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Leila's Yr 5 Pathology > Histopathology 8 : Bone pathology > Flashcards

Histopathology 8 : Bone pathology Flashcards

1
Q

2 main types of bone in the body? Where are these bones?

A 
Cortical bone (80% of skeleton) -appendicular skeleton
cancellous bone - axial skeleton + pelvis
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2
Q

Main function of cortical bone and cancellous bone, respectively

A

Cortical: mechanical and protective function (85% calcified)
Cancellous: metabolic function

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3
Q

3 main types of bone cells

A

Osteoblasts
Osteoclasts
Osteocytes

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4
Q

Osteoclast cell type?

A

Macrophage family

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5
Q

What are osteocytes?

A

Osteoblast like cells but they sit in the LACUNAE

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6
Q

How do osteoblasts regulate osteoclast function?

A

Osteoblasts have osteoprotegerin receptors which bind to RANK on osteoclast precursors (osteoprotegrin acts as a RANK ligand) which stops osteoclast precursor differentiation in to an osteoclast

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7
Q

Denosumab MOA

A

Monoclonal antibody which mimics osteoprotegrin (RANK ligand AB)

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8
Q

3 main catégories of metabolic bone disease

A

Non-endocrine: age related osteoporosis
Endocrine (Vit D, PTH etc)
Disuse osteopenia

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9
Q

Main cause of osteoporosis

A

90% due to insufficient calcium intake and post-menopausal oestrogen deficiency

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10
Q

Which bone cells do steroids have an effect on?

A

Osteoclasts
Osteoblasts
Osteocytes

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11
Q

Common sites of fracture in osteoporosis

A

Colles’, NOF, hip

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12
Q

T score vs Z score

A

T score: comparison of person’s bone density with that of a healthy 30 year old
Z-score: comparison to age matched population

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13
Q

Where is bone biopsy taken from in suspected bone metabolic disease?

A

Iliac crest

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14
Q

4 organs affected by pTH

A

Bone
Kidneys
Parathyroid
Small intestine (proximal)

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15
Q

What is osteomalacia?

A

Defective bone mineralisation

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16
Q

2 types of osteomalacia?

A

Deficiency of Vit D

dEFICIENCY of phosphorus

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17
Q

Classical radiological findings in osteomalacia

A

Bowing of legs (rickets)

Horizontal pseudo fractures in looser’s zones

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18
Q

Skeletal changes in hyperparathyroidism

A

Osteitis fibrosa cystica

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19
Q

biochemical picture in hyperparathyroidism

A

hypercalcaemia

hypophosphataemia (increased phosphate excretion in urine)

20
Q

Most common cause of hyperparathyroidism

A

Parathyroid adenoma

21
Q

Histology in hyperparathyroidism

A

Brown cell tumours

22
Q

What are brown cell tumours?

A

multinucleate giant cells

23
Q

What is required for the histological diagnosis of hyperparathyroidism?

A

Brown cell tumours

24
Q

skeletal changes in renal osteodystrophy? (5)

A
  1. osteomalacia (Due to low calcitriol synthesis)
  2. Increased bone resorption –> osteitis fibrous cystic
  3. Osteosclerosis
  4. Growth retardation
  5. Osteoporosis
25
Q

3 stages of Paget’s disease

A

osteolytic
osteolytic-osteosclerotic
quiescent osteosclerotic

26
Q

Virus possibly involved in the pathophysiology of Paget’s

A

Parvomyxovirus

27
Q

bone changes consistent with osteitis fibrosa cystica

A

Brown tumours

Salt and pepper skull

28
Q

Osteomyelitis common sites

A

Vertebrae, jaw secondary to dental abscess, toe secondary to diabetic ulcer, long bones (metaphysis)

29
Q

Investigations for osteomyelitis

A

Xray, eventually becomes lytic

2nd line = MRI (more sensitive)

30
Q

Most common bacterial infection in osteomyelitis

A

S.aureus

31
Q

Sickle cell + osteomyelitis

A

SCD

32
Q

IVDU + osteomyelitis –> ? bacteria

A

Pseudomonas

33
Q

TB osteomyelitis histology

A

Granulomas + langerhans-type giant cells

34
Q

neuropathic joints in syphilis = ?

A

Tabes dorsaliis

35
Q

what is Lyme disease?

A

inflammatory arthropathy

36
Q

name of skin rash in lyme disease

A

erythema chronicum migrans

37
Q

osteoarthritis radiological changes

A

loss of joint space
subchondral sclerosis
bone cysts
osteophytes

38
Q

main sites affected in osteoarthritis?

A

Vertebrae
Hips
Knees

39
Q

Name of two signs in the hands in osteoarthritis

A

Bouchards (PIP) and Heberden’s (DIP) nodes

40
Q

HLA associations in rheumatoid arthritis

A

HLADR4 HLADR1

41
Q

Class of immunoglobulin of rheumatoid factor

A

IgM

42
Q

Structure of the immune complexes in rheumatoid arthritis?

A

The Rf (IgM) forms complexes with IgG and these immune complexes may be responsible for extra-articular diseases

43
Q

RA sites involved, which joint is spared?

A

Small joints of hands and feet, DIPJ spared

44
Q

characteristic deformities include

A

swan neck deformity
boutonnieres radial deviation of wrist
ulnar deviation of fingers
Z shaped thumb

45
Q

severe chronic relapsing synovitis

A

RA

46
Q

Grimley-Sokoloff cells

A

multinucleate giant cells in RA

47
Q

SITES OF PSEUDOGOUT

A

Knees (calcium pyrophosphate

Knees +shoulders (calcium phosphate)

Leila's Yr 5 Pathology (100 decks)

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