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38 Cards in this Set
- Front
- Back
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Osteogenesis Imperfecta
sx test: |
-mutaiton to type I collagen
-bone manifestation-too little, fragile -extraskeltal manifestaiton -abnormal vs. normal -abnormal: type II, fracture -normal: type I, not as bad-blue sclera -hearing loss -detinogenesisi imperfecta-different genetics -bone bend test: collagen, genetic, xray, history of fractures -may also |
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Osteopetrosis
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-genetic mutation-->reduced osteoclast fxn/presence-->dense bone which is weak
-fracture/infection -reduced hematoposiesless blood cells-->susceptible to infection -bone marrow transplant for new osteoclasts |
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Aquired diseases of bone
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osteoporosis
paget rickets/osteomalacia hyperparathyroidism |
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osteoporosis
sx diagnose treatment |
-increase bone resoprtion
-senil/postmenopausal most common -aging-->decrease in estrogen(women) and test(men), reduced osteoblast fxn and activity -diagnose bone density -bisphosphonate improve density but decrease resorption/modeling |
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Pagets
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-osteolytic lesion-->mixed staged(radiolucent and opaque via overactive osteoblasts and clasts)
-cells burn out -osteosclerotic abnormal/unsound bone -big skull, and jaw expansion -radiograph: cotton wool -benign, pain is the worst sx. -use calcitonin/bisphosophnates -bone structurally sound |
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hormone and bone diseases
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Sex hormones: senile osteoporosis
parathyroid hormone: hyperparathyroidism Vistamin D: rickets and osteomalacia |
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increase pth --> ?
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kidney Ca reabsorption
bone: bone resoprtion increase serum Ca |
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PTH
from? regulates? targets? feedback mechanism? |
-pth gland
-calcium -bone, kdney(reabsorption and potentiates vitamin D) -serum calcium elvel |
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Primary vs. Secondary parathyroidism
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-primary: tumor/hyperplasia or pth gland
-secondary: PTH delivered but problems it its target: renal autodystrophy |
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HyperPTH
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-excessive bone resoprtion
-osteitis fibrosa cystica(brown tumor) -multinucleus giants cells which are osteoclass -cystic-like lesions dx: high pth tx: treat underlying disease |
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vitamin D sources
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-sunlight
-dietary -helps increase clacium resopriton in intestine |
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vitamin d deficiency
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-poorly mineralize bone matrix susceptible to fracture
-Growthplate: -closed: adult osteomalacia-increase potential for fracture -open: rickets -over produce crtilage and osteoid, poorly mineralized bone-->skeletal deformitry and growth reatrd(bowing bones) |
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Fracture types
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-closed: skin intact
-compiund/open -compression |
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Osteomyelitis
routes bacteria |
-inflammation of bone via infection chornic or acute
-routes: hematogenous, from adjacent, traumautic/iatrogenic -bacterial: fungus not comon -pyogenicosteo osteomyelitis(staph aureus) Tuberculous osteo -from pulmonary tuber -hematogenous route -pott disease: tuberculosis of betebral bodies |
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acute osteomyelitis
pathway sequestrum involucrum histology treatment? |
-bone infection-->chemotactic bacteria proliferate-->inflammation
-sequestrum: dead bone...no osteocytes -involucrum: new bone fromed around sequestra of jaw bone loss of well-defined border at fast rate, empy lacuna. antibiotics/surgery |
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osteonecrosis
types: pathway |
-avascular necrosis
-bisphosphonate-associated osteonecrosis of jaw = ONJ,BON -radio-osteonecrosis disease/trauma-->compromised blood supply-->bbone ischemic necrosis treat: surgery |
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Bisphosphonates
aminobisphosponates |
-potent inhibitors of osteoclast
-affects angiogensis -addition o nitrogen, more potent as not metablized by osteoclasts |
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bisphosphonate assoicated osteonecrosis
sx caused by? prevention? |
-in jaw
-exposed non-vital bone(sequestrum) -occurs after invasice dental procedure -inhibition of bone remodeling due to inhibiting ostelcast fxn all invasive dental procedures performed b4 starting IV bisphosphonate. |
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osteoradionecrosis
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-complication in jaw via radiation
-get exposed non vital bone -damages bone cells, decreased bone metabolism, inhibits angiogensis |
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classification of bone tumors
bone forming benign: malignant Cartilage forming benign malignant fibroosseous others |
Bone forming
Benign: Osteoma, Osteoid osteoma & Osteoblastoma Malignant: Osteosarcoma Sarcoma- malignancy derived from mesenchymal cells Carcinoma- malignancy derived from epithelial cells Cartilage forming Benign: Osteochondroma, Chondroma Malignant: Chondrosarcoma Fibro-osseous: Fibrous dysplasia, Ossifying fibroma Others Giant cell tumor of bone (mostly benign) Ewing tumor (malignant) |
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Osteoma
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-benign
-intramembranous-mature lamellar bone -head and neck-paranasal sinus -feature of Gradner's syndrome |
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osteiod osteoma/oseoblastoma
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-anastomosing trabeculae of osteiod lined by active osteoblast-->well defined border
-blastoma: >2m, pain not localized/relieve with asprin -osteoma: <2cm localized pain relieved by asprin |
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osteosarcoma
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-production of bone matrix by malginant osteoblast
-most common primary malignant tumor of bone -metastatis(spreded) tumors are most common malginant tumor of bone -mutation in tumor supressor genes RB and P53 -painful enlarging mass-->fracture codman tirangle: only edges of periosteum ossifed tumor grows fast, lifts periosteum so that outside layer becomes calcified -sunburst/sunray spicules/hair-on end..new bone layed perpidicular to cortex |
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exostosis
in endochonrol bones called? |
-bony protuberance on surface of a bone
-oral cavity: not a tumor -exostosis in endochonral bone=osteochondroma |
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osteochonroma
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-most common bengin tumor
-enchondral -near metaphysis near gorwth plate -stops after growth of skleton -no treamtent needed |
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chondroma
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tumor of hyaline cartilage
-endochonroma: in medulla/marrow -juxtacorticol condroma: corticol surface |
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endochromatosis
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-ollier, maffucci
-maffucci also have heamigoma-worst -enchondromas develop earliy in life |
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chondrosarcoma
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-condrocytes producing chondroid matrix
-graded...lower=better survial rate -can mestatsize hematogenously to lung |
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fibrous dyplasia
types |
-developmental tumor in oral cavity,
-normal bone replaced by proliferating cellular fibrous stroma with irregular trabeculase -Golnaz -monostatic: single bone, poly: multiple--McCune-Albright syndrome(pigmention, multiple endorinopathies) |
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ossifying fibroma
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-true tumor with histology of fibrous dyplasia involving JAW
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-Giant cell tumor of bone
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-osteoclastoma
-multinucleated osteoclast giant cells -in jaw = giant cell granuloma |
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-Ewing sarcoma/primitive neuroendocrine
-similarities -differentiations |
-fusion b/w EWS gene with ETS TF.
-small round cell tumor differences: -ewing sarcoma: undifferentiates..mostly bone -PNET: neural differentiation..mostly soft tissue |
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cartilage pathology: joint
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-arthritis
-OA -RA -Gout -ganglion and synovial cysts |
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OA
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-degenerative arthrisis: most common
-age, obesity, joint trauma -in weight bearing, one or a few -primary: destroyed cartilage -2ndary: inflamed synovium(epsiodic) -leads to osteophytes and subchondral sclerosis -stiffness-->cured by excerise/weightloss, hyaluronic acid, reduce pain and inflammation |
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RA
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-inflam-->TNF-A-->synovial cell hyperpalsia-->pannus(invasive granulation tissue-->bone/cartilage destruction
-affects many small joints treatment: steroid inhibit inflammation tnf-A good target for treatment |
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Gout
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-purines-->purine nucelotides/bases-->uric acid pool
-hyperuricemia: high degree of uric acid-->tophus(aggregates of urate crystals -1st attack is scute,,,gradually becomes polyarticular and attacks are shorter intervals |
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ganglion cyst
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-bible cyts
-small fluid filled swelling, not true cist, near joint capsule or tendon sheet -occrus via cystic degenreation of connective tusse |
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synovial cyst
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-para-articular mass filled with synovial fluid
-caused by overproduced synovial fluid trapped outside of joint bake cyst: synovial cyst on knee |
