Br Pathology: Musculoskeletal And Soft Tissues

Front 1

What type of genetic disorder is achondroplasia? what is pathogenesis?

Back 1

1) Autosomal dominant
2) Mutation in fibroblast growth factor receptor gene
a. Gene mutations increase with paternal age
3. Impaired proliferation of cartilage at the growth plate

Front 2

Clinically how does achondroplasia present? How are GH and IGF-1

Back 2

1. Normal-sized head and vertebral column
2. Shortened arms and legs
3. Normal growth hormone and insulin growth factor-1 levels

Front 3

"marble bone" disease is also known as? What are genetics?

Back 3

1) Osteopetrosis
2) Autosomal recessive (severe)
a. Autosomal dominant (less severe)

Front 4

Pathologically what is occurring in osteopetrosis?

Back 4

1. Deficiency osteoclasts
2. Normal balance of osteoblasts making bone and osteoclasts breaking down bone is disrupted favoring increased bone formation.
3. Overgrowth and sclerosis of cortical bone ("too much bone")

Front 5

Clinically how does osteopetrosis present?

Back 5

1. Pathologic fractures
2. Anemia
a. Replacement of marrow cavity
3. Cranial nerve compression
a. Visual and hearing loss

Front 6

How does osteomyelitis occur? where is the most common site?

Back 6

1) Most commonly due to sepsis with subsequent spread to bone
2) Metaphysis is the most common site.
a. Favors the tibia and fibula in children

Front 7

What is the most common pathogen causing osteomyelitis?

Back 7

1) S aureus (most common)
2) Streptococcus pyogenes
3) Haemophilus influenzae

Front 8

osteomyelitis in sickle cell disease is caused by?

Back 8

Salmonella paratyphi

Front 9

Tuberculous osteomyelitis commonly occurs where? How does it get there?

Back 9

1) commonly involves vertebral column (Pott's disease)
2) Hematogenous spread from a primary lung focus

Front 10

Cause of osteomyelitis Most often due to puncture of foot through rubber footwear?

Back 10

Pseudomonas aeruginosa osteomyelitis

Front 11

Pathologically what is occurring in osteomyelitis? What is devitalized bone and reactive bone called?

Back 11

1) Neutrophils enzymatically destroy bone
2) Devitalized bone is called sequestra.
3) Chronic disease produces reactive bone formation in periosteum.
a. Called involucrum
4) Draining sinus tracts to the skin surface often occur

Front 12

What is the risk with a sinus tract opening onto the skin from osteomyelitis?

Back 12

Danger of squamous cell carcinoma developing at orifice of sinus tract

Front 13

How does osteomyelitis typically present?

Back 13

Fever, bone pain

Front 14

How is osteomyelitis caused by staph and salmonella treated?

Back 14

1. Surgical débridement
2. Staphylococcus aureus: vancomycin + ceftazidime
3. Salmonella paratyphi (sickle cell): ciprofloxacin

Front 15

What is the most common metabolic abnormality of bone?

Back 15

osteoporosis