Skeletal System

Question 0

idiopathic avascular osteonecrosis of the epiphysis of the femoral head, leading to an interruption of the blood supply of the head of the femur close to the hip joint

Answer 0

Legg-Calve-Perthes syndrome

Question 1

Genetic bone disorder in which people are born with defective connective tissue due to a deficiency of normal type-1 collagen

Answer 1

Osteogenesis imperfecta

Question 2

softening of the bones in children, potentially leading to fractures and deformity

Answer 2

Rickets

Question 3

one of the most frequent dz in many developing countries

Answer 3

rickets

Question 4

dz characterized by low bone mass and structural deterioration of bone tissue

Answer 4

osteoporosis

Question 5

osteoporosis may occur as a result of … or as a result of a more …

Answer 5

generalized loss of bone mass; localized process i.e. casted limb

Question 6

What can result in accelerated osteoporosis?

Answer 6

underlying malabsorption d/o, hyperthyroidism, hyperparathyroidism

Question 7

What leads to bone fragility and increased susceptibility to fractures in osteoporosis?

Answer 7

increased porous nature of osteoporotic bone

Question 8

Main class of d/o’s leading to secondary osteoporosis

Answer 8

endocrine

Question 9

Exaggerated curvature of the spine that results in a rounded or hunched back

Answer 9

kyphosis

Question 10

Kyphosis is commonly seen in pts with osteoporosis due to…

Answer 10

compression fractures of vertebrae

Question 11

aka osteitis deformans

Answer 11

Paget’s dz of bone

Question 12

High bone turnover with accelerated osteoclast and osteoblast activity

Answer 12

Paget’s dz of bone

Question 13

End result of Paget’s dz of bone

Answer 13

Increased calcification of bone

Question 14

Paget’s dz of bone has a predilection for what?

Answer 14

increased bone deposition in the skull, pelvis, tibia, and femur

Question 15

What is elevated in Paget’s dz of bone?

Answer 15

serum alkaline phosphatase

Question 16

mosaic pattern of lamellar bone which is likened in appearance to a jigsaw puzzle

Answer 16

Paget dz of bone

Question 17

Pathognomonic of Paget dz

Answer 17

mosaic pattern of lamellar bone

Question 18

Osteopetrosis presents … while Paget dz most commonly develops …

Answer 18

at birth; 4th decade of life

Question 19

Paget dz is most common in what population?

Answer 19

Caucasian males

Question 20

Pts with Paget dz have an inc risk for what?

Answer 20

malignant neoplasms (osteosarcoma in the area of abnormal bone growth)

Question 21

Cotton ball appearance

Answer 21

Paget dz

Question 22

15% of cases of Paget dz affect … and 85% affect

Answer 22

one bone; multiple bones

Question 23

widened bone with course trabecular marking is characteristic of

Answer 23

Paget dz

Question 24

bones afflicted with Paget dz are ... fractures

Answer 24

linear

Question 25

rare inherited d/o whereby the bones harden and become more dense

Answer 25

osteopetrosis

Question 26

infxn of the bone or bone marrow

Answer 26

osteomyelitis

Question 27

term used to describe collectively all of the skeletal changes of chronic renal dz

Answer 27

Renal osteodystrophy

Question 28

What are (4) changes of renal osteodystrophy?

Answer 28

inc osteoclastic bone resorption, osteomalacia, osteosclerosis, osteoporosis

Question 29

Children with renal osteodystrophy are at an inc risk for

Answer 29

rickets

Question 30

3 conditions associated with renal osteodystrophy

Answer 30

inadequate kidney function, secondary hyperparathyroidism, altered vit D metabolism

Question 31

Some of the most common pathologic conditions affecting bone

Answer 31

fractures

Question 32

fractures are classified as ... when the overlying tissue is intact

Answer 32

simple (closed)

Question 33

fractures are classified as ... when the fracture site communicates with the skin surface

Answer 33

compound (open)

Question 34

a fracture is ... when the ends of the bone at the fracture site are not aligned

Answer 34

displaced

Question 35

a fracture is called ... when the bone is splintered or crushed

Answer 35

comminuted

Question 36

If the break occurs in bone already altered by a disease process, it is described as

Answer 36

a pathologic fracture

Question 37

A ... is a slowly developing fracture that follows a period of increased physical activity in which the bone is subjected to repetitive loads

Answer 37

stress fracture

Question 38

Where do solitary bone cysts predominantly occur?

Answer 38

distal ends of long bones (femur and humerus)

Question 39

In which population are solitary bone cysts most common?

Answer 39

10-20yo male

Question 40

smooth, thin cortex in close proximity to the epiphysis on x-ray

Answer 40

solitary bone cyst

Question 41

symmetrical, bone diameter may be increased, cavity filled with clear or bloody fluid, no specific microscopic features

Answer 41

solitary bone cyst

Question 42

recurrence of solitary bone cyst is (common/uncommon)

Answer 42

uncommon

Question 43

Where do aneurysmal bone cysts most often occur?

Answer 43

metaphysis of the long bones and vertebrae

Question 44

Most frequent population for aneurysmal bone cysts

Answer 44

20-30yo females

Question 45

honey-combed appearance on x-ray

Answer 45

aneurysmal bone cysts

Question 46

distortion of bone and less symmetry to its shape

Answer 46

aneurysmal bone cysts

Question 47

Must be differentiated from osteosarcoma

Answer 47

Aneurysmal bone cysts

Question 48

recurrence of aneurysmal bone cysts (common/uncommon)

Answer 48

common (20-25%)

Question 49

expansion of the cortex and "honey-combed" appearance

Answer 49

aneurysmal bone cyst

Question 50

5 most common bone tumors

Answer 50

osteoid osteoma, osteosarcoma, Ewing sarcoma, multiple myeloma, metastatic lesions

Question 51

Osteoid osteoma is (benign/malignant)

Answer 51

benign

Question 52

small area of neoplastic tissue surrounded by wide zone of mature, reactive bone

Answer 52

osteoid osteoma

Question 53

Most osteoid osteomas are (solitary/mutliple)

Answer 53

solitary

Question 54

Multiple osteoid osteomas are seen in children with which syndrome?

Answer 54

Gardner syndrome

Question 55

Most common population for osteoid osteomas

Answer 55

children and young adults

Question 56

on x-ray: small, well circumscribed lesion which is round or oval, located in or near the cortex and surrounded by densely sclerotic bone

Answer 56

osteoid osteoma

Question 57

Lesion may have radio-lucent and radio-opaque aspects

Answer 57

osteoid osteoma

Question 58

grossly: area of gritty, cherry red tissue, surrounded by dense sclerotic bone

Answer 58

osteoid osteoma

Question 59

Where are osteoid osteomas usually located?

Answer 59

in or near the cortical area of a bone. Sometimes medullary area

Question 60

Microscopically: nidus is composed of narrow trabeculae of osteoid or newly formed bone produced by osteoblasts in richly vascularized parenchyma, surrounded by wide trabeculae and sclerotic bone

Answer 60

osteoid osteoma

Question 61

primary malignant tumor of bone

Answer 61

osteosarcoma

Question 62

Osteosarcomas represent approx. what percentage of all primary bone cancers?

Answer 62

20%

Question 63

75% osteosarcoma patients are what group?

Answer 63

children under 20

Question 64

Third most common malignancy in adolescents, after leukemia and lymphoma

Answer 64

osteosarcoma

Question 65

Osteosarcoma is more common in elderly pts with underlying

Answer 65

Paget dz of bone

Question 66

x-ray variable with combination of bone destruction and bone formation

Answer 66

osteosarcoma

Question 67

3 main types of osteosarcoma and percentages

Answer 67

25% lytic, 35% sclerotic, 40% mixed

Question 68

radio-lucency and radio-opacities and spicules of calcium in the soft tissue

Answer 68

osteosarcoma

Question 69

aggressive, rapid growth with high risk of local spread. May metastasize as "skip" lesions within the bone

Answer 69

osteosarcoma

Question 70

Early pulmonary metastasis is common

Answer 70

osteosarcoma

Question 71

Atypical cells with large nuclei and small amt of cytoplast and osteoid formation

Answer 71

osteosarcoma

Question 72

uncommon bone tumor usu found around knee in either distal femur and/or proximal tibia

Answer 72

fibrosarcoma

Question 73

Fibrosarcoma produces ... but not...

Answer 73

collagen matrix; osteoid or chondroid

Question 74

Fibrosarcoma may be primary or arise in what conditions?

Answer 74

Paget dz, chronic osteomyelitis, prior bone infarct, bone irridation

Question 75

sheets of spindle shaped cells

Answer 75

fibrosarcoma

Question 76

Tumor of adulthood, most common in 30yo

Answer 76

Giant cell tumor

Question 77

Oval tumor cells and multinucleated tumor cells uniformly distributed throughout

Answer 77

giant cell tumor

Question 78

causes cortical erosion and thinning, which expands the bone contours without a border of new bone formation and sclerosis

Answer 78

giant cell tumor

Question 79

nonsclerotic but well defined

Answer 79

giant cell tumor

Question 80

small, rounded cells that are uniform in size and densely packed

Answer 80

Ewing sarcoma

Question 81

Males, average age 13-14

Answer 81

Ewing sarcoma

Question 82

uniform, densely packed, tumor cells with a single, round or oval nucleus, indistinct cellular borders with a size and appearance somewhat resembling lymphocytes

Answer 82

Ewing sarcoma

Question 83

mottled, "moth eaten" destructive lesion

Answer 83

Ewing sarcoma

Question 84

commonly infiltrates the medullary cavity and penetrates through the cortex

Answer 84

Ewing sarcoma

Question 85

malignant dz of plasma cells in the bone marrow

Answer 85

Multiple myeloma

Question 86

monoclonal overgrowth of one clone of plasma cells occurs which produces monoclonal immunoglobulin or paraprotein

Answer 86

multiple myeloma

Question 87

In adults, 75% of skeletal metastasis originate from which cancers?

Answer 87

breast, prostate, kidney, lung

Question 88

In children, bone metastasis most commonly originate from which cancers?

Answer 88

Wilm's tumor, neuroblastoma, osteosarcoma, Ewing sarcoma

Question 89

Skeletal metastasis are typically (multifocal/focal)

Answer 89

multifocal

Question 90

Boney metastasis may appear as lytic, blastic, or mixed

Answer 90

metastatic breast cancer

Question 91

ivory vertebra sign

Answer 91

metastatic breast cancer or Paget dz

Question 92

3 primary ways to contract osteomyelitis

Answer 92

blood stream infxn, contiguous infxn (cellulitis), direct infxn (trauma)