Lecture 8- Musculoskeletal pathology

Question 1

… aka “brittle bone disease, these are a group of hereditary bone disorders with abnormal synthesis of type 1 collagen

Answer 1

osteogenesis Imperfecta (OI)

Question 2

… and … may be seen as components of OI

Answer 2

blue sclera

opalescent teeth (dentinogenesis imperfecta-like)

Question 3

most OI’s are autosomal…

Answer 3

dominant

Question 4

…. aka “marble bone disease” is a group of rare hereditary bone disorders with defective bone remodeling (osteoclast dysfxn)

Answer 4

osteopertosis

Question 5

affected bone of osteopetrosis is … but structurally … and…

Answer 5

dense

unsound

weak

Question 6

patients with osteopetrosis are prone to .. and …

Answer 6

fractures

infections (osteomyelitis)

Question 7

in osteopetrosis, compression of … can lead to …

Answer 7

cranial foramina

blindness, deafness

Question 8

in osteopetrosis, bone can replace … and lead to …

Answer 8

marrow stem cells

pancytopenia (anemia, thrombocytopenia, leukopenia)

Question 9

… is an increased porosity of the skeleton resulting from reduced bone mass and leading to bone fragility

Answer 9

osteoporosis

Question 10

most common form of acquired, metabolic bone disease?

Answer 10

osteoporosis

Question 11

… million people in the US have osteoporosis and … million have osteopenia

Answer 11

10

44

Question 12

postmenopausal women are at the greatest risk for osteoporosis because it is associated with…

Answer 12

reduced estrogen

Question 13

most common sites of osteoporosis?

Answer 13

vertebral bodies, pelvis, femoral neck and other weight bearing bones

Question 14

osteoporosis may lead to … and subsequent…

Answer 14

kyphoscoliosis

reduced respiratory fxn

Question 15

dx for osteoporosis

Answer 15

dual X-ray absorptiometry (DEXA scan)

Question 16

tx for osteoporosis

Answer 16

diet/exercise

calcium with vit D supp

bisphosphonates

hormone replace. therapy

monoclonal Ab (denosumab, Prolia)

Question 17

prognosis for osteoporosis

Answer 17

guarded

Question 18

…. disease is an abnormal dense bone formation which is structurally weak and prone to fracture. usuall affects multiple bones (85% polyostitic) and affects adults over the age of 40

Answer 18

paget disease

Question 19

etiology of paget disease?

Answer 19

unknown but paramyxovirus infection suspected

Question 20

T/F most cases of paget disease are asymptomatic

Answer 20

true, may be detected on routine radiographs or blood studies

Question 21

what symptoms could you see in paget disease

Answer 21

bone enlargement

bowing of leg bones

cranial nerve compression

pain

fractures

Question 22

a very distinct feature that you could see from paget disease is …. which is termed a “lion face” characterized by overgrowth of facial and cranial bones and a slight increased risk (1% lifetime) for development of sarcomas (particularly osteosarcoma)

Answer 22

leontiasis ossea

Question 23

paget disease happens in these 3 phases:

Answer 23

1. osteoclactis activity , hypervascularity, bone loss
2. osteoclastic and osteoblastic proliferation
3. late osteosclerotic phase

Question 24

what is the bone called in paget disease due to its histologic appearance

Answer 24

mosaic

Question 25

tx for paget disease

Answer 25

calcitonin, bisphosphonates analgesic for bone pain

Question 26

... is the inappropriate secretion of PTH

Answer 26

hyperparathyroidism

Question 27

Primary hyperparathyroidism is due to ... , ... or ... and is more ... but less...

Answer 27

parathyroid hyperplasia, adenoma, carcinoma more severe less common

Question 28

Secondary hyperparathyroidism leads to poor ... and altered .... commom complication of ESRD or vit. D deficiency

Answer 28

calcium retention vit. D metabolism

Question 29

PTH actions

Answer 29

osteoclastic activation increased calcium absorption by the kidneys increased vit. D syn (kidneys) promoting calcium absorption from gut ALL increase serum calcium

Question 30

... is infection of bone and marrow and are usually bacterial

Answer 30

osteomyelitis

Question 31

bacteria can colonize in bone one of 3 ways:

Answer 31

hematogenous spread (staph) contiguous infection (odontogenic) implantation following fracture of surgery

Question 32

T/F osteomyelitis is usually asymptomatic

Answer 32

false. associated with pain/tenderness, possible overlying erythema or swelling

Question 33

tx for osetomyelitis

Answer 33

drainage antibiotics surgical debridement