Term
| The chief structural element of vertebrate bone? |
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Definition
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Term
| Cementing substance in the subq tissue? |
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Definition
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Term
| Provides the tensile strength of bones? |
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Definition
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Term
| Type of bone seen in rapid growth? |
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Definition
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Term
| Fully matured bone in adults is called? |
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Definition
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Term
| Flared region @ end of bone composed of trabecular (spongy) bone & contains red marrow. |
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Definition
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Term
| Entire bone is covered with this? |
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Definition
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Term
| Collagen, Type 1 & this construct the bone matrix? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| osteoblasts secrete what when forming bone? |
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Definition
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Term
| what can be measured in serum to indicate inc bone metabolism- fractures? |
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Definition
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Term
| mature bone cells- act as pathway for chem exchange |
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Definition
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Term
| move over the bone and produce proteolytic enzymes that break down bone- Ca and phosphate released into blood |
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Definition
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Term
| This "hormone" controls rate of Ca excretion in urine |
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Definition
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Term
| bone softening- due to excess Ca reabsorption from extracellular bone matrix |
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Definition
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Term
| where is 99% of calcium found in the body? |
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Definition
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Term
| what are the 2 locations calcium is excreted? |
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Definition
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Term
| Daily req of Ca for child? |
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Definition
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Term
Daily req of Ca for adolescent?
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Definition
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Term
Daily req of Ca for adults?
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Definition
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Term
Daily req of Ca for adult (peri and post menopaulsal)?
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Definition
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Term
Daily req of Ca for pregnancy?
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Definition
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Term
Daily req of Ca for breast feeding?
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Definition
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Term
Daily req of Ca for pt with fracture?
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Definition
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Term
| where is 85% of phosphate in body contained? |
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Definition
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Term
| besides in the bone, where is the remaining phosphate located in the body? |
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Definition
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Term
| where does phosphate absorption occur? |
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Definition
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Term
| is phophate absorption increased by high levels of Vita D? |
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Definition
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Term
| is phosphate absorption decreased by high calcium diet? |
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Definition
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Term
| Phosphate is mostly excreted by? |
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Definition
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Term
| what hormone is the primary regulator of extracellular calcium? |
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Definition
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Term
| what cells release calcium stored in the lacunar space as a rapid response to hyPOcalcemia? |
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Definition
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Term
| How does PTH aid the gut in absorbing Ca? |
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Definition
| increases permeability of gut cells to calcium |
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Term
| How does PTH affect the kidneys in relation to Ca absorption? |
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Definition
| PTH increases the absorption of calcium by stimulating the kidneys to make the activated form of Vitamin D- Calcitriol |
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Term
| What affect does PTH have on phosphate in the kidneys? |
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Definition
| PTH causes kidneys to excrete more phosphate |
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Term
| Most active form of vita D is called? |
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Definition
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Term
| Calcitonin is secreted by |
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Definition
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Term
| main effect of calcitonin |
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Definition
| inhibit osteoclastic resorption of bone- in other words, prevents bone breakdown |
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Term
| Glucocorticoids in excess affect the bone by |
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Definition
| decreasing bone formation: NOT GOOD for skeletal growth |
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Term
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Definition
| GOOD! helps bone remodeling and growth |
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Term
| kind of cartilage that lines joints |
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Definition
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Term
kind of cartilage that forms the public symphysis?
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Definition
| Fibrio- mix of cartilage and fibrous tissue |
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Term
kind of cartilage only found in c-spine ligamentum nuchae?
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Definition
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Term
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Definition
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Term
| chondroblasts mature into... |
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Definition
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Term
| the cartilage matrix is called the |
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Definition
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Term
| the chondroblasts secrete this to form the cartilage matrix |
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Definition
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Term
| what provides most of the cartilage matrix and what type is it? |
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Definition
collagen type 2
type 1 is in bone |
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Term
| the ability to repeatedly absorb energy without failure by the hyaline chondroid is related to? |
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Definition
| the degree of proteoglycans polymerization |
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Term
| type of cartilage seen in meniscus and vertebral disks? |
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Definition
| Fibrocartilage- also pubic symphysis |
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Term
| type of joint that doesnt move |
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Definition
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Term
| what type of joint is seen at cranial sutures? |
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Definition
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Term
| type of joint with minimal movement- ligaments, meniscus, costrochondral joints... |
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Definition
| cartilaginous (amphiarthrodial) |
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Term
| freely movable joint- tmj, knee |
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Definition
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Term
| the synovial joint has what kind of cartilage? |
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Definition
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Term
| the presence of a "tideline" is a biological marker for |
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Definition
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Term
| the capsule of the joints 3 layers: |
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Definition
outer fibrous layer
intermediate layer
inner synovial membrane |
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Term
| joint lubrication secreted by synovial cell |
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Definition
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Term
| 2 principal purposes of synovial fluid: |
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Definition
| lubrication and nutrition to articular cartilage |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
Synovial Fluid: Gout color and wbc
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Definition
straw- white- cloudy
10-20,000 |
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Term
Synovial Fluid: RA color and wbc
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Definition
straw-yellow-cloudy
15-20,000 |
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Term
Synovial Fluid: Reiters syndrome color and wbc
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Definition
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Term
Synovial Fluid: Infectious arthritis color and wbc
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Definition
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Term
| type of fracture that is angle across bone |
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Definition
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Term
type of fracture that is from twisting
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Definition
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Term
| type of fracture with splinters and more than 2 bone fragments |
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Definition
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Term
| fracture involving bone at insertion of ligament or tendon site |
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Definition
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Term
| fractures that involve the epiphysis are called |
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Definition
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Term
| buckle fracture usually seen in who and where? |
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Definition
| in kids, in cancellan bone (softer bone) |
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Term
| fracture description by the degree of deviation |
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Definition
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Term
| fracure description by the extent of displacement |
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Definition
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Term
| refers to any deviation from norm alignment |
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Definition
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Term
| if no portion of the articular cartilage is still touching it is called.. |
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Definition
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Term
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Definition
osteoma
chondroblastoma
enchondroma
giant-cell tumor |
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Term
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Definition
MM
osteogenic sarcoma
chondrosarcoma
ewing's sarcoma |
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Term
| where and in whom are chondroblastomas seen? |
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Definition
adolescent males
epiphysis of bone- most commonly in humerus |
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Term
| where are enchondroma (central chondromas) seen and tx: |
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Definition
metaphysis of tubular bones- hands and feet
surgical excision is tx due to risk of pathologic fracture |
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Term
| Giant-cell tumor seen mostly in whom and where? |
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Definition
young females
end of long bones- knee and wrist
tx: surgical removal |
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Term
| most common malignant bone tumor is? by prolif of what cells? |
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Definition
multiple myeloma
plasma cells proliferate
bone pain is most common symptom |
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Term
| primary MALIGNANT tumor in metaphysis? |
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Definition
osteogenic sarcoma (osteosarcoma)- commonly end of long bones (knees)
young adults and kids, or pts over 50 with pagets dz |
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Term
| which tumor is characterized by the sunburst pattern |
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Definition
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Term
| presents as painless mass in men over 35 y/o in bone |
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Definition
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Term
| which tumor produces a onionskin effect with sxs of pain, swelling, and fever? |
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Definition
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Term
| what type of osteoporosis is seen in postmenopausal women? |
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Definition
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Term
| whats the underlying cause of type 1 osteoporosis? |
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Definition
| estrogen deficiency- skeleton becomes more sensitive to PTH which weakens bone. |
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Term
| the two major determinants of risk in development of osteoporosis are? |
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Definition
peak bone mass
and rate of bone loss |
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Term
| who is at highest risk for osteoporosis? |
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Definition
white and asian women
blacks and hispanics are relatively protected bc of greater peak bone mass |
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Term
| osteopenia doesnt show up on plain film until bone loss is what percent? |
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Definition
| greater than or equal to 30% loss |
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Term
| if you see osteopenia on plain film, what do you do next? |
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Definition
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Term
| what are two major risk factors for men in developing osteoporosis? |
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Definition
hypogonadism- low pooled testosterone &
alcohol use |
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Term
| indications for a DEXA scan: |
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Definition
hypercalciurea- with or without kidney stones
GI diseases- and hemigastrectomy
RA or ankylosing spondylitis
anticonvulsant use for 5 yrs
prolonged thyroid replacement
tx with methotrexate
postmeno women with two or more risk factors
low calcium intake- lifelong
prev fracture in adult years |
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Term
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Definition
normal bone mineral density > -1.0
Osteopenia: -1.0 to -2.5
Osteoporosis: < 2.5 |
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Term
| percent bone loss rate per year is? |
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Definition
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Term
| most common kind of arthritis is |
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Definition
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Term
| joint pain w/ movement or weight bearing exercise and improves with rest is... |
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Definition
| osteoarthritis clinical feature----classic! |
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Term
| heberden's nodes, PIP, DIP fingers is what kind of OA? |
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Definition
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Term
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Definition
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Term
| chronic dz that affects mult organ sys- autoimmune |
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Definition
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Term
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Definition
| digestive destruction in synovial fluid |
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Term
| vascular granulation tissue that forms from the inflamed synovium in RA |
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Definition
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Term
| pannus will spread to cover what? |
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Definition
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Term
| symmetrical polyarthritis is seen where? |
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Definition
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Term
| what cardiac probs can you see in RA? |
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Definition
pericarditis
pericardial effusion |
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Term
| what lung probs can you see in RA? |
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Definition
pulm nodules
pleural effusion |
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Term
| what ophthalmologic manifestations are seen in pts with RA? |
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Definition
keratoconjunctivitis sicca
scleritis
episcleritis
keratitis |
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Term
| what neurologic manifestations can been seen in pts with RA? |
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Definition
rheumatoid granulomata near nerve roots
cervical spine subluxation resulting from bone erosions |
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Term
| what is a systemic condition that can be seen in pts with RA? |
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Definition
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Term
| what antibody is present in 85% of RA pts |
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Definition
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Term
| At least 4 of these must be present for >6 weeks to meet RA criteria |
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Definition
morning joint stiffness longer than 1 hr
arthritis of 3 or more joint areas
arthritis of hand joints (wrists, MCP, or PIP)
symmetrical arthritis
rheumatoid nodules
positive serum RF
radiographic changes- erosions, deformities |
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Term
| distinguishing characteristics of RA and not Osteoarthritis |
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Definition
joints: MCP, wrists, elbows, MTP & ankles
warmth swelling, & erythema of joints
synovial hypertrophy (doughy feeling) on exam
joint deformity- ulnar deviation at MCPs
joint symptoms typically wax & wane |
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Term
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Definition
NSAIDS
Methotrexate
Plaquenil
Enbrel
corticosteriods
DMARDS |
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Term
| chronic inflammatory autoimmune disorder of unknown cause |
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Definition
| systemic lupus erythematosus: SLE |
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Term
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Definition
| the disorder when it only involves the skin |
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Term
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Definition
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Term
| lupus nephritis occurs when.. |
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Definition
| anti nuclear antibody (ANA) immune complex is deposited in the glomerulus |
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Term
| several disorders have ANAs, but only SLE has.. |
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Definition
anti-dsDNA
anti-sm
antibodies |
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Term
| best screening test for SLE? |
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Definition
the fluorescent test for ANA
95% have positive |
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Term
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Definition
NSAIDS
corticosteriods
antimalarials
immunosuppressive drugs
avoid UV light! |
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Term
| scleroderma is typically in.. |
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Definition
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Term
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Definition
diffuse/systemic: cutaneous
limited: CREST variant- face and hands
localized |
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Term
| what is leading cause of death from scleroderma? |
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Definition
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Term
| paroxysmal vasospastic disorder of hands |
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Definition
| raynauds phenomenon- white, blue, red |
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Term
| uncommon connective tissue dz characterized by fibrosis of the skin and other organs |
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Definition
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Term
| faces appear tight leathered look |
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Definition
| scleroderma- collagen overproduction |
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Term
| sausage like fingers seen in? |
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Definition
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Term
| proteinuria and hematuria with HTN and dysphagia seen in |
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Definition
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Term
| definitive diagnosis for scleroderma |
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Definition
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Term
| in crest syndrome, scleroderma is limited to? |
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Definition
| face and hands- they DO NOT develop renal or lung disease |
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Term
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Definition
calcinosis- Ca deposits in skin
Raynauds
Esophageal motility disorder
Sclerodactyly- abnorm fingers
Telangiectasia |
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Term
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Definition
no effective tx that reverses fibrosis
protect hands
tx symptoms |
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Term
| metabolic disorder- elevation of serum uric acid |
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Definition
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Term
| monosodium urate crystals seen in |
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Definition
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Term
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Definition
| plasma uric acid > 7.0 mg/dL |
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Term
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Definition
| asymptomatic hyperuricemia |
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Term
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Definition
acute gouty arthritis- starts w/o warning
overindulgence of purine-rich food
MTP of big toe most often invloved (podagra) |
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Term
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Definition
intercritical stage
follows gouty attack- mo to yrs |
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Term
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Definition
chronic gout stage
chronic inflammation from urate crystals results in joint swelling and irritation
Tophi
olecrannon bursa |
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Term
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Definition
MSU crystal aggregates- can be seen on xray of joints as punched out lesions
leads to kidney damage |
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Term
|
Definition
| Colchicine- drug relieves sxs |
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Term
|
Definition
| uric acid crystals in synovial fluid |
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Term
| blocks formation of uric acid |
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Definition
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Term
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Definition
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Term
| gout related disorder without RF in serum |
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Definition
| seronegative spondyloarthropathies |
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Term
|
Definition
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Term
| chronic inflammatory progressive dz of SI joints and spinal articulations |
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Definition
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Term
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Definition
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Term
| 25% of pts will have complete fusion of the spine including the cervical spine |
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Definition
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Term
| 90% of pts have teh HLA-B27 antigen |
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Definition
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Term
| inflammatory arthritis with psoriasis of skin or nails |
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Definition
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Term
| pencil -in- cup sign, DIP joints |
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Definition
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Term
| one of leading causes of arthritis in young men- related to nongonoccocal urethritis |
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Definition
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Term
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Definition
conjunctivitis
arthritis
urethritis |
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Term
|
Definition
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Term
| arthritis with ulcerative colitis and crohns dz |
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Definition
enteropathic arthritis
peripheral joints affected
tx of bowl dz resolves arthritis usually |
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