Mhd Pathology Bone

Front 1

Makes up 65% of bone?

Back 1

Hydroxyapatite: 99% of bone calcium, 85% of phosphorus, 65% of sodium and magnesium

Front 2

Osteoid?

Back 2

Unmineralized bone

Front 3

Osteoprogenitor Cells?
Differentiation?

Back 3

Pleuripotent stem cells at bony surface.
Differentiate to Osteoblasts when stimulated by BMP

Front 4

Osteoblast Function?
Osteoclast Function?

Back 4

Synthesize, transport and arrange proteins, institute mineralization.
Bone resorption.

Front 5

Activates osteoclastogenesis?
Blocked by?

Back 5

RANKL binding to RANK and bloked by OPG(osteoprotegrin)

Front 6

Proteins in Bone?

Back 6

collagen type 1

Front 7

Woven Bone?

Back 7

Seen in fetal skeleton, at growth plates, pathologic in adults

Front 8

Lamellar bone?

Back 8

Layered, Types: circumferential, concentric, interstitial, trabecular

Front 9

BMU?

Back 9

Bone multicellular unit: osteoclasts and osteoblasts.
Remodel 10% of skeleton anually

Front 10

Stages of bone growth?

Back 10

cartilage model, endochondrial ossification, primary and secondary centers of ossification, growth plate of physis

Front 11

Common congenital agenises of bone?

Back 11

Phalanx, rib, clavical

Front 12

Extra bones?

Back 12

Ribs or digits

Front 13

Fusion of two adjacent digits?

Back 13

Syndactyly

Front 14

Spider fingers?

Back 14

Arachnodactyly

Front 15

Clinical Manefistation of Achondroplasia?

Back 15

Major cause of dwarfism, shortened proximal extremities, normal trunk, frontal bossing, saddle nose, no change in intelligence or reproductive status

Front 16

Pathogenesis of Achondroplasia?

Back 16

Abnormalities of growth plate, AD, most are new mutations, FGFR3(fibroblast growth factor) always on inhibiting cartilage proliferation

Front 17

Clinial manifestations of Osteogenesis imperfecta?

Back 17

Large spectrum, skeletal fragility(brittle bone disease), Blue sclera, hearing impaired, Dental abnormalities

Front 18

Pathology of Osteogenesis imperfecta?

Back 18

Brittle bones due to defective type 1 cartilage, systemic disorder of connective tissue disorder

Front 19

Etiology of Osteogenesis imperfecta?

Back 19

AD, some AR, some acquired.
Mutaion in genes for alpha1 and alpha2 chains of collagen

Front 20

Treatment of Osteogenesis imperfecta?

Back 20

Pain control, decrease fractures, psychiatric anlysis

Front 21

Pathogenesis of Osteopetrosis?

Back 21

AR and rarely AD, osteoclast dysfunction which leads to dense bones.

Front 22

Pathology of Osteopetrosis?

Back 22

Marble bone disease, diffuse skeletal sclerosis, boes lack medullary canal, no room for marrow.

Front 23

clinical manifestation of Osteopetrosis?

Back 23

Some die early, some diagnosed later in life, multiple bone fractures, anemia, blindness, deafness and CN impingement of neuronal foramina

Front 24

Pathology of Osteoporosis?

Back 24

Absolute reduction of bone mass, weak bones, decrease size and number of traceculae

Front 25

Greatest bone loss in Osteoporosis seen in?

Back 25

Vertebrae, wrists(colle's fracture), ribs and pelvis

Front 26

Pathogenesis of Menopausal Osteoporosis?

Back 26

decrease estrogen, decrease IL-1,6, TNF levels, Increase RANK and RANKL levels, increase osteoclast activity

Front 27

Pathogenesis of aging Osteoporosis?

Back 27

Decrease replicative activity, decrease osteoblast activity, decrease matrix bound growth factors, decrease physical activity

Front 28

Secondary causes of Osteoporosis?

Back 28

Hyperthyroid, hyperparathyroid, corticosteroids, hypogonadism, immobilization

Front 29

Clinical manifestation of Osteoporosis?

Back 29

Bone fractures, weight loss, shortened stature, kyphoscoliosis,

Front 30

Diagnosing Osteoporosis?

Back 30

X-ray:no, ca PO4 Vit D Alk Phos not diagnostic, Bone density scan(T and Z-values)

Front 31

Pathology of Rickets?

Back 31

Decrease mineralization, craniotabes, frontal bossing, Rachitic rosary: noby costocondrial joints, pigeon breast, bowing of legs

Front 32

Pathology of Osteomalacia?

Back 32

Weak and vulnerable bone, fractures and microfractures, bone pain, osteopenia

Front 33

Pathogenesis of Rickets and osteomalacia?

Back 33

Vit D deficiency

Front 34

Pathology of Hyperparathyroidism?

Back 34

unabated osteoclast activity, Dissecting osteitis(osteoclast tunnel), osteitis fibrosa cystica: peritrabecular fibrosis, cystic brown tumors

Front 35

Clinical manifestation of Hyperparathyroidism?

Back 35

Decrease bone mass and skeletal deformity from weight bearing stress, bone changes can regress with control of PTH

Front 36

Pathogenesis of Scurvy?

Back 36

Vit C deficiency

Front 37

Pathology of Scurvy?

Back 37

Defects in collagen synthesis, deformed bones in kids and tissue hemorrhage. Defects in Hydroxylation of procollagen

Front 38

Clinical Manifestation of Scurvy?

Back 38

Decreased osteoid leads to bone deformation, weakness in blood vessels leads to hemorrhage, purpura, ecchymoses, Gingina with hemorrhage, poor wound healing

Front 39

Pathology of Paget's disease (osteitis deformans)

Back 39

Osteolytic phase, mixed phase, osteosclerotic phase
Get poorly organized bone, highly vascularized

Front 40

Clinical manifestation of Paget's disease?

Back 40

middle adulthood, Bone pain, leotiasis ossea, hearing loss, hypervascularity(warm tibia): leads to high output heart failure, increased alk phos

Front 41

Leontiasis ossea?

Back 41

Thickening of skull and craniofacial bones in Paget's

Front 42

Complications of Paget's disease?

Back 42

Bone pain/ fractures
High-output cardiac failure
Hearing loss
Osteosarcoma
mosaic bone formation

Front 43

Etiology of Osteonecrosis?

Back 43

trauma, corticosteroids, dysbarism(air embolis), sickle cell and other myoglobinemias, gaucher

Front 44

Clinical Maifestation of Osteonecrosis?

Back 44

Bone or joint pain, subchondral infarcts lead to collapse of affected bone: secondary arthritis
Medullary infarcts are silent

Front 45

Pathology of Osteonecrosis?

Back 45

Infartion of bone, dullay oor subchondral region of epiphysis

Front 46

Pott's disease?

Back 46

TB in the vetebral bodies, thoracic and lumbar

Front 47

Mixed lytic and blastic bone mets?

Back 47

Breast, Lung, Thyroid, Kidney, Multiple myeloma

Front 48

Blastic Bone Mets?

Back 48

Prostate, Infamous lymphoma, Transitional cell carcinoma, Treated breast cancer, APUDoma(carcinoid)

Front 49

Osteoma?

Back 49

Benign, middle aged men, craniofacial bones, multiple found in Gardner's syndrome

Front 50

Osteoid osteoma?

Back 50

Benign, haphazardly arranged trabecullae and woven bone, cortex of femer or tibia, men<25, nocternal pain relieved by aspirin.

Front 51

Osteosarcoma?

Back 51

Malignant, 60% by knee, 15% by hip, shoulder, jaw, 50-60 y/opainful enlarged mass, prognosis correlates to tumor grade

Front 52

EWING'S SARCOMA or PNET?

Back 52

neural=PNET(Primitive neuroectodermal tumor,
No neural=Ewing's sarcoma

Front 53

Pathology of EWING'S SARCOMA or PNET?

Back 53

Round mesenchymal cells, found in medulary cavity of long bones, translocation in 11/22 chromasomes

Front 54

Clinical manifestation of EWING'S SARCOMA or PNET?

Back 54

pts<20, painful enlarging mass, aggressive, looks like lymphoma, rhabdomyosarcom
75% 5 yr survival