Week 5 Bone Pathology- Witrak Flashcards Preview

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Flashcards in Week 5 Bone Pathology- Witrak Deck (36):
1

Define osteopenia

Generalized decrease in bone mineralization

2

What is a pathological fracture?

fracture through a diseased bone- usually refers to fracture through tumorous or tumor-like bone

3

What molecule is required for MINERALIZATION of bone osteoid?

Vit D(OH)2

4

What do you need for healthy bone?

-Ca, P from diet
-Vit D
-good absorption in gut
-Healthy kidney
-Parathyroid functioning

5

Why is the parathyroid important?

It is the master gland for Ca regulation and bone metabolism

6

What is osteoporosis?

A type of osteopenia due to bone atrophy caused by an imbalance of the bone remodeling process

7

Who is likely to have osteoporosis?

POSTMENOPAUSAL/ SENILE women

8

What happens to PTH secretion in osteoporosis?

Diminished PTH secretion by parathyroid glands in response to hypocalcemic stimulus.

9

What is the difference between secondary and common osteoporosis?

Secondary = often more treatable/ reversible causes (ex. hyperthyroidism).

Common = everything else, if its not secondary.

10

Best prevention of osteoporosis? Predictor of risk?

-maximize peak bone mass while teen/young adult
-encourage weight bearing exercise and Ca supplementation

-Maternal hip fracture = strong predictor of risk

11

Who do anit-osteoporosis medications work?

Inhibit bone resorption

12

Is there a biochemical serum marker of bone formation and resorption?

NO! Not sufficiently standardized or studied

13

What is primary hyperparathyroidism?

Hypercalcemia due to primary hyperlasia or neoplastic enlargement of parathyroid glands

-spectrum of bony changes!

14

What is osteomalacia?

Decreased bone mineralization with excess osteoid due to interference with Ca, P, or Vit D metabolism

-Radiologically appears osteopenic
-may present with diffuse skeletal pain

15

What is a common cause of osteomalacia?

Liver or renal disease (impaired hydroxylation of Vit D)

16

What is osteomyelitis?

Infection of bone

Can be:
Primary- from blood
Secondary- from other joint or soft tissue infection
Direct- compound fractures

17

Most common cause of osteomyelitis?

Staph. Aureus
If sickel-cell then salmonella

18

Clinical presentation of osteomyelitis?

Bone pain
erythema
swelling
fever/chills variable

19

Best way to detect osteomyelitis?

bone scans/MRI scans better at early detection

20

What is often associated with osteomyelitis in adults?

diabetic vascular disease

21

Treatment for osteomyelitis?

AGGRESSIVE IV antibiotic therapy

22

What is avascular bone necrosis/ infarction?

Bone infarcts due to ischemia of varring/often poorly understood causations

23

Most common cause of avascular bone necrosis?

Prolonged Cortiocosteroid therapy

24

What is Paget's disease?

Deforming bone disease of middle-aged to elderly adults

-latent viral infection of osteoclasts in a genetically susceptible person

25

What are the three phases of paget's disease?

-Lytic (inc. osteoclast with bone resorption, increased vascularity)
-Mixed (inc. osteoclast and osteoblasts, increased vascularity)
-Sclerotic- (osteoblastic phase, most characteristic radiologically)

26

Clinical findings of Paget's disease?

Usually asymptomatic
but may see WIDENING/bowing of long bones, general WEAKENING of affected bone, causing more fractures

27

Biochemcial give-away of Paget's?

increased serum alkaline phosphatase (sign of bone break down) typical for active disease with normal serum calcium

28

Osteogenesis imperfecta?

Congenital disorders of type 1 collagen
-abnormal or not enough
-insufficient/inadequate collagen for normal osteoid production
-results in varying degrees of osteopenia/osteoporosis

29

Classifications of bone tumors by x-rays

Osteolytic- demineralizing effect
Osteoblastic- increased bone density relative to normal bone
Mixed

30

What would you think of if you saw purely osteolytic lesions?

Myeloma
Plasmacytoma

31

Leukemia

By definition always affects bone marrow

32

Where do tumors usually arise in long bones?

metaphyses

33

Most common primary malignant tumor of children/ young adults?

Osteosarcoma

34

Most common primary malignant tumor of middle-aged/oder adults?

Chondrosarcoma

35

What is fibroma?

benign developmental defect
most common bone lesion
Found in 1/3 of children

36

Ewing's sarcoma

most leathal primary bone tumor