Pathology
Class at the National Academy of Osteopathy
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225 questions
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| An inherited skeletal disorder beginning before birth; cartilage is converted to bone resulting in DWARFISM. | Achondroplasia is the most common form of.... |
| 1) Decreased bone formation 2) Premature ossification of the growth plate | Pathology of Achondroplasia (2 points) |
| Obesity Subluxation (dislocation) of the 1st and 2nd cervical vertebrae and compression of the spinal cord. spinal stenosis/neural tube narrowing (L1 – L4). Obstructive sleep apnea. | Consequences of Achondroplasia's clinical findings: (4 points) |
| No known treatment. Growth hormone does not help. Surgical limb-lengthening. | How to treat Achondroplasia? |
| What is another name for "Brittle Bone Disease"? | What is another name for Osteogenesis Imperfecta? |
| - Osteopenia (poor bone density/health) from poor development/frequent fractures - Thin and blue scelera - Hypermobility - Early hearing loss - Short stature - Easily Bruised - Fragile and small teeth that are discolored. | Osteogenesis Imperfecta Pathological and Clinical Findings: |
| No cure. Treatment is supportive. Therapeutic exercises. Physical therapy. Counselling and emotional support for patients and their parents. | Osteogenesis Imperfecta treatments: |
| "Marble Bone Disease" | Another name for Osteopetrosis |
| A hereditary defect: decreased osteoclast function, leading to decreased bone resorption and thick sclerotic/rigid bones. | What is Osteopetrosis? |
| - Autosomal dominant. - Usually is diagnosed in young adults who undergo X – ray for fractures. - Mild anemia. - Cranial nerve impingement | Clinical Findings of BENIGN Osteopetrosis: (4 pts) |
| - Increased bone mass (both cortical and trabecular bone.) - "Flask Shaped" deformity | Radiography of Osteopetrosis: |
| Genetics. Radiation Therapy Chemotherapy. Benign tumors. Other bone conditions: - Paget disease. - Chronic osteomyelitis. | Risk Factors for Bone Tumors: |
| 1) Osteoma. 2) Osteoid Osteoma. 3) Otseoblastoma. 4) Osteochondroma. 5) Enchondroma. 6) Osteoclastoma (Giant Cell Tumor of Bone). | What are the 6 types of benign bone tumors? |
| The face and sinus | What bones of the body are mainly effected by Osteoma? |
| Mostly affects the long bones especially femur and tibia. | What bones of the body are mainly effected by Osteoid Osteoma? |
| Affects Vertebrae (but similar to Osteoid Osteoma). | What bones of the body are mainly effected by Osteoblastoma? |
| Originates from growth plates (near ends of longbones) of the long bones in children and adolescent. | What bones of the body are mainly effected by Osteochondroma? |
| Mostly affects the CARTILAGE of HANDS and FEET. | What bones of the body are mainly effected by Enchondroma? |
| Usually affects the epiphyses/head of the long bones(common around the knee). | What bones of the body are mainly effected by Osteoclastoma? |
| 1) Osteosarcoma. 2) Chondrosarcoma. 3) Ewing`s Sarcoma. | What are the names of the three kinds of MALIGNANT bone tumours. |
| Osteosarcoma. | What is the most common MALIGNANT bone cancer (45%)? |
| Osteosarcoma and Osteochondroma | What two kinds of bone cancers mostly effect children and teens? (1 malignant, 1 benign)? |
| Osteosarcoma. | What kind of cancer is this? |
| Osteosarcoma | What kind of cancer is this? |
| Osteosarcoma | What kind of cancer is this? |
| Usually affects metaphyses of the long bones. A common place is around the knee. | What bones are usually affected by Osteosarcoma? |
| Middle-aged individuals are most at risk for this malignant bone cancer. | Who is mainly effected by Chondrosarcoma? |
| Mostly affects flat bones, especially the shoulder and pelvic girdles. | What bones are usually affected by Chondrosarcoma? |
| Chondrosarcoma | What bone cancer is this? |
| Teens and young adults are most effected by this kind of malignant bone cancer. | Who is most effected by Ewing`s Sarcoma? |
| Ewing`s Sarcoma | Which malignant bone cancer is the least common? |
| Typically involves the diaphyseal region of the lone bones. Has also affinity to flat bones. | Where does Ewing's Sarcoma usually present? |
| The body of a longbone. | What is the "diaphyseal" reason of a bone? |
| Ewing's Sarcoma (onion peel appearance). | What kind of cancer is this? |
| Osteomyelitis | It is an infection of bone that leads to tissue destruction and often to debility. |
| Through the blood (most common), or via an adjacent site. | How is Osteomyelitis spread? |
| Inflammation along with pus. Bone necrosis. Vascular insufficiency. New bone formation. | Pathological findings of Osteomyelitis: (4) |
| It is the death of bone tissue due to a lack of blood supply. | Avascular Necrosis/Osteonecrosis/Aseptic Necrosis: |
| Trauma or fracture | What is the most common cause of avascular necrosis/osteonecrosis? |
| The epiphisis of long bones. | What area of the bone does avascular necrosis/osteomecrosis typoically effect? |
| Osteoartheritis is the least common artheritis. True or False? | What is the most common type of artheritis? |
| Hip, Elbow, Ankle are the most effected areas in Osteoartheritis? True or False? | What joints do Osteoartheritis spare? |
| Maybe because their particular cartilages are uniquely resistant to loading stress that these 3 joints are resistant to osteoartheritis? | Why might the hip, elbow and ankle be particularly resistant to Osteoartheritis? |
| _____________ is joint failure, a disease in which all structures of the joint have undergone pathologic changes, often at the same time. | What causes Osteoartheritis? |
| Repeated joint injury via failure of protective mechanisms causes what? | What causes joint failure? |
| ____________ Reduces friction between articular cartilage and the surface by providing lubrication. | What does synovial fluid do? |
| Lubricin is secreted by the ______ ______ in the joint capsule? | What is secreted by the synovial fibroblast? |
| Joint injury or synovial inflammation causes ________ to decrease secretion. | Lubricin decreases secretion after _________ or _________? |
| _______ and _______ contain mechanoreceptors that signals the spinal cord to adjust loading. | Ligaments and Tendons contain ____________ that signals the spinal cord to adjust loading. |
| 1) provide power and acceleration for the limb. 2) minimize focal stress across the joint by distributing the impact | The contractions of muscles and tendons do what (2)? |
| _________ causes compressive stiffness to cartillage. | Aggrecan causes ________ ________ to cartillage. |
| Chondrocyte, collegen and aggrecan make up __________. | Cartillage is made up of what 3 things? |
| Chondrocytes synthesize what? | What synthesizes the elements of "matrix"? |
| Healthy cartillage is indicated by what 3 traits? | What are the following traits indicative of? - Is metabolically sluggish. - Has a slow matrix turnover. - Has synthesis and degradation in balance. |
| - Previous damage (e.g., meniscectomy). - Weakness of bridging muscles. - Increasing bone density. - Misalignment (e.g., varus and valgus). - Proprioceptive deficiencies (e.g., diabetes). - Obesity These increase the likelihood of what joint disease? | What are 3 non-genetic factors that might lead to osteoartheritis? |
| Bone spurs are also called...? | What's another name for "osteophytes"? |
| Synovial inflamation, joint effusion/fluid, bone marrow edema/swelling, capsular stretching are causes of pain in this joint disease. | What causes Osteoartheritic pain? |
| What is the medical term for "swelling"? | What is "edema"? |
| "Water on the knee"? is medically called ________? | What is "joint effusion"? |
| Morning stiffness Deep, aching joint pain (increases with activity) Crepitous (Cracking Sound) Reduced Range of Motion Joint effusion/swelling Bone spurs | What are the CLINICAL FEATURES of Osteoartheritis? |
| The cracking quality of a joint is called ______? | What is "crepitus"? |
| _________ nodes: osteophytes at the distal phalanges joints (DIP). | Heberden nodes: osteophytes at the _IP joints. |
| _________ nodes: osteophytes at the proximal phalanges joints (PIP). | Bouchard nodes: osteophytes at the _IP joints. |
| To alleviate pain. To minimize loss of physical function. To prevent from further damage This is the process of treating what? | The goals, when treating osteoartheritis, are: |
| Nonsteroidal anti-inflammatory drugs are also abbreviated as ______? | What does NSAID mean? |
| True. | True or false: NSAIDS are effective in treating Osteopartheritis? |
| False. Chondrocyte transplantation has NOT been found to be efficient in OA, perhaps because OA includes pathology of joint mechanics, which is NOT corrected by chondrocyte transplantation. | Chondrocyte transplantation has been found to be efficient in treating OA. True or False. |
| An inflammitory condition characterized by polyarthritis (artheritis in 5, or more, joints; early on it can effect fewer). | What is rheumatoid artheritis? |
| Synovial Tissue is mainly affected by this type of artheritis. | What does rheumatoid artheritis (RA) specifically affect in joints? |
| Type A: Macrophage Derived (Of Phagocyte Origin; Responsible for absorbing bacteria) Type B: Fibroblast Derived; responsible for the creation of collagen, fibronectin, laminin and synovial matrix | What are the two cell-type origins of Synovial Tissue? |
| What contributes to the viscous (thickness of a liquid) nature of synovial fluid? | What is the purpose of Hyaluronan? |
| What glycosaminoglycan (a sugar molecule type) lubricates the surface of articular cartillage? | What is the purpose of Lubricin? |
| The joint is swollen (likely red, due to hypervascularization), and quite possibly disfigured somewhat (due to pannus formation). | What are the visual characteristics of a joint affected by RA? |
| _______ is an abnormal layer of fibrovascular tissue or granulation tissue (it is not limited to joints). | What is "pannus formation"? |
| False; Rheumatoid artheritis is symmetric. | True or false: rheumatoid artheritis is asymmetric. |
| All the joints from the wrist-down, as illustrated. | What joints are effected by Rheumatoid Artheritis? |
| Top to bottom: Mallet Finger, Boutonnièr Deformity, Swan Neck Deformity. | Label "Swan Neck Deformity," Mallet Finger," and "Boutonnièr Deformity". |
| Baker's Cyst; appears in the "knee pit" (as opposed to "arm pit" in annalogy) | What is the name of this cyst? |
| Misalignment/Sublaxation of the C1 and C2 vertebrae Baker's Cyst (back of knee) Hand deformities (Mallet Finger, Boutonnièr Deformity, Swan Neck Deformity) Large joints, such as the shoulders, and knees Rarely: the lumbar and thoracic areas. Wrist Deformities. | Name as many possible deformities/deformed areas you might find in a patient with RA. |
| Constitutional: malaise, fatigue, weightloss, depression, high fever (signs of infection). Subcutaneous nodules, spleen, Heart Disease Vascular and Sjogren`s syndrome, Anemia, renal | What are some possible extra-articular (non-articular) feature areas of Rheumatoid Artheritis? |
| Rheumatoid Artheritis (RA) | What is the general malady being shown in this image? |
| A and d are the ONLY correct answers for a DOMP. | What of the following treatments are within a DOMP's ethical right to recommend for an RA patient: a) NSAIDs, b) Glucocorticoids, c) DMARDs (disease-modifying antirheumatic drugs), d) Physical Therapy and Assistive Devices. e) Surgery. |
| What are some very common Musculoskeletal Manifestations of Crystal – Induced Conditions? | Tendonitis, carpal tunnel, Bursitis, Osteoartheritis, PSEUDO Rheumatoid Artheritis, Spinal Stenosis, tendon rupture |
| What is the most prevalent form of artheritis? | Osteoartheritis |
| Name 3 joints mainly effected by Osteoartheritis. | Lumbosacral spine. Hip. Knee. 1st Metatarsophalangeal (1st joint of big toe) Hands: DIP, PIP and base of the thumb. |
| What chemical does MSU stand for? | Monosodium Urate |
| Gout is characterized by recurrent attacks of artheritis due to monosodium-urate (MSU) deposits, and an increased uric acid level. What are 3 potential causes for increased uric levels? | Alcohol use, Low function thyroid, Medications: esp diuretics, Genetics, Diets (high in red meats, anchovis), Leukemia, Lymphoma, Psiriosis, Chemotherapy, Dehydration and Renal diseases |
| What is a condition that often comes in association with gout? | Obesity. Diabetes. Hypertension. Atherosclerosis. |
| The most common early expression of gout is what? | Acute-Artheritis |
| Simply, what is acute-artheritis? | Acute arthritis is a joint infection that evolves over hours or days. The infection resides in synovial or periarticular tissues and is usually bacterial. It is temporary and is caused by MSU crystals in the joints. |
| What are the two joints least effected by gout? | Shoulders and hips |