Metabolic bone disease histopath Flashcards Preview

Pathology > Metabolic bone disease histopath > Flashcards

Flashcards in Metabolic bone disease histopath Deck (22):
1

Osteoporosis: aetiology (3), Disease features (3),

Age related
Post-menopause in women
Can be secondary to systemic disease/drugs
Features:
REDUCED BONE MASS
DEXA scan: T score > 2.5 SD below normal

2

Osteoporosis Symptoms (2):

Low impact fractures (Hip - NOF, wrists -Colles)
Back pain

3

Osteoporosis RFs (5)

Age
Female
smoking
Low BMI
poor diet

4

Osteoporosis X ray, histology, biochemistry

nothing
Loss of cancellous bone
all normal - Ca, ALP, PO4

5

Osteomalacia: Aetiology (4), Disease feature (1)

Reduced dietary vit D, malabsorption of vit D
Low sunlight
genetic
Disease feature: REDUCED BONE MINERALIZATION

6

Osteomalacia: symptoms - adults (2), children (4)

adults - bone pain, proximal muscle weakness
children - bone pain, bowing of tibia, rachitic rosary, delayed walking

7

Osteomalacia: RFs (4)

Poor diet
Malabsorption
CKD
Lack of sunlight

8

Osteomalacia: X-ray

LOOSER'S ZONES (pseudo fractures) - splaying of metaphysis

9

Osteomalacia: histology (1) & biochem

Excess UNMINERALIZED bone (osteoid)
biochem - low or norm Ca
Low PO4
raised ALP

10

Primary hyperparathyroidism: Aetiology (5) & Disease features (1)

Excess PTH - increased Ca2+ reabsorption & PO4- excretion
causes - Parathyroid adenoma, hyperplasia, carcinoma, MEN
Feature - bone changes of osteitis fibrosa cystica

11

Primary hyperparathyroidism: symptoms

Hypercalcaemia - moans, bones, stones, groans, psychiatric overtones
depression, renal stones, bone pain, constipation, pancreatitis, polyuria, polydipsia

12

Primary hyperparathyroidism: RFs

Secondrary hyperPTH > CRF
low vit D
malabsorption

13

Primary hyperparathyroidism: X-ray findings (3)

BROWN'S TUMOUR
SALT AND PEPPER SKULL
subperiosteal BONE RESORPTION in PHALANGES

14

Primary hyperparathyroidism: histology (1) & biochem

Histo - osteitis fibrosa cystica (marrow fibrosis + cysts - AKA Brown tumour)
Biochem - raised Ca, low/ norm PO4, high/norm ALP

15

Paget's disease: aetiology, disease features

A disorder of bone turnover
Both lytic & sclerotic lesions

16

Paget's disease: symptoms (6)

bone pain
microfractures
high output CF
nerve compression
skull changes - increase head size
deafness

17

Paget's disease: RFs (2)

>50 yrs
Caucasian

18

Paget's disease: X-ray findings in skul (2), vertebrae (2), pelvis (2)

Skull - osteoporosis circumscripta, cotton wool
vertebrae - picture frame, ivory vertebrae
Pelvis -- sclerosis & lucency

19

Paget's disease: histology (2)

HUGE OSTEOCLASTS - with > 100 nuclei
MOSAIC PATTERN - of lamellar bone

20

Paget's disease: biochem

Main thing is very ELEVATED ALP
Ca & PO4 normal

21

Renal osteodystrophy - aetiology

All skeletal changes assocaited with CKD:
osteitis fibrosia cystica (secondary to raised PTH)
osteomalacia
osteoporosis
osteosclerosis

22

Renal osteodystrophy - biochem:

Low Ca
Raised PO4
secondary hyperPTH & metabolic acidosis