Musculoskelatal Flashcards

1
Q

Skeleton turnovers __ per year

A

10%

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2
Q

Osteogenesis Imperfecta aka

A

Brittle bones

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3
Q

Osteogenesis imperfecata is a group of bone disorders with abnormal

A

Synthesis of type I collagen

Skeletal fragility

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4
Q

Osteo. Imperfecta moats are autosomal ___

A

Dominant

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5
Q

Osteo. Imperfecta teeth might look

A

Opalescent teeth

Dentinogensis very similar

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6
Q

Osteo. Imperfecta sclera

A

Blue

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7
Q

Prognosis of Osteo. Imperfecta depends on

A

Type and expression of the gene

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8
Q

Osteopetrosis aka

A

Marble bone disease

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9
Q

Osteopetrosis is a group of

A

Rare hereditary bone distorted with defective bone remodeling

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10
Q

Osteopetrosis is a dysfunction of

A

Osteolclast

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11
Q

Osteopetrosis affected bone

A

Is dense but structurally unsound and weake

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12
Q

Osteopetrosis prone to

A

Fractures and infections

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13
Q

Osteopetrosis can cause narrowing of

A

Cranial formanina

Leading to blindness deafness

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14
Q

Osteopetrosis can undergo bone marrow transplant which

A

Can repopulate functional osteoclasts

-derived from monocytes precursors

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15
Q

Osteoporosis is an increased

A

Porosity of the skeleton resulting from reduced bone mass

—> increased bone fragility

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16
Q

Osteoporosis affect

A

Postmeno females—-> reduced estrogen

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17
Q

______% of women sustain fractures by age 65

A

25%

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18
Q

___% females sustain fractures by 90

A

50%

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19
Q

Osteoporosis is an imbalance of

A

Favor is in osteoclasts

Reduced osteoblasts activity

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20
Q

Peak bone mass

A

Genetic factors
Physical activity
Nutrition

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21
Q

Menopause

A

Decreased estrogen

Increased IL1 IL6 TNF levels

Increased expression of RANK, RANKL

Increased osteoclast activity

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22
Q

Aging

A

Decreased replicative activity of osteoprogentior cells
Decreased synthetic activity of Ob

Decreased biologic activity of matrix bound growth factors

Reduced physical activity

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23
Q

Most common osteoporosis sites

A

Vertebral bodies
Pelvis
Femoral neck
Other weight bearing bones

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24
Q

Osteoporosis may lead to

A

Kyphoscoliosis and subsequent reduced respiratory function

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25
Q

Osteoporosis diagnosis

A

Dual X-ray absoprotometry

DEXA scan

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26
Q

Osteoporosis treatment

A
Diet and exercise
Calcium and VIt D supplement 
Bisphosphonates
Hormone therapy
Monoclonal Ab
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27
Q

Pagets Disease of Bone abnormal

A

Dense bone formation whic is structurally weak and prone to fracture

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28
Q

Pagets Disease usually affects

A

Multiple bone (85% polyostotic)

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29
Q

Pagets Disease usually affects who

A

Adults> 40

Paramyxovirus infection suspected

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30
Q

Pagets Disease usually asymptomatic but

A
Bone enlargement
Fractures
Pain
Cranial nerve compression
Bowing of legs
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31
Q

Pagets Disease 3 Phases

A

Osteolytic Phase
Mixed Phase
Osteosclerotic Phase

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32
Q

Pagets Disease Treatment

A

Calcitonin, bisphosphonates

Analgesics for bone pain

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33
Q

Bone is Pagets Disease has a ______appearance

A

Mosaic

Very random placement of bone

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34
Q

Hyperparathyroidism inappropriate secretion of

A

PTH

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35
Q

Primary Hyperparathyroidism

A

Due to parathyroid hyperplasia adenoma or carcinoma more severe but less common

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36
Q

Secondary Hyperparathyroidism

A

Leads to poor calcium retention and lowered viatamine D metabolism common complication of end stage renal disease of vitamin deficiency

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37
Q

Which Hyperparathyroidism is less common and more severe

A

Primary Hyperparathyroidism

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38
Q

Actions of PTH

A

Osteoclastic activation

Increased Ca resorption by kidneys

Increased VIt D synthesis (kidney) promoting Ca absorption from gut

39
Q

All actions of PTH work to

A

Increase serum Ca

40
Q

Osteitis Fibrosa Cystica

A

Cyst like brown tumors of bone

41
Q

Hyperparathyroidism Treatment for primary

A

Remove affected gland/tumor

42
Q

Hyperparathyroidism Treatment for secondary

A

Renal transplant VIt D supplementation

43
Q

Osteomyelitis

A

Infection of bone and marrow

Usually bacterial

44
Q

Osteomyelitis colonize bone through 3 ways

A

Hematogenous spread
Contiguous i infraction
Implantation following fracture or surgery

45
Q

Hematgoenous spread

A

Staph aureus

46
Q

Contiguous infection

A

Odontogenic infection

47
Q

Osteomyelitis assocaited with

A

Pain/tenderness, possible overlying erythema or swelling

48
Q

Chronic Osteomyelitis

A

Non-vital bone

Surround by rim of new bone (involucrum)

49
Q

Osteomyelitis treatment

A

Drainage, antibiotics, +/- surgical debridement

50
Q

Fibrous Dysplasia is replacement

A

Of normal bone by fibrous CT and abnormal bony trabeculae

51
Q

Fibrous Dysplasia usually affects

A

Adolescents young adults

52
Q

Fibrous Dysplasia can be _____ or ______

A

Monostotic

Polystotic

53
Q

Fibrous Dysplasia polyostotic Disease often associated with ____ and ____

A

Cafe-au-Liat spots

Endocrine disorders

54
Q

Jaffa-lichenstein syndrome

A

Cafe-au-Lait

55
Q

McCune-Albright Syndrome

A

Cafe-au-Lait and endocrine disorders

56
Q

Fibrous Dysplasia can have a ____appearance

A

Ground glass

Ill defined radiolucency

57
Q

Fibrous Dysplasia Treatment

A

Observation
Anti-restorative therapy
Surgical reduction

58
Q

Fibrous Dysplasia after puberty

A

Usually arrests once plates close

Should wait if before puberty because growth can still continue

59
Q

Osteosarcoma _____malignancy that produces ________ and _____

A

Mesenchymal

Osteoid
Bone

60
Q

Osteosarcoma is the most common

A

PRIMARY malignant bone tumor

61
Q

Osteosarcoma usually affects

A

Patients under 20; average 18

62
Q

Osteosarcoma patients will have

A

Pain and swelling of affected bone

63
Q

Osteosarcoma lesions are

A

Mixed

Will be calcified

64
Q

Codmans triangle

A

Often seen on long bones partly tumor partly reaction of periosteum to tumor

65
Q

Starburst

A

Radiating trabecular enlarging size of bone. Late stage and very painful

66
Q

Osteosarcoma diagnosis

A

Histology evidence of direct production of steroid by malignant mesenchymal cells

67
Q

Osteosarcoma treatment

A

Surgery and chemotherapy

68
Q

Osteosarcoma prognosis

A

60-70% 5 year

69
Q

Osteoarthritis aka

A

Degenerative joint disease

70
Q

Osteoarthritis age related

A

Over 50

71
Q

Osteoarthritis stems from

A

degeneration of articular cartilage

-bone changes are secondary

72
Q

Osteoarthritis _____ play a major role

A

Mechanical stresses

73
Q

Rheumatoid arthritis

A

Autoimmune disease

Affects women more than men

74
Q

Osteoarthritis symptoms

A

After 50
Creptius & joint stiffness
Deep, aching pain
Pain, deformity and limitation of motion develop late

75
Q

Osteoarthritis Treatment

A
NSAIDs
Intrajoint hyualruonic acid
Cortisone shots
Physical therapy
Joint replacement
76
Q

Gout accumulation

A

Uric acid accumulation

77
Q

Gout results in

A

Episodic acute arthritis
Tophus formation
Kidney damage

78
Q

Gout usually affects

A

Adult males, great toe (90%)

79
Q

Tophi

A

Sodium urate deposits

80
Q

Gout food that has a lot of

A

Pyrines

Meat seafood etc

81
Q

Gout Treatment

A

Diet modification (no beer reduce red meat)

NSAIDs, corticosteroids, colchicine, allopurinol

82
Q

Muscular Dystrophy a heterogenous group of

A

Heritable diseases with spontaneous progressive degeneration of muscle fibers

83
Q

Duchenne MD

A

X-linked condition

84
Q

Duchenne MD absence of

A

Dystrophin, key structural protein in skeletal and cardiac muscle

85
Q

Muscular Dystrophy symptoms usually begin by

A

Ages 3-5

86
Q

Muscular dystrophy weakness of

A

Pelvic and shoulder areas, progressive atrophy and deterioration of muscle

87
Q

Muscular dystrophy Treatment

A

None

Most patients in wheelchair by early teens and die before age 30 of diseases related complication

88
Q

Myasthenia gravis is an acquired

A

Autoimmune disease

89
Q

Myasthenia gravis autoAb production to

A

AChR

—> leads to muscle weakness/fatiguability

90
Q

Myasthenia gravis usually affects

A

Females; any age; onset often insidious

91
Q

Myasthenia gravis problems with

A

Eye muscles and muscles of mastication Amy be initial presentation

92
Q

Myasthenia gravis weakness worsens

A

With repeated contractions, symptoms worse later in day

93
Q

Myasthenia gravis Treatment

A

Cholinesterase inhibitors (improves transmission)
Immunosuppressive
Thymectomy may induce remission

Spontaneous remission in some cases

94
Q

Myasthenia gravis prognosis

A

Good
Respiratory compromise was a past major cause of death

5 year 95% survival