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Flashcards in More bone disease Deck (13):

Paget disease of bone

imbalance btw osteoclast and osteoblast function, usually seen in late adulthood. osteoclasts begin resorbing bone wildly. eventually, the osteoblasts activate and try to lay down as much bone as possible. then, osteoclasts burnout, and then you just have osteoblasts laying down as much bone as possible in a rush. stages: lytic, mixed, sclerotic (quiescent)
May be a viral process. involves a few bones, not the whole skeleton.
end result: thick, sclerotic bone that fractures easily


What cell is regulated by PTH

osteoblast. then the osteoblast directs osteoclast resorption


histo finding of paget disese

mosaic pattern of lamellar bone


clinical features and lab features of paget disease

bone pain from microfractures, incr. hat size, hearing loss (narrowing the foramen), lion like faces, isolated, elevated alk phos


Tx of paget disease

calcitonin and bisphosphonate


complications of paget disease

high output cardiac failure (AV shunts through thick bone). osteosarcoma.



infectionsof marrow space and bone. usually in kis. usually bacterial from hematogenous spread. seeds metaphysis in kids (from transient bacteremia). epiphysis in adults (from open wounds). remember, epiphysis at top


causes of osteomyelitis

S. aureus, N gonorrhea, salmonella (sickle cell diseae), pseudomonas (diabetic, IV drug user), pasturella (dog/cat bite), TB


Clinical features of osteomyeltis

bone pain w/ fever and leukocytosis. lytic focus surround by sclerosis on x ray. Dx by blood culture


aseptic necrosis: associated diseases, complications

ischemic necrosis of bone and bone marrow from trauma/fracture, steroids, sickle cell (esp. in finger or toe bones), caisson disease (gas emboli preciptate out of the blood).
complications: osteoarthritis, fracture


Most common site of aseptic necrosis:

femoral head from insufficiency of medial circumflex femoral artery


osteomalacia lab findings

decr. serum Ca and phosphate, increased alk phos and PTH


What are findings associated with hypervitaminosis D

incr. Serum Ca and PO4 3-, normal Alk phos, decr. PTH. caused by over-supplementation or granulomatous disease (like sarcoid)

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