osteosclerotic stage- coarse thick irregular trabecular

Question 17

v-shaped “blade of grass” lesion is characteristic of what

Answer 17

lytic pause of page’s disease

Question 18

chalk stick-type fracture is seen in what

Answer 18

paget disease

Question 19

what are calcium and phosphate levels in paget disease

Answer 19

normal

Question 20

in paget disease what are alkaline phosphate levels

Answer 20

high

Question 21

what benign tumors are associate with paget disease

Answer 21

giant cell tumor
giant cell reparative granuloma
extraosseous hematopoeisis

Question 22

what malignant tumors are associate with paget disease

Answer 22

osteosarcoma

fibrosarcoma

Question 23

how does one treat paget disease

Answer 23

calcitonin and biphosphonates

Question 24

what is a soft tissue callus (procallus)

Answer 24

hematoma fibrin creates framework
influx inflammation, fibroblasts, and capillaries
osteoprogenitor cells activated
no rigidity, easily disrupted

Question 25

boney callus is what

Answer 25

woven bone is made +/- cartilage for enchondral ossification over time remodels to bear full weight

Question 26

when is the maximum girth of a callus

Answer 26

3 weeks

Question 27

what are some complications with fractures

Answer 27

misaligned bone infected, displaced or devitalized bone leads to deformity pseudoarthrosis: nonunion

Question 28

what is the most common cause of osteonecrosis

Answer 28

corticosteroids

Question 29

what is osteonecrosis

Answer 29

infarction of bone and marrow | dead bone/fat is replaced by calcium soaps

Question 30

what are some of the most common causes of avascular necrosis

Answer 30

``` corticosterioids infection dysbarsim (bends) pregnancy sickle cell disease and other anemias ```

Question 31

avascular necrosis due to subchondral infarct can be easily recognized in a photograph by what

Answer 31

crack in the bone

Question 32

avascular necrosis due to a medullary infarct casuses what

Answer 32

geographic necrosis small silent and stable large painful (dysbarism, sickle cell)

Question 33

avascular necrosis due to subchondral infarct causes what

Answer 33

chronic pain wedge-shaped subchondral bone (often crack beneath preserved cartilage, overlying cartilage nurtured by synovial fluid) secondary collapse lead to osteoarthritis

Question 34

what is osteomyelitis

Answer 34

inflammation almost always from infection

Question 35

how do bacteria reach the bone in osteomyelitis

Answer 35

hematogenous (most common in children) direct extension implantation

Question 36

what is the classic x-ray seen in osteomyelitis

Answer 36

lytic bone lesion with surrounding sclerosis

Question 37

what is the most common cause of pyogenic osteomyelitis

Answer 37

staph aureus

Question 38

what causes pyogenic osteomyelitis in people with GU infection and IV drug users

Answer 38

E Coli pseudomonas klebsiella

Question 39

pyogenic osteomyelitis in infants is commonly caused by what

Answer 39

H. flu | Group B strep

Question 40

what location is influenced by blood supply in pyogenic osteomyelitis of a neonate

Answer 40

metaphysis and or epiphysis (can spread into join through articular surface or adjacent structures)

Question 41

what location is influenced by blood supply in pyogenic osteomyelitis of a children

Answer 41

metaphysis (subperiosteal abscess)

Question 42

what location is influenced by blood supply in pyogenic osteomyelitis of an adult

Answer 42

epiphysis and subchondral bone

Question 43

what is sequestrum and when is it seen

Answer 43

dead piece of bone | pyogenic osteomyelitis

Question 44

what is involucrum and when is it seen

Answer 44

reactive surrounding bone | pyogenic osteomyelitis

Question 45

what is sclerosing osteomyelitis of Garre

Answer 45

in jaw with extensive new bone formation

Question 46

what are complications of chronic osteomyelitis

Answer 46

pathologic fracture | sarcoma

Question 47

how does osteomyelitis present

Answer 47

acutely sick to unexplained fever local pain draining sinus (can develop squamous cell carcinoma)

Question 48

what is potts disease

Answer 48

TB osteomyelitis of the lumbar/thoracic spine | break through discs to other vertebrae (scoliosis and kyphosis)

Question 49

most common TB osteomyelitis

Answer 49

potts disease

Question 50

what causes syphilis of the bone

Answer 50

T pallidum and T pertenue (yaws)

Question 51

what is seen in acquired syphilis of the bone

Answer 51

involves bone in tertiary phase SADDLE NOSE palate skull