P4 PATHOLOGY

Question 1

death of bone & BM due to interference of blood supply & absence of infection is known as

Answer 1

Aseptic / avascular bone necrosis

Question 2

mention at least 4 causes of osteonecrosis

Answer 2

1- emboli
2- systemic diseases
3- radiation
4- trauma
5- corticosteroids
6- idiopathic factors
7- specific focal bone necrosis
8- thrombosis

Question 3

mention the 2 types of specific focal bone necrosis

Answer 3

• legg-calve-perthes disease
• Kohler disease

Question 4

Necrosis of navicular bone is seen in which disease

Answer 4

Kohler disease

Question 5

legg-calve-perthes disease location

Answer 5

femoral head

Question 6

legg-calve-perthes disease age group

Answer 6

children

Question 7

type of detachment seen in the shown coronal section of femoral head

Answer 7

partial detachment

Question 8

type of detachment seen in the shown coronal section of femoral head

Answer 8

Complete detachment

Question 9

in shown histology of femoral head
Describe what is seen

Answer 9

normal mature trabeculae of cancellous bone evenly distributed osteocytes

Question 10

in shown histology of femoral head
Describe what is seen

Answer 10

Necrotic bone with empty lacunae & necrotic BM spaces showing dystrophic calcification

Question 11

healing of necrotic cortical bone by

Answer 11

cutting cones / needles

Question 12

healing of necrotic cancellous bone is by

Answer 12

creeping substitution

Question 13

a metabolic bone disease characterised by diffuse lesions with reduced mineralised bone mass is known as

Answer 13

Osteoporosis

Question 14

Osteoporosis mostly are seen at ( location )

Answer 14

Cancellous bones of vertebrae , ribs . Pelvis , end of long bones

Question 15

balance of activity of osteoblasts , osteocytes & osteoclasts is known as

Answer 15

Remodelling

Question 16

accretion , deposition , bone formation , osteoblastic bone lesions are all activities of

Answer 16

osteoblasts

Question 17

resorption , rarefaction , osteopenia , bone removal , bone loss & lytic lesions are all activities of

Answer 17

osteoclasts

Question 18

gross pictures of osteoporosis case
Describe what is seen

Answer 18

• changes in size , shape , architecture of vertebral bodies
• biconcave deformity
  -protrusion / herniation of IVD into vertebrae
• fracture collapse
• micro-architectural deterioration

Question 19

State whether the shown gross image is normal / abnormal vertebral body

Answer 19

normal

Question 20

gross pictures of osteoporosis case
Describe what is seen

Answer 20

• shorten vertebra due to multiple compression fractures
  -biconcave deformity
• loss of horizontal trabeculae
• thickened vertical trabeculae

Question 21

Showing vertebral osteoporosis
Describe what is seen

Answer 21

Thinning of trabeculae & loss of intertrabecular connections on bone

Question 22

in the shown histology of osteoporosis case
Describe what is seen

Answer 22

• lamellar bone trabeculae reduced in size & thickness
• loss of interconnection

Question 23

Physiological osteoporosis is seen in

Answer 23

senile patients
post menopausal ladies

Question 24

type of fractures seen in pathological osteoporosis

Answer 24

• vertebral crush / compression fracture
• distal radius ( colle’s )
• femur - neck fracture
• neck of humerus

Question 25

type 1 osteoporosis ( post menopausal ) is due to

Answer 25

Increased activity of osteoclasts due to decreased oestrogen

Question 26

age group of type 2 primary (senile ) osteoporosis

Answer 26

above the age of 70

Question 27

most common cause of 2ndry osteoporosis

Answer 27

Corticosteroids

Question 28

effect of corticosteroids on osteoblastic activity

Answer 28

Inhibit their activity

Question 29

Effect of hyperparathyroidism on osteoclast activity

Answer 29

Increase their activity > secondary osteoporosis

Question 30

Effect of hyperthyroidism on osteoclast activity

Answer 30

Increase osteoblastic activity > increased bone turnover

Question 31

Genetic syndrome seen in males leading to 2ndry osteoporosis

Answer 31

klienfelter syndrome

Question 32

Genetic syndrome seen in females leading to 2ndry osteoporosis

Answer 32

Turner syndrome

Question 33

cancers of thyroid , GIT , kidney & neuroblastomas produce lytic lesions by stimulating what cells

Answer 33

osteoclasts

Question 34

cancers of prostate , stomach , breast & lungs causes bone Formation by stimulating what cells

Answer 34

Osteoblasts

Question 35

small cell carcinoma of the lung causing secondary osteoporosis is seen in what syndrome

Answer 35

paraneoplastic syndrome

Question 36

Direct inhibitor of osteoblasts & calcium absorption

Answer 36

alcohol