Musculoskeletal Disorders Part 2

Question 0

What are the three phases of Paget’s Disease?

Answer 0

Osteolytic phase, mixed osteolytic and osteoblastic phase, osteosclerotic phase

Question 1

What is the older term for Paget’s Disease?

Answer 1

Osteitis Deformans

Question 2

What occurs in Paget’s Disease?

Answer 2

Massively enlarged, disorganized, and irregular bone that is prone to fractures

Question 3

The appearance of Paget’s Disease of the pelvis on X-ray is what?

Answer 3

Fuzzy/shaggy looking

Question 4

What is the name of the perpendicular fractures seen on X-ray with Paget’s Disease?

Answer 4

Chalk stick fracture

Question 5

What is the appearance of the bone cells with Paget’s Disease?

Answer 5

Mosaic, jigsaw puzzle appearance

Question 6

Most cases of Paget’s Disease are asymptomatic: true or false?

Answer 6

True (up to 90%)

Question 7

What are the general symptoms of Paget’s Disease when they’re present?

Answer 7

Bone pain, multiple fractures, nerve compression

Question 8

What is found in the diagnosis of Paget’s Disease?

Answer 8

Increased levels of serum alkaline phosphatase

Question 9

What is a positive note on the current findings of Paget’s Disease diagnoses?

Answer 9

It is becoming less common and less severe

Question 10

What population is more like to develop Paget’s Disease?

Answer 10

Caucasians

Question 11

Why are there increased levels of serum alkaline phosphatase in those with Paget’s Disease?

Answer 11

It is a byproduct of osteoblast activity

Question 12

When ivory vertebra sign is present, what are likely causes?

Answer 12

Paget’s Disease, metastatic cancer (usually from prostate cancer), lymphoma

Question 13

What is ivory vertebra sign?

Answer 13

Increased density of one specific vertebral level

Question 14

If a patient comes in saying they’ve noticed their hats don’t quite fit anymore, it could be indicative of what condition?

Answer 14

Paget’s Disease

Question 15

What named conditions result from vitamin D deficiency?

Answer 15

Rickets (in children) or osteomalacia (in adults)

Question 16

What is the average age of diagnosis of Paget’s Disease?

Answer 16

70 years (older individuals)

Question 17

What gender is at a greater risk for Paget’s Disease?

Answer 17

Males (2X)

Question 18

What is the treatment for Paget’s Disease?

Answer 18

Bisphosphonates

Question 19

What is the intention with treating Paget’s Disease with bisphosphonates?

Answer 19

Slowing of the osteolytic (first) phase

Question 20

Vitamin D deficiency has what effect on bone?

Answer 20

Decreased bone mineralization (less calcium)

Question 21

What are ways vitamin D deficiency can occur?

Answer 21

Malnutrition, deficient UV Rays, abnormal metabolism

Question 22

Femoral and tibial bowing is a sign of what condition?

Answer 22

Vitamin D deficiency

Question 23

Which is more severe: rickets or osteomalacia?

Answer 23

Rickets

Question 24

Osteomalacia is associated with what issue?

Answer 24

Hyperparathyroidism

Question 25

Osteomalacia is similar to what condition?

Answer 25

Osteoporosis

Question 26

What is secreted from the parathyroid glands?

Answer 26

Parathyroid hormone (PTH)

Question 27

What is the main function of the parathyroid glands?

Answer 27

Maintains serum calcium (in blood)

Question 28

What type of hyperparathyroidism involves autonomous PTH production?

Answer 28

Primary

Question 29

What is the most common cause of excessive PTH?

Answer 29

From an adenoma (80%)

Question 30

Excessive PTH has what kind of effect on bone cells?

Answer 30

Increased osteoclast activity

Question 31

What is absorbed more heavily from renal tubules in a state of excessive amounts of PTH?

Answer 31

Vitamin D and calcium

Question 32

What can result from secondary hyperparathyroidism?

Answer 32

Mild renal failure

Question 33

How is hyperparathyroidism diagnosed?

Answer 33

Hypercalcemia, parathyroid immunoassay

Question 34

What is the most common nonmalignant cause of hypercalcemia?

Answer 34

Hyperparathyroidism

Question 35

In which group is hyperparathyroidism most common?

Answer 35

Post menopausal women

Question 36

In what percentage of cases is hyperparathyroidism asymptomatic?

Answer 36

>50%

Question 37

Hyperparathyroidism results in resorption of what type of bone?

Answer 37

BOTH cortical and trabecular bone

Question 38

When cortical and trabecular bone are resorbed in hyperparathyroidism, what replaces that bone?

Answer 38

Loose connective tissue

Question 39

In what condition can a "brown tumor" result?

Answer 39

Hyperparathyroidism

Question 40

What is a "brown tumor"?

Answer 40

Collection of loose connective tissue filling a space, giving off a bloody appearance (not actually a tumor but a lesion)

Question 41

Renal stones, peptic ulcers, bowing of long bones, and pathological fractures are present with what condition?

Answer 41

Hyperparathyroidism

Question 42

The salt & pepper skull is indicative of what condition?

Answer 42

Hyperparathyroidism

Question 43

What is a condition that produces holes in the skull that can appear similar to the salt and pepper skull seen on X-rays of those with hyperparathyroidism?

Answer 43

Multiple myeloma

Question 44

Rugger-jersey spine is seen on X-rays of those with what condition?

Answer 44

Hyperparathyroidism

Question 45

Bone pain, fractures, deformation, kidney stones, nausea, anorexia, fatigue, and decreased cognition are features of what condition?

Answer 45

Hyperparathyroidism

Question 46

What are possible treatments for hyperparathyroidism?

Answer 46

Drinking water and physical activity, avoidance of diuretics (water pills)

Question 47

Is hyperparathyroidism possibly reversible?

Answer 47

Yes, with normalization of PTH levels

Question 48

Subperiosteal resorption of the radial side of the middle phalanges is unique to what condition?

Answer 48

Hyperparathyroidism

Question 49

What issues in muscle can be seen with hyperparathyroidism?

Answer 49

Weakness, aches, and fasciculations