Bone Pathology Cu Dental

Front 1

Develpomental bone disorders include achondroplasia, osteogenesis imperfecta and ________.

Back 1

osteopetrosis

Front 2

Achondroplasia cuases dwarfism, a defect in endochondral ossification. It is autosomal dominant and caused by a mutation in ________, a gene coding for collagen.

Back 2

FGFR3

Front 3

Why are flat bones (eg. Calvarium) not affected by achondroplasia?

Back 3

flat = intramembranous not endochondal ossification

Front 4

This bone disease is a genetic defect of type __ collagen resulting in fragile bones, blue sclera, floppy mitral valve and dentinogenesis imperfecta.

Back 4

1, Osteogenesis imperfecta

Front 5

Of the four types of osteogenesis imperfecta type __ is most common and type ___ is lethal.

Back 5

1,2

Front 6

Osteopetrosis is a defect in _________ function resulting in defective bone remodeling causing dense, weak and painful bones. Bone marrow transplants result in normal function of these cells,

Back 6

osteoclast

Front 7

________ can be pyogenic (staph aureus) or tuberculous (of the spine - Pott's disease), and forms "islands of necrotic bone" (sequestrum) normally found at the ______ of long bones.

Back 7

Osteomyelitis, metaphesis

Front 8

Osteomeyelitis is caused by bacteremia, bone fracture, surgery, spread from adjacent tissue and ______ _______ leading to infections of the mandible a common site due to limited flow.

Back 8

dental infections

Front 9

Radiographs, especially __________, reveal the sequestrum and irregular radiolucencies of osteomyelitis and are used in conjuction with histologic examinations and ____ _____ for diagnostic purposes.

Back 9

CT scans, bone scans

Front 10

The distinguishing symptoms of osteomyelits include tooth mobility and _______ _______.

Back 10

altered sensation

Front 11

Tx for osteomyelitis includes antibiotics, debridement, decortication and hyperbaric O2. T/F

Back 11

TRUE

Front 12

Avascular necrosis is a bone ______ secondary to a circulatory disturbance caused by trauma, emboli, endodartitis (from chemo/rad.s) or idiopathically. Examples include ___________, ischemic / aseptic necrosis and NICO.

Back 12

infarction, osteonecrosis

Front 13

Clinically avascular necrosis is commonly found in ____ bones of children and _____ ______ of the elderly.

Back 13

carpal, femoral heads

Front 14

Osteoporosis, rickets, osteomalacia and hyperparathyroidism are forms of ________ disturbances.

Back 14

metabolic

Front 15

The etiology of primary osteoporosis is unknown while secondary is caused by inadequate vit. __ and ___ intake, immobilization and some medications.

Back 15

D, Ca+

Front 16

Overall aposition < resorption in osteoporosis leading to thin, brittle bones prone to fracture. T/F

Back 16

TRUE

Front 17

Risk factors of osteoporosis include: = Female (Asian), __________, inactivity, heredity and dietary deficiency. T/F

Back 17

post-menopausal *also excessive corticosteroids

Front 18

Diagnosis of osteoporosis is made via bone ____ tests and _____. Treatment includes biphosphonates (dec. osteoclast activity), calcitonin, Ca+ and ________ supplementation.

Back 18

density, x-rays, estrogen

Front 19

Inadequate bone mineralization due to a vitamin D disturbances (affects phosphate/Ca+ metabolism) in _______ is termed osteomalacia and in children ________.

Back 19

adults, rickets

Front 20

Reduced absorption of Ca+ and PO4 lowers serum levels. The body compensates for this by releasing _____ causing resorption of bone.

Back 20

PTH --> inc Ca+(serum) along with inc renal Ca+ retention and excretion of PO4.

Front 21

Rachitic rosary, craniotabes, bow legs and fractures are endochondral ossification disturbances due to _______.

Back 21

Rickets

Front 22

Osteomalacia --> soft bones, fractures and muscle weakness due to?

Back 22

decreased serum Ca+

Front 23

______ dental eruption and ______ mineralized teeth are caused by Rickets.

Back 23

delayed, poorly

Front 24

List in order from most to least common etiologies of hyperparathyroidism: parathyroid - hyperplasia, adenoma, carcinoma and chronic renal disease.

Back 24

parathyroid-- 1. adenoma 2. hyperplasia 3. carcinoma ****chronic renal is a secondary cause

Front 25

Clinical signs of hyperparathyroidism include renal stones, painful bones (cysts, __________ - giant cell aggregates), ________ moans (ulcers) and psychic groans (seizures) do to Ca+/PO4 imbalance.

Back 25

brown tumors of hyperPTH, abdominal

Front 26

_____________ could be the first manefestation of hyperfarathyroidism.

Back 26

CGCG central giant cell granuloma

Front 27

Treatment for hyperthyroid includes surgical removal of the affected gland (neoplasia) or 3-4 glands due to ______.

Back 27

hyperplasia

Front 28

A 45 year old British patient presents with thick skull, deafness, back pain and bowed legs. Lab tests show elevated serum alkaline phosphatase and normal Ca+/PO4. The bone biopsy shows mosaic "reversal lines" and a "cotton wool" appearance is found on his ceph. He is suffering from _______.

Back 28

pagets disease (>40 yrs old)

Front 29

Peget's disease also causes enlargement of the maxilla, spacing of teeth and an increased risk of _________.

Back 29

osteosarcoma -- assume if >50 yrs old

Front 30

Comminuted fractures have multiple fracture lines and fragmentsC. T/F

Back 30

TRUE

Front 31

Complicated fractures are ________.

Back 31

infected

Front 32

Hematoma formation --> granuloma tissue --> bony callus = steps of fracture healing. T/F

Back 32

TRUE

Front 33

_______ tumors of the bone include, osteochondroma, chondroma and osteoma.

Back 33

Benign

Front 34

________ is a shaped benign growth of both bone and cartilage with the marrow space contiunous with the rest of the bone.

Back 34

Osteochondroma

Front 35

Chondromas are benign growths of cartilage found mostly in small bones. Some undergo malignant transformation especially in the ____________.

Back 35

maxilla and mandible

Front 36

Osteomas are a benign growth of bone often found in the head and neck. T/F

Back 36

True - often found in the sinuses

Front 37

CGCG are painless, _______, well demarcated radiolucencies found in the mand/maxilla anterior to the first molars caused by overproliferation of giant cells and fibroblasts.

Back 37

solitary

Front 38

Malignant tumors of the bone include osteosarcoma, chondrosarcoma and ______ sarcoma. Miscellaneous tumors include ________ _______, lymphomas and Langerhans cell histiocytosis.

Back 38

Ewings, Multiple myeloma

Front 39

Head and neck osteosarcoma etiology is mostly unknown although irradiation and Pagets increase risk. These are characterised by their "____-____" lytic appearance and peripheral "sunray" periosteal reaction.

Back 39

moth-eaten

Front 40

T/F Teeth near underlying osteosarcomas are usually vital.

Back 40

True

Front 41

________ are malignant tumors of cartilage-producing cells affecting __ to __ year old patients and have a tendency to metstasize to the lungs. Tx = surgery.

Back 41

Chondrosarcoma, 35-60

Front 42

Cartilagenous lesions of the jaw (anterior maxilla) are usually benign. T/F

Back 42

False - all should be considered malignant until proven benign

Front 43

"Small round blue cell" tumors (gene rearrangement) are found in a biopsy of the _______ of a childs tibia suffering from ______ _______.

Back 43

diaphysis, Ewings sarcoma

Front 44

Which is most common in children osteosarcoma or Ewings?

Back 44

osteosarcoma = #1, Ewings = #2

Front 45

Tx for Ewings includes surgical excision, chemo and _______, known as the big three.

Back 45

radiotherapy

Front 46

Most common metastatic cancers to attack bone are ______ and ______.

Back 46

breast and prostate.

Front 47

Osteosarcomas are more common than mateastatic carcinomas (to bone) in s. T/F

Back 47

False - metastatic to bone = #1 in s --> uncommon to jaws but of those which do 80% to mandible.

Front 48

A malignant glandlike tumor found in the mandible of a 65 year old patient is most likely a ________.

Back 48

metastatic adenocarcinoma

Front 49

A patient complains of morning joint pain, stiffness, crepitus and swelling due to to the breakdown of articular cartilage and formation of bone cysts, spurs and sclerosis. The patient is most likely suffering from_______.

Back 49

osteoarthritis

Front 50

Osteoarthritis is a ________ joint disease usually found in _________ joints due to wear and tear and inflamation.

Back 50

degenerative, weight-bearing (knee, hip, vertebrae)

Front 51

Rheumatoid arthritis is a systemic __________ disease affecting small _______ joints found 4:1 in women.

Back 51

autoimmune, synovial

Front 52

Pathogenesis of RA is as follows: inflamation of joint --> ingrowth of vessels --> proliferation of synovial cells --> _______ ______ --> cartilage destruction --> ______ ______.

Back 52

granulation tissue (pannus), joint spacing

Front 53

Juvenile RA affects small joints. T/F

Back 53

False - affects large joints

Front 54

Infectious arthritis is caused by what diease?

Back 54

Lyme

Front 55

Hyperuricemia (purine metabolism) --> excess uric acid --> crystalization in joints, tissues and kidneys --> phagocytosis of crystals = cell lysis --> inflamation. This pathogenesis is charactieristic of _______?

Back 55

gout

Front 56

Gout primarily affects males/females and is genetic/hormonal?

Back 56

Males 95%, both genetic and hormonal

Front 57

Gout develops __ to __ years after the onset of hyperuricemia commonly in the ___ ___.

Back 57

15-30, big toe

Front 58

Gout can be classified as acute or chronic. Acute causes pain for 2-3 days while chronic is less painful but displays joint _______ and subcutaneous uric acid deposits called ______.

Back 58

deformation, tophi