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33 Cards in this Set

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Define osteomyelitis.
Infection of bone and marrow
What is the most common cause of osteomyelitis in general?
Bacterial infection,

but all types of infection is possible.
What type of osteomyelitis is common in children?
Acute hematogenous osteomyelitis
In children, where is the most frequent site of acute hematogenous osteomyelitis?
Knee joint

(specifically femoral/tibial metaphysis)
What organism is commonly associated with osteomyelitis in children?
Staphylococcus
What is a common osteomyelitis for adults, and what is it secondary to?
Post-traumatic osteomyelitis secondary to surgery or compound fracture.
What osteomyelitis is commonly seen in elderly patients?

What organism is often responsible?
Spinal osteomyelitis

Gram negative organisms
For osteomyelitis in drug addicts, what organism is usually involved?
Pseudomonas
For osteomyelitis in sickle cell patients, what organism is usually involved?
Salmonella
Pott's Disease

- what is it?
- what patients are at risk?
- AKA?
Tuberculous osteomyelitis involving the VERTEBRAL

TB patients

Tuberculous Spondylitis
Acute osteomyelitis may be resolved with what treatment?
Antibiotics
Untreated osteomyelitis would lead to what?
Sequestrum formation,

leading to involucrum
Define sequestrum.
Necrotic bone that separates itself from surrounding healthy tissue.
Define involucrum.
New bone formation / reactive shell that surrounds sequestrum
What is Brodie's abscess?
When bone abscess becomes localized and NO periosteal reaction is seen, but is surrounded by granulation tissue.
Squamous cell carcinoma can be a complication of what non-neoplastic disease?
Untreated osteomyelitis
Define osteoporosis.
Decrease in TOTAL BONE MASS with NORMAL bone mineralization.
What is the cause of osteoporosis?
Multifactorial:

(menopause + aging)
Describe the trabeculae in osteoporosis.
Thin and disconnected from each other.
What type of bone is lost in osteoporosis?
Cancellous bone
Type I osteoporosis

- Patients at risk
- Most common fracture
Post menopausal women

Vertebral compression fx
Type II osteoporosis

- Patients at risk
- Most serious fracture
Senile or age related (>70 y.o.)

Fx to head of femur
What are some causes for Secondary Osteoporosis. x5
Medication induced osteopenia

Immobilization / Prolonged bed rest

Burn injury

Hyperparathyroidism

Prolonged total parental nutrition (TPN)
What is the principle morphologic feature of RA?
Proliferative synovitis
What is rheumatoid nodules?
Area of fibrinoid necrosis

surrounded by palisaded histiocytes

and chronic inflammatory cells.
Is genetics a major determinant in RA?
Yes
What is the microbial agent currently considered to be the initiator of the disease RA?
Ebstein-Barr virus,

but also many others
Paget's disease is AKA?
Osteitis Deformans
General definition of Paget's disease.
Chronic skeletal disorder characterized by abnormal bony architecture and turnover caused by increase in BOTH osteoclastic and osteoblastic activity.
What is remarkable about lab results in Paget's disease?

What is normal? x3
Marked increase in Serum Alkaline Phosphate

Normal Serum Calcium
Normal phosphate
Normal PTH
What are the stages of Paget's disease?

Describe character of each stage.
1. Osteolytic phase:
osteoclast hyperactivity

2. Mixed osteoblastic & osteolytic phase:
Increase in new bone formation and increase in mosaic pattern

3. Late phase:
Prominent mosaic pattern of lamellar bone
What is the primary histologic feature of Paget's disease?
Mosaic pattern on lamellar bone.
List complications of Paget's disease. x4
1. Hearing loss
2. Bone pain
3. Arthritis
4. Deformity of bone