Musculoskeletal System Flashcards by isabelle courtney

Achondroplasia

Pathology:

Symptoms/Signs:

Causes:

Path:
Impaired cartilage proliferation in the growth plates of lone bones (Dwarfism)

Signs:
1) Short extremities & normal head/chest (poor endochondral growth)

Causes:
FGFR3 mutation (overexpression)

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Path:
Impaired cartilage proliferation in the growth plates of lone bones (Dwarfism)

Signs:
1) Short extremities & normal head/chest (poor endochondral growth)

Causes:
FGFR3 mutation (overexpression)

Achondroplasia

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Osteogenesis imperfecta

Pathology/cause:

Symptoms/Signs:

Path:
Defective bone resorption due to deficient type 1 collage synthesis

Signs:
1) Multiple fractures
2) Blue sclera
3) Hearing loss

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Path:
Defective bone resorption due to deficient type 1 collage synthesis

Signs:
1) Multiple fractures
2) Blue sclera
3) Hearing loss

Osteogenesis imperfecta

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Osteopetrosis

Pathology:

Symptoms/Signs:

Causes:

Treatments:

Path:
Defective bone resorption causing abnormally thick bones

Signs:
1) Fractures
2) Anemia/Thrombocytopenia/Leukopenia with extramedullary hematopoiesis
3) Vision/Hearing loss
4) Hydrocephalus
5) Renal tubular acidosis

Causes:
Carbonic anhydrase mutation (osteoclast dysfunction)

Treatment:
Bone transplant

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Path:
Defective bone resorption causing abnormally thick bones

Signs:
1) Fractures
2) Anemia/Thrombocytopenia/Leukopenia with extramedullary hematopoiesis
3) Vision/Hearing loss
4) Hydrocephalus
5) Renal tubular acidosis

Causes:
Carbonic anhydrase mutation (osteoclast dysfunction)

Treatment:
Bone transplant

Osteopetrosis

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Rickets

Pathology:

Symptoms/Signs:

Cause:

Path:
Abnormal bone mineralization in children (<1yrs)

Signs:
1) Pigeon chest
2) Frontal bossing (enlarged forehead)
3) Rachitic rosary
4) Bowed legs

Cause:
Vit D deficiency in kids

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Path:
Abnormal bone mineralization in children (<1yrs)

Signs:
1) Pigeon chest
2) Frontal bossing (enlarged forehead)
3) Rachitic rosary
4) Bowed legs

Cause:
Vit D deficiency in kids

Rickets

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Osteomalacia

Pathology:

Symptoms/Signs:

Cause:

Labs:

Path:
Inadequate bone mineralization in adults

Signs:
1) Fractures

Cause:
Vit D deficiency in adults

Labs:
Low serum Ca2+ & PO4-
High PTH & Alkaline phosphatase

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Path:
Inadequate bone mineralization in adults

Signs:
1) Fractures

Cause:
Vit D deficiency in adults

Labs:
Low serum Ca2+ & PO4-
High PTH & Alkaline phosphatase

Osteomalacia

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OsteoPOROSIS

Pathology:

Symptoms/Signs:

Cause:

Labs:

Treatment:

Avoid ________

Path:
Trabecular bone loss (porous bones)

Signs:
1) Bone pain & fractures in weight bearing areas (spine/hips etc)
2) Shortened height & Kyphosis

Causes:
1) Genetics (vit D receptor variants)
2) Diet (vit D deficiency)
3) Sedentary

Labs:
Low bone density (DEXA scan)
Normal serum Ca2+, PO4-, & Alkaline phosphatase

Treatment:
Exercise
Vit D & Ca2+ sup
Bisphosphates
Estrogen replacement

AVOID Glucocorticoids

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Path:
Trabecular bone loss (porous bones)

Signs:
1) Bone pain & fractures in weight bearing areas (spine/hips etc)
2) Shortened height & Kyphosis

Causes:
1) Genetics (vit D receptor variants)
2) Diet (vit D deficiency)
3) Sedentary

Labs:
Low bone density (DEXA scan)
Normal serum Ca2+, PO4-, & Alkaline phosphatase

Treatment:
Exercise
Vit D & Ca2+ sup
Bisphosphates
Estrogen replacement

AVOID Glucocorticoids

Osteoporosis

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Paget’s disease of the bone

Pathology:

Symptoms/Signs:

Treatments:

Complications:

Path:
Osteoclast & osteoblast imbalance localized to one or more bones occurring in stages:
1) Osteoclastic
2) Mixed
3) Osteoblastic
Results in thick/sclerotic bones that fracture easily

Signs:
1) Bone pain
2) Bigger hat size
3) Hearing loss
4) Lion-facies

Treatments:
1) Calcitonin (inhibit osteoclasts)
2) Bisphosphates (osteoclast apoptosis)

Complication:
1) High-out out cardiac failure (AV shunts in bone)
2) Osteosarcoma

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Path:
Osteoclast & osteoblast imbalance localized to one or more bones occurring in stages:
1) Osteoclastic
2) Mixed
3) Osteoblastic
Results in thick/sclerotic bones that fracture easily

Signs:
1) Bone pain
2) Bigger hat size
3) Hearing loss
4) Lion-facies

Treatments:
1) Calcitonin (inhibit osteoclasts)
2) Bisphosphates (osteoclast apoptosis)

Complication:
1) High-out out cardiac failure (AV shunts in bone)
2) Osteosarcoma

Paget’s disease of the bone

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Osteomyelitis

Pathology:

Symptoms/Signs:

Cause:

Diagnostic tests:

Path:
Systemic bone marrow infection with hematogenous spread

Signs:
1) Bone pain & Fever/Leukocytosis
2) Sequestration/Lytic focus (abscess)
3) Involucrum/Sclerosis

Causes:
1) S. aureus (main)
2) N. gonorrhea (sexually +ve adults)
3) Salmonella (sickle-cell)
4) Pseudomonas (diabetes/IV drug abuse)
5) Pasteurella (cat/dog scratches)
6) M. tuberculosis (Pott disease)

Tests:
Blood cultures

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Path:
Systemic bone marrow infection with hematogenous spread

Signs:
1) Bone pain & Fever/Leukocytosis
2) Sequestration/Lytic focus (abscess)
3) Involucrum/Sclerosis

Tests:
Blood cultures

Osteomyelitis

“SMelly Socks Need ProPer washing”

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Avascular/Aseptic necrosis

Pathology:

Cause:

Complications:

Path:
Ischemic necrosis of bone & marrow

Causes:
1) Trauma/Fracture (main)
2) Steroids
3) Sickle cell
4) Caissons disease

Complications
Osteoarthritis & fractures

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Path:
Ischemic necrosis of bone & marrow

Causes:
1) Trauma/Fracture (main)
2) Steroids
3) Sickle cell
4) Caissons disease

Complications
Osteoarthritis & fractures

Avascular/Aseptic necrosis

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Osteoma

Pathology:

Associated condition:

Path:
Benign facial bone tumor

Ass:
Gardeners syndrome

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Path:
Benign facial bone tumor

Ass:
Gardeners syndrome

Osteoma

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Osteoid Osteoma

Pathology:

Symptoms/Signs:

Diagnostic tests:

Path:
Benign osteoblast tumor of the cortex of long bones in young adults (men)

Signs:
1) Bone pain (relieved by aspirin)

Tests:
Boney mass <2cm with a radiolucent core (osteoid)

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Path:
Benign osteoblast tumor of the cortex of long bones in young adults (men)

Signs:
1) Bone pain (relieved by aspirin)

Tests:
Boney mass <2cm with a radiolucent core (osteoid)

Osteoid Osteoma

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Osteochondroma

Pathology:

Histological findings:

Complications:

Path:
Bone tumor with a cartilage cap that arises in the metaphysis

Histo:
Bone is continuous with marrow space

Complication:
Cartilage cap rarely transforms into a chondrosarcoma

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Path:
Bone tumor with a cartilage cap that arises in the metaphysis

Histo:
Bone is continuous with marrow space

Complication:
Cartilage cap rarely transforms into a chondrosarcoma

Osteochondroma

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Osteosarcoma Pathology: Symptoms/Signs: Cause/Risk: Tests/Histology:

Path: Malignant Osteoblastic tumor in teens that arises in long bone metaphysis (distal femur or proximal tibia) Signs: 1) Fractures 2) Bone pain & swelling Cause/risk: Familial retinoblastoma or Paget's disease Histo/tests: 1) Destructive mass with a sunburst app & lifted periosteum 2) Pleomorphic cells (make osteoid)

Osteosarcoma

Giant cell tumor Pathology: Diagnostic tests/Histology: Complication:

Path: A locally aggressive multinucleated GC & Stromal tumor in the epiphyses of long bones (dist. femur & prox. tibia) in young adults Test/Histo: Soap bubble X-ray Complication: Reoccurrence

Giant cell tumor

Ewing sarcoma Pathology: Diagnostic tests: Complication:

Path: Malignant poorly differentiated neuroectoderm tumor in the diaphysis of long bones in male children under 15yrs Tests: 1) Onion skin X-ray 2) Round blue cells 3) 11;22 Translocation Complication: Metastasis

Ewing sarcoma

Chondroma Pathology:

Path: Benign cartilage tumor in medulla of small bones of the hands/feet

Chondroma

Chondrosarcoma Pathology:

Path: Malignant cartilage tumor in the medulla of the pelvis & central skeleton

Chondrosarcoma

Metastatic bone tumor Pathology:

Path: Osteolytic (punched-out) lesions usually from colon cancer metastasis

Metastatic bone tumor

Osteoarthritis Pathology: Causes: Symptoms/Signs:

Path: Progressive degeneration of articular cartilage in a limited number of joints (oligoarticular) Cause: 1) Wear & Tear (age, obesity, & trauma) Signs: 1) Joint stiffness that worsens throughout the day 2) Disrupted cartilage lining the articular surface & joint mice (floating cartilage) 3) Eburnation of subchondral bone 4) Osteophytes (reactive bony growths in the DIP (Heberden nodes) & PIP (Bouchard nodes)

Osteoarthritis

Rheumatoid arthritis Pathology: Symptoms/Signs: Cause: Labs/Histological findings: Complications:

Path: Autoimmune destruction of cartilage (entire skeleton EXCEPT DIP) Cause: HLA-DR4 gene (middle-aged women) Labs/Histo: 1) IgM vs Fc part of IgG 2) Neutrophils & high protein in synovial fluid 3) Pannus (synovitis causing inflamed granulation tissue) 4) Narrowed joint spaces & fusion 5) Osteopenia Complications: Anemia of chronic disease & secondary amyloidosis

Rheumatoid arthritis

Ankylosing spondylarthritis Pathology: Symptoms/Signs: Causes: Complication:

Path: Arthritis-like involvement of the sacroiliac joints & spine in young men Signs: 1) Lower back pain 2) Bamboo spine (vertebra fusion) 3) Uveitis 3) Aortitis Causes: Lacking a rheumatoid factor HLA-B27 association Complication: Aortic regurgitation

Ankylosing spondylarthritis

Reiter syndrome Pathology: Symptoms/Signs: Cause:

Path: Arthritic-like signs weeks following a Gi or Chlamydia trachomatis infection in young men Sigs: 1) Arthritis 2) Urethritis 3) Conjunctivitis Causes: Lacking a rheumatoid factor HLA-B27 association

Reiter syndrome

Psoriatic arthritis Pathology: Symptoms/Signs: Cause:

Path: Arthritic-signs in 10% of psoriasis cases Signs: 1) Sausage-like fingers/toes Causes: Lacking a rheumatoid factor HLA-B27 association

Psoriatic arthritis

Infectious arthritis Pathology: Symptoms/Signs: Causes:

Path: Infection of a joint (knee) Signs: 1) Warmth/redness 2) Limited ROM 3) Fever/High WBC & ESR Causes: 1) N. gonorrhea (young adults #1) 2) S. aureus (older children & adults #2)

Infectious arthritis

Pseudogout Pathology: Symptoms/Signs: Labs/Histological findings:

Path: Deposition of CPPD (Ca2+ pyrophosphate dihydrate) into joints/tissues Signs: 1) Gout Labs/Histo: Rhomboid-crystals with weakly +ve birefringent under polarized light

Pseudogout

Chronic gout Pathology: Symptoms/Signs: Labs/Histological findings:

Path: Long-term deposition of monosodium urate crystals in joints/tissues Signs: 1) Renal failure (urate nephropathy) 2) signs of gout Labs/Histo: 1) Hyperuricemia 2) Needle-crystal with -ve birefringent under polarized light 3) Tophi (chalky-white uric acid crystals)

Chronic gout

Primary gout Pathology: Labs:

Path: Deposition of monophosphate urate crystals in joints/tissues due to ideological hyperuricemia Labs: Hyperuricemia & needle-crystals with -ve birefringent under polarized light

Primary gout

Secondary Gout Pathology: Symptoms/Signs: Causes: Labs/Histological findings:

Path: Deposition of monosodium urate crystals in the joints/tissues due to another condition Signs: 1) SUPER painful big toe (podagra) (avoid alcohol & meat!) Causes: 1) Leukemia & myeloproliferative disorder (increase cell turnover) 2) Lesch-Nyhan syndrome (def HGPRT resulting hyperuricemia, self-mutilation, & retardation 3) Renal insufficiency Labs/Histo: 1) Needle-shaped crystals with -ve birefringent under polarized light 2) Hyperuricemia

Secondary Gout

Dermatomyositis Pathology: Symptoms/Signs: Cause: Lab/Histological findings: Treatment:

Path: Inflammation of the skin & muscles Signs: 1) Bilateral proximal muscle weakness 2) Heliotrope rash (upper lids) 3) Grotton lesions (red papules on elbows/knuckles/knees) Cause: Ass with gastric carcinoma Labs/Histo: 1) High CK 2) +ve ANA cells 3) +ve Anti-Jo-1 Antibodies 4) Perimysial inflammation (CD4+T) 5) Perivascular trophy (CD8+T) Corticosteroids

Dermatomyositis

Polymyositis Pathology: Lab/Histological findings:

Path: Inflammation of skeletal muscles (ONLY) Labs/Histo: 1) Endomysial inflammation (CD8+T) with necrotic muscle fibers

Polymyositis

X-linked muscular dystrophy Pathology: Cause:

Path: Muscle wasting & replacement with fat Cause: Mutated dystrophin

X-linked muscular dystrophy

Duchenne muscular dystrophy Pathology: Symptoms/Signs: Cause:

Path: Proximal muscle weakness in 1 yr olds Signs: 1) Calf pseudohypertrophy 2) Cardiorespiratory failure (Death) Cause: Deleted dystrophin

Duchenne muscular dystrophy

Becker muscular dystrophy Pathology/Cause:

Path/Cause: A milder condition due to mutated dystrophin

Becker muscular dystrophy

Myasthenia gravis Pathology: Symptoms/Signs: Associated condition: Treatments:

Path: Autoantibodies vs post synaptic Ach receptors in the NMJ Signs: 1) Muscle weakness (worse with use) 2) Ptosis & Diplopia Ass: Thymic hyperplasia or thymoma Treatments: AchE agents or Thymectomy

Myasthenia gravis

Lambert-Eaton syndrome Pathology: Symptoms/Signs: Cause: Treatment

Path: Autoantibodies vs presynaptic Ca2+ channels in the NMJ (inhibiting Ach release) Signs: 1) Proximal muscle weakness (better with use) Cause: SCLC Treatment: Resecting the cancer (AchE doesn't help)

Lambert-Eaton syndrome

Lipoma Pathology:

Path: Benign fat tumor in adults

Liposarcoma Pathology/Histology:

Path/Histo: Malignant fat tumor inn adults with lipoblast cells

Liposarcoma

Rhabdomyoma Pathology: Labs/Histological findings:

Path: Malignant skeletal muscle tumor in children Labs/Histo: 1) Tumor in the head, neck, or vagina 2) Rhabdomyoblast cells that are desmin +ve

Rhabdomyoma

Musculoskeletal System Flashcards

Pathoma MS Chp 18 (75 cards)