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83 Cards in this Set
- Front
- Back
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Radiolucency - thinned cortical bone & enlarged medullary cavity
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Osteoporosis
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Risk factors for osteoporosis
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Caucasian
Petite Women |
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S/S osteoporosis
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Easily fx w/ falls (esp. hip)
Compression fx vertebrae |
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Causes of osteoporosis
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Estrogen deficient state
Physical inactivity/bedridden Hypercortisolism Hyperthyroidism Subclinical Ca deficiency |
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Is osteoporosis r/t calcium deficiency?
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No
Osteomalacia is d/t Ca deficiency |
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Who is idiopathic primary osteoporosis seen in?
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Unknown cause
Children & adolescents |
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Who is Type I primary osteoporosis seen in?
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"Postmenopausal osteoporosis"
Women w/i 15 yrs menopause |
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Who is Type II primary osteoporosis seen in?
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"Involutional osteoporosis"
Men & Women > 70 yo |
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Optimal Ca intake
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1000-1500 mg/day
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Tx for osteoporosis
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Wt bearing activity
Ca w/ Vit D HRT (not recommeded) Bisphosphonates |
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Inadequate bone mineralization
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Osteomalacia
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If osteomalacia found in children caused by Vit D deficiency
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Rickets
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Serum findings osteomalacia
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Low CA
Low P High alkaline phosphatase |
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S/S osteomalacia
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Bone pain
Skeletal deformities Freq fx |
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Causes of osteomalacia
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Vit D deficiency
Severe liver dz Anticonvulsant drugs Renal osteodystrophy Fanconi's syndrome Malnutrition/malabsorption |
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Looser's zones seen radiographically in
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Osteomalacia
(radiolucent bands run perpendicular to periosteal surface - pseudofx) |
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Increased, uncontrolled bone turnover (formation > resorption) Formation - disorganized
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Paget's disease of bone
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S/S Paget's disease of bone
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Frontal bossing
Deafness Bony pain Pain 2nd SC & CN compression Vertebral compression fx (kyphosis) Chalkstick fx LE High-output cardiac failure |
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Lab findings of paget's disease of bone
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Extremely high alkaline phosphatase
occ. Hypercalcemia at time of "remission" |
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Radiologic findings of Paget's disease of bone
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Enlarged, thickened bones w/ course, thickened cortices
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1st symptom seen in osteosarcoma
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Pathologic fx
(then - painful, progressively enlarging mass) |
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Age range osteosarcoma
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< 20 yo
Elderly (bimodal) |
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Peak age range ewing's sarcoma
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10-15 yo Caucasian male
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Where do ewing's sarcoma occur typically
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Femer
Flat bones of pelvis |
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S/S Ewing's sarcoma
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PAINFUL
Tender & swollen Fever, anemia, leukocytosis |
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Where in the bone does ewing's sarcoma occur
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Medullary cavity & invades cortex and periosteum
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Histological ewing's sarcoma
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Homer-Wright rosettes
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Lack dystrophin - what disease?
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Duchenne Muscular dystrophy
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1st muscle weakness to occur with DMD
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Pectoral m. --> pelvic girdle
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Onset of DMD
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2-3 yo
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S/S DMD
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Delayed motor milestones
Cognitive impairment + Gower's sign Hypertrophied calves |
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What and cause of death in DMD
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Early 20s
Pneumonia |
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Becker's muscular dystrophy caused by
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Decreased amt dystrophin
Onset 5-15 yo |
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Some things that would make you think brain tumor
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Positional HA
Focal neurologic deficit New-onset seizures |
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80% of ALL adult primary brain tumor
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Fibrillary astrocytoma
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Location w/i brain of fibrillary astrocytoma
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Cerebral hemisphere
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Most common brain tumor of adults
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Glioblastoma multiforme
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Anaplastic, w/ increased nuclear density line up along edges of necrotic regions. Both hemispheres
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Glioblastoma multiforme
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Mean survival from dx of glioblastoma multiforme
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8-10 mos (ALWAYS fatal)
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What ectodermal brain tumor is derived from Rathke's pouch
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Craniopharyngioma
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Most common supratentorial tumor of children
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Craniopharyngioma
(epithelium w/ cystic calcifications) |
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Amenorrhea, galactorrhea, loss of libido, infertility, visual distrubance (bitemporal heteronomous hemianopsia)
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Prolactinoma
(most common, macroadenoma) |
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2nd most common type of pituitary ademoma, can cause either acromegaly or gigantism
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Growth Hormone adenoma
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Cushings disease vs. cushings syndrome
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Dz - adrenal gland hypersecretion of cortisol from corticotroph tumor
Syndrome - anything with hypersecreation of cortisol (SCC lung) |
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Brain gross of alzeheimer's disease
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Widening of cerebral sulci
Enlarged ventricles (decreased neurons in nucleus basalis Meynert) |
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What gene increases the risk for Alzheimer's disease
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ApoE - epsilon 4 allele chrom. 19
(also decreases ago of onset) |
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Deposition of what is seen in alzheimer's disease, congo stain red
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Amyloid protein
(product of processed APP - Chrom 21) |
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Picks disease - cause, sex predilection, histological
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frontotemporal dementia (atrophy)
Female + Pick bodies - histologically |
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S/S Picks disease
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Change in personality
Language problems Then dementia (2-3 yrs to adv. stage) |
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Cause of Parkinson's disease
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Loss of substantia nigra --> locus ceruleus atrophy --> dopamine reduction
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Bradykinesia
Muscle rigidity Resting tremor (pill-rolling) Postural instability/gait abn Fluctuating hallucinations |
Parkinson's disease
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Histological Parkinson's disease
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Lewy bodies
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Cause of most cases of parkinson's disease
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Idiopathic
(von economo's encephalitis, repeat trauma, drugs) |
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Tx Parkinson's disease
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Anticholinergic
COMT inhibitor Dopaminergic agent MAOI |
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What is ALS
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Degeneration of UMN & LMN
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Initial symptoms in ALS
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Asymmetric weakness in hands
(Both LMN & UMN) |
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Genetics in Huntington's disease
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AD
Triple repeats CAG (age of onset dependent on # repeats) |
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Typical age of onset of Huntington's disease
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30-40s
(symptomatic for 15 yrs) |
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S/S Huntington's disease
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Whole-body chreoathetosis --> hypertonicity
Fecal & urinary incontinence Anorexia, wt loss Depression Dementia Death |
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Gross in Huntington's dz
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Degeneration & atrophy caudate, putamen, frontal cortex
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HLA-DR2 a/w what disease
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Multiple Sclerosis
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Cause of MS
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autoimmune demyelinating dz of CNS
(Most common) |
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Age of onset & sex with MS
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20-40 yo
Female |
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MRI in MS - characteristics
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Plaques in white matter around ventricles & optic n.
(myelin breakdown w/ lipid-laden macrophages) |
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Oligoclonal bands found in what disease
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MS
Increased CSF immunoglobulins |
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High risk for MS
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Northern Europeam ancestry
Temperate climate (1st 15 yo of life) |
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S/S MS
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Fatigue
Diplopia Visual loss Vertigo Weakness of m +/- paresis Retrobulbar pain Sensory disturbances Detrusor hyperreflexia Babinski sign Increased DTRs Lhermitte's sign |
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Charcot's triad for MS
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Nystagmus
Intention tremor Scanning speech |
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Tx for MS
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Glatiramer
Interferon beta Natalizumab |
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Cause of Guillain-Barre
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Virus - influenza
Immunization Campylobacter gastroenteritis |
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What is Guillian-Barre
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Demyelination of peripheral n.
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S/S Guillian-Barre
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Ascending m. weakness +/- ascending sensory loss
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CSF sample in Guillian-Barre
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Albumino-cytologic dissociation
(a lot of protein w/ only mild increase in cells) |
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Cause of Subacute combined degeneration
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Vit B12 deficiency
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What is subacute combined degeneration
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Demyelination & eventual destruction of SC posterior columns
Later, destruction of corticospinal tract |
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S/S subacute combined degeneration
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Distal paresthesia, then weak, unsteady gait +/- megaloblastic anemia
Progresses to spastic weakness of legs Eventually paraplegia |
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S/S alcohol WD
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Seizures
Hallucinations DTs - deadly, complete loss of autonomic NS control |
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S/S hepatic encephalopathy seen in alcoholics
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Acute confusion & asterixis (wrist flap)
(caused by increased ammonia, bowel toxins) |
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S/S Wernicke's syndrome
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Ophthalmoplegia
Confusion (confabulation) Ataxia (focal hemorrhage & necrosis mammillary bodies) |
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Cause of Wernicke's syndrome
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Severe B1 (thiamine deficiency)
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Cause of Korsakoff's syndrome
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Macrophage accumulation at hemorrhage sites (from wernickes)
Leads to open cysts in brain lined w/ hemosiderin-laden macrophages |
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S/S Korsakoff's syndrome
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Severe psychosis
Dementia |
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Cause Marchiafava-Bignami disease
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Large consumption Red wine
(frontal lobe dementia d/t degeneration corpus callosum) |
