Path musculoskeletal

robbypowell's version from 2015-10-13 19:15


Question Answer
what are the 2 diagnostic markers for Paget's disease (radiographic & serum level)"cotton wool" radiographic appearance; & elevated Alkaline Phosphatise (serum levels)
Vit D is essential for ___ absorption in the ___Ca2+; GI tract
Vit D is essential for the conversion of ___ to ___... this conversion is done in the ___.
Osteomalacia is caused by ____ deficiency and manifests in what age?Vit D; Adulthood
Rickets is caused by ____ deficiency and manifests in what age?Vit D; Childhood
How would a patient with Paget's disease diet be modified?Calcium Free diet
What 3 types of pharmaceutical treatment typically given to Paget's disease patients?Pain meds, Antibiotics, Bone Stabilizers (bisphosphonate or calcitonin)
How does Osteomalacia appear differently than normal bone on radiograph?Pseudofracture (looks like fracture... but its not, just denser islands of Osteoid)
How does Osteomalacia appear different than normal bone under the microscope?EXCESS OSTEOID (mineralized)
____ is characterized by excessive accumulation of osteoid matrix without calcificationOsteomalacia
T/F: Amelogenesis Imperfecta is associated with a subtype of Osteogenesis ImperfectaFALSE (instead, Dentinogenesis... Dentin... not enamel)
T/F: Dentinogenesis Imperfecta is associated with a subtype of Osteogenesis ImperfectaTrue
Shell Teeth and Pulp Obliteration are radiographic descriptions seen in ____ ____Dentinogenesis Imperfecta (which can be associated with Osteogenesis Imperfecta)
Malignant Osteopetrosis is transmitted via autosomal _____ genetic disorderRecessive
Benign Osteopetrosis is transmitted via autosomal _____ genetic disorderDominant
_____ is also called Marble Bone diseaseOsteoporosis
Myelopthisic means what?marrow is replaced
_____ _____ is also called Brittle Bone disease Osteogenesis Imperfecta
Mouth breathing in Osteopetrosis patients is due to what?narrowing of paranasal sinuses
Marked thickening and opacity of bone (lack of marrow space) is associated with what disease?Osteopetrosis
Which diseases we learned about have susceptibility to infection as a complication????
Destruction of neurons would lead to atrophy of which muscle fibers?Type 1 & Type 2 (denervation atrophy)
Muscle disorder where someone becomes weak and tired after expending effortMyasthenia Gravis
What is the etiology of Myasthenia Gravis?Autoimmune; Antibodies for Postsynaptic Acetylcholine receptors
What type of muscle fiber wasting is associated with Myasthenia Gravis?None, there is no muscle wasting with Myasthenia Gravis
Presenting features frequently include ocular muscle weakness w/ ptosis or diplopia, tired jaw musclesMyasthenia Gravis
70-80% of Myasthenia Gravis patients have ____ hyperplasia & _____ is noted in 15-20%Thymic Hyperplasia; Thymoma
Primary treatment for Myasthenia Gravis (pharmaceutical)Acetycholine Esterase Inhibitors
Genetically determined, progressive disorders characterized by degeneration of skeletal muscle & profound wasting and weaknessMuscular Dystrophy
What serum enzyme level is high in patients with Muscular Dystrophy (genetic)Creatine Kinase
Why is Duchenne Muscular dystrophy seen almost always in boys?X-linked recessive genetic disease
What disease begins in 1-year old boys, initially manifesting with generalized clumsiness, progresses to immobilization & wasting?Duchenne Muscular Dystrophy
Most common final cause of death in Muscular DystrophyWeakness of respiratory muscles --> Pneumonia & death
In what disease (Microscopically) is there random variation of muscle size, necrosis & eventually replacement by fibrous tissue and fat?Duchenne Muscular Dystrophy
Pseudohypertrophy (ppt was wrong, double checked in text) of the calves of a young male patient could be the result of what X-linked recessive disease?Duchenne Muscular Dystrophy
What causes the pseudohypertrophy in Duchenne Muscular Dystrophy?Hypertrophy of ERRATIC muscle fibers that NECROSE and are replaced by FIBROUS TISSUE & FAT
Bone is a dynamic structure subjected to continuous formation & resorption w/ a net loss of ___% each year0.7% (this is probably after building years)
T/F: Skeletal growth is faster in boys than girlsFalse (faster in girls, lasts longer in boys)
Definition: seam of UNMINERALIZED matrix formed by OsteoblastsOSTEOID
Definition: bone forming cellsOsteoblasts
Bisphosphonates affect the function of what type of cell?Osteoclasts (turn off)
What bone related cells have receptors for PTH?Osteoblasts (ppt says Osteoclasts and PPT is wrong... Clasts have RANKL receptors)
Outermost, dense, bone layer with Laminated Trabecular is what type of bone?Cortical
Inner, weaker, bone layer with many anastomoses is what type of bone?Cancellous (where the marrow is)
What two visceral organs play vital roles in the synthesis of vitamin D?Liver & Kidney
Important (preventative) measure for maintaining normal healthy bone in genetically normal peoplephysical activity
Which of the following is NOT a Metabolic bone disease: A) Osteoporosis B) Von-Recklinghausen C) Paget's or D) OsteopetrosisOsteopetrosis (is a hereditary bone disease)
What are three metabolic functions of PTH in terms of raising serum Ca2+ levels?1) Initiate Osteoclast activity (by causing osteoblasts to release RANKL) 2) convert Hydroxy-cholecalciferol to active vitamin D (Di-hydro-cholycalciferol)(in kidney) 3) Increase urinary PHOSPHATE excretion (causes more Ca reabsorption)
Where does the conversion of the immediate precursor of fully active Vit D take place? what is the necessary hormone instigator?Kidney; PTH
PTH --> Increases urinary excretion of what ion?Phosphate (this leads to greater reabsorption of Ca2+)
In either primary or secondary Hyperparathyroidism, excess ___ is produced... ultimately leading to leading to excessive levels of what ionPTH
What is the typical manifestation of Hyperparathyroidism?Hypercalcemia
Secondary Hyperparathyroidism is often caused by failure of what organ?Kidney (End Stage Renal Disease)
Why would End stage renal disease lead to bone loss?(Secondary Hyperparathyroidism) Parathyroid Hyperplasia (thus bone loss) in response to constantly losing Calcium to urine
Most common tumor type of the Parathyroid glandAdenoma (80-90%)
Von-Recklinghausen is evident from what two elevated serum levels?PTH & Calcium (Hyperparathyroidism)
What is the range for homeostatic control of serum Calcium levels by the Parathyroid gland?8.6-10.4 mg/dL
In secondary hyperparathyroidism it is the initial state of ______ that leads to hypercalcemiaHYPO-PHOSPHAT-EMIA (low phosphate)
Renal Osteodystrophy is associated with what disease?Secondary Hyperparathyroidism (hyperparathyroidism = Von-Recklinghausen disease of bone)
What are the two most common causes of Hypercalcemia?Malignancy (non-parathyroid) & Hyperparathyroidism
metastatic calcification in hypercalcemic patients is seen in what 4 tissues?Blood vessels, Lungs, Dura, & Sclera (of the eye)
What are the 3 dental radiographic findings of Hyperparathyroidism?Brown Tumors (in advanced disease), Loss of Lamina Dura, Osteopenia (Ground glass bone appearance)
Osteitis Fibrosa Cystica are also called ____ tumorsBrown Tumors (Hyper-Parathyroidism)
When a patient's jaw has a "ground glass" appearance on radiographs this finding is called Osteo-____Osteo-PENIA (demineralization)
A patient with metastatic calcification is likely to have what metabolic condition?Hyperparathyroidism (--> Hypercalcemia)
Larger, but weaker bones is likely due to ___ ___Paget's disease (of bone) (Osteitis Deformans)
What metabolic bone disease has Increased tendency for malignant bone neoplasms (Osteosarcoma)?Paget's disease (of bone) (Osteitis Deformans)
What bone disease is etiologically be related a PARAMYXOVIRUS?Paget's disease (of bone)
What diseases have elevated levels of Alkaline Phosphatase?Paget's disease
What bone disease has impaired vision and hearing as a clinical feature?Paget's
bone disease with bowing of long bones and radoisotope uptakePaget's
Leontiasis Ossea (lion face) & a cotton wool appearance of bone on radiographs are clinical features of what bone disease?Paget's
Hypercementosis of teeth is associated with what bone disease?Paget's
Mosaic bone is associated with what bone disease?Paget's
Bone stabilizer (pharm) treatment for Paget'sBisphosphonates and Calcitonin
Bone loss: Normal Calcium, Phosphate & Alkaline PhosphataseOsteoporosis
Bone loss: Elevated Calcium, Low Phosphate, high PTHHyperparathyroidism
Bone loss: Elevated Alkaline Phosphatase, normal Ca & PO4Paget's disease (of bone)
Defective calcification of excessive Osteoid matrix is associated with what disease?Osteomalacia
What causes Osteomalacia?Vit D deficiency (osteomalacia is in adults)
Excessive accumulation of non-calcified osteoid matrix is associated with what disease?Rickets
thinning & softening of occipital & parietal bones in children (name of clinical sign)Craniotabes
Rachitic Rosary is due to the thickening of _____ junctions and a sign of what bone diseaseCostochondral; Rickets
Wider joints in children associated with what vitamin deficiency?Vit D
Two Hereditary Bone disease examples: ____ ____ & _____Osteogenesis Imperfecta & Osteopetrosis
What disease is aka Brittle Bone DiseaseOsteogenesis Imperfecta
group of disorders caused by deficiencies of type I & II collagen resulting in defect in bone matrix, fragility & susceptibility to fractureOsteogenesis Imperfecta
Osteogenesis Imperfecta is caused by mutation in genes coding for what?α1 & α2 chains of the collagen molecule
Orally, Osteogenesis Imperfecta can manifest as Dentinogenesis Imperfecta... this is because of its defective _____Collagen (α1 & α2 chains)
Blue Sclera is a clinical feature of what disease?Osteogenesis Imperfecta (collagen defect)
Gray to blue teeth are associated with what bone disorder?Osteogenesis Imperfecta
What disease is also known as Marble Bone disease?Osteopetrosis
hereditary bone condition results in excess bone deposition & mineralization resulting in brittle bone which becomes susceptible to fracture & infectionOsteopetrosis
Osteopetrosis acts by affecting what cells?Osteoclasts (reduction in normal function)
Mouth breathing, due to narrowing of sinonasal caivities, what bone disease?Osteopetrosis
4 bone diseases listed as being especially susceptible to fracturesOsteoporosis, Paget’s disease, Osteogenesis imperfecta, Osteopetrosis
What is the #1 cancer of bone?Osteosarcoma
What is the #1 cancer of jaw bones?Osteosarcoma
What are three most common sites of Osteosarcoma (greatest to least)Femur, Humerus, Mandible
What radiographic pattern is associated with Osteosarcoma?Sunburst pattern w/in tumor
How does osteosarcoma appear around teeth on radiograph?Widened PDL space
Tumor that shows microscopically as Malignant Osteoblasts producing Lacy OsteoidOsteosarcoma

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