1
Q
What is osteopenia?
A
A condition characterized by low bone mineral density (BMD) that is not as severe as osteoporosis but still increases the risk of fractures
2
Q
The pathophysiology of osteopenia involves what?
A
an imbalance between bone formation and bone resorption, leading to decreased bone density
3
Q
what is the T-score of osteopenia?
A
-1.0 and -2.4
4
Q
what are the reasons why osteopenia happen?
A
- Bone remodeling imbalance
- Hormonal factors
- Nutritional deficiencies
- Age
- Genetic factors
5
Q
Which cells control bone remodeling?
A
Osteoclasts resorb bone, osteoblasts form bone
6
Q
What happens to bone remodeling in osteopenia?
A
Osteoclast activity exceeds osteoblast activity, leading to net bone loss
7
Q
How does estrogen affect bone?
A
educes bone resorption and protects against bone loss
8
Q
Why does menopause increase risk of osteopenia?
A
Estrogen levels drop, leading to increased bone resorption
9
Q
How does testosterone support bone health?
A
- Stimulates osteoblast activity
- Inhibits osteoclast activity
- Increases muscle mass, which promotes bone formation
10
Q
How does muscle mass influence bone density?
A
Muscle force on bone during activity stimulates bone formation
11
Q
Which nutritional deficiencies contribute to osteopenia?
A
Low calcium and vitamin D intake
12
Q
Why is vitamin D important for bone health?
A
Enhances calcium absorption and supports bone mineralization
13
Q
How does aging affect bone density?
A
Bone density peaks in early adulthood and declines with age due to reduced bone formation
14
Q
How do genetic factors influence osteopenia?
A
They affect baseline bone density and susceptibility to bone loss
15
Q
what are the clinical features of osteopenia?
A
- Asymptomatic
- Height loss
- Bone pain
- Fractures ((MC: vertebrae, hips, wrists, metatarsals, and ribs)
- Decreased grip strength
16
Q
what is osteoporosis?
A
A systemic skeletal disorder with reduced bone strength, micro-architectural deterioration, and increased fracture risk
17
Q
What defines osteoporosis on a T-score?
A
Less than −2.5
18
Q
Which population has the highest prevalence of osteoporosis?
A
Postmenopausal women
19
Q
Does osteoporosis affect men?
A
Yes, risk increases with age and underlying conditions
20
Q
What are the key pathological features of osteoporosis?
A
- Bone Density Reduction
- Micro-architectural Changes
- Imbalance in Bone Remodelling
- Trabecular and Cortical Bone Affection
21
Q
What are the main causes of osteoporosis?
A
- Nutritional deficiencies
- Aging
- Genetic factors
22
Q
What happens to bone mineral density in osteoporosis?
A
It decreases significantly compared to a healthy young adult
23
Q
What are micro-architectural changes in osteoporosis?
A
- Thinning of trabeculae
- Increased porosity
- Reduced connectivity
24
Q
What is the bone remodeling imbalance in osteoporosis?
A
Bone resorption exceeds bone formation
25
Which cells are responsible for bone loss in osteoporosis?
Osteoclast activity exceeds osteoblast activity
26
Which types of bone are affected in osteoporosis?
Both trabecular and cortical bone
27
Which type of bone is more severely affected in osteoporosis and why?
Trabecular bone, due to higher metabolic activity
28
Why does osteoporosis increase fracture risk?
Reduced density and disrupted structure weaken bone strength
29
What is the hallmark clinical feature of osteoporosis?
Fragility fractures
30
What is a fragility fracture?
A fracture from minimal trauma, such as a fall from standing height
31
What are the most common fracture sites in osteoporosis?
Spine, hip, and wrist
32
Why do fractures occur easily in osteoporosis?
Reduced bone strength and structural deterioration
33
What causes back pain in osteoporosis?
Vertebral compression fractures
34
How does osteoporotic back pain typically present?
Localized pain that worsens with movement or weight-bearing
35
Why does osteoporosis lead to loss of height?
Repeated vertebral compression fractures
36
What postural change is associated with osteoporosis?
Kyphosis, or stooped posture
37
38
What are common secondary complications after hip fractures?
- Pneumonia
- Deep vein thrombosis
- Pressure ulcers
39
Why is osteoporosis often diagnosed late?
It is asymptomatic until a fracture occurs
40
How is osteoporosis sometimes detected before fractures?
Incidentally on imaging such as DXA scans
41
What muscle changes are associated with osteoporosis?
Reduced grip strength and muscle weakness
42
What does a T-score measure?
Bone mineral density compared to a healthy young adult
43
What does a T-score of 0 mean?
Bone density equal to a healthy young adult
44
What do negative T-scores indicate?
Lower bone density than average
45
What T-score range defines osteopenia?
−1.0 to −2.4
46
What T-score defines osteoporosis?
≤ −2.5
47
Key difference between osteopenia and osteoporosis?
Osteopenia shows mild bone loss, osteoporosis shows severe bone loss with high fracture risk
48
What is Paget’s disease of bone?
A chronic disorder with abnormal bone remodeling leading to enlarged, weak, and disorganized bone
49
What is another name for Paget’s disease?
Osteitis deformans
50
What is the key pathophysiologic feature of Paget’s disease?
Increased bone resorption with accelerated but disorganized bone formation
51
What is the etiology of Paget’s disease?
Unknown, with genetic and viral factors implicated
52
What viral association is linked to Paget’s disease?
Paramyxoviruses such as measles and respiratory syncytial virus
53
What evidence supports viral involvement in Paget’s disease?
- Viral inclusions in osteoclasts
- Viral mRNA in osteoclasts
- Transformation of osteoclast precursors
- Reduced incidence after measles vaccination
54
What initiates Paget’s disease at the cellular level?
Excessive osteoclast-mediated bone resorption
55
What happens after increased bone resorption in Paget's disease?
Increased osteoblast activity produces disorganized, weak bone
56
What type of bone forms in Paget’s disease?
Woven bone with poor structural integrity
57
What vascular change occurs in Paget’s disease?
Increased vascularity due to high metabolic activity
58
What microscopic bone pattern is seen in Paget’s disease?
Mosaic pattern with disorganized trabeculae and irregular cement lines
59
What occurs in the osteolytic phase in Paget's disease?
High osteoclast activity and bone resorption with hypervascularity
60
What is the radiographic sign of the osteolytic phase in Paget's disease?
“Blade of grass” lytic lesion
61
What occurs in the mixed phase in Paget's disease?
Active bone resorption and formation with woven bone replacing lamellar bone
62
What occurs in the sclerotic phase in Paget's disease?
Reduced resorption, dense and hardened “burned-out” bone
63
What type of bone pain is seen in Paget’s disease?
Dull, aching, localized pain
64
What lab marker is elevated in Paget’s disease?
Alkaline phosphatase
65
What does elevated alkaline phosphatase indicate in Paget’s disease?
Increased bone turnover
66
What is scoliosis?
A musculoskeletal disorder with an abnormal lateral curvature of the spine
67
When does scoliosis most commonly develop?
During childhood or adolescence
68
Which group is most affected by scoliosis?
Females, often around ages 10 to 12
69
What are the four main types of scoliosis?
- Idiopathic
- Congenital
- Neuromuscular
- Syndromic
70
Which type of scoliosis is most common?
Idiopathic, about 80% of cases
71
What is the primary structural abnormality in scoliosis?
Lateral curvature of the spine
72
What shapes can the spinal curve take in scoliosis?
C-shaped or S-shaped
73
What is vertebral rotation in scoliosis?
Rotation of vertebrae around their vertical axis
74
How do muscles and ligaments contribute to scoliosis?
Imbalance in support structures contributes to spinal curvature
75
What is the most obvious clinical sign of scoliosis?
Visible spinal curvature
76
What body asymmetries are seen in scoliosis?
Uneven shoulders, hips, or waist
77
What determines severity of back pain in scoliosis?
Degree of curvature and muscle strain
78
How does scoliosis affect spinal mobility?
Reduces range of motion for bending and twisting
79
When do breathing problems occur in scoliosis?
In severe thoracic curvature
80
What is osteogenesis imperfecta?
A genetic connective tissue disorder with fragile bones prone to fractures
81
What is another name for osteogenesis imperfecta?
Brittle bone disease
82
What is the primary cause of osteogenesis imperfecta?
Mutations in type I collagen genes
83
Why is type I collagen important in bone?
Provides strength and structural support to bone matrix
84
What happens to collagen in osteogenesis imperfecta?
Defective synthesis or structure of type I collagen
85
How does defective collagen affect bone?
Produces weak, brittle bone with poor structural integrity
86
What is the bone matrix like in osteogenesis imperfecta?
Abnormal and prone to deformation and fracture
87
What is the hallmark clinical feature of osteogenesis imperfecta?
Recurrent fractures with minimal trauma
88
What causes blue sclerae in osteogenesis imperfecta?
Thin connective tissue allows underlying structures to show through
89
What dental condition is associated with osteogenesis imperfecta?
Dentinogenesis imperfecta
90
How do teeth appear in dentinogenesis imperfecta?
Discoloured, weak, and prone to breakage
91
What skeletal deformities occur in osteogenesis imperfecta?
- Bowed limbs
- Scoliosis
- Chest wall deformities
92
What is the leading cause of death in osteogenesis imperfecta?
Pulmonary disease
93
What cardiovascular complications occur in osteogenesis imperfecta?
- Mitral regurgitation
- Aortic root dilation
94
Why does osteogenesis imperfecta affect the heart?
Type I collagen is important in valves and aortic wall
95
What is osteomyelitis?
A serious infection of bone caused mainly by bacteria
96
What are the main routes of infection in osteomyelitis?
- Hematogenous spread
- Contiguous spread
- Vascular insufficiency or neuropathy
97
Where does hematogenous osteomyelitis most commonly occur in adults?
Vertebral column
98
What is contiguous spread in osteomyelitis?
Infection spreads from nearby tissue, often after surgery or trauma
99
How does osteomyelitis begin?
Bacterial invasion of bone via blood or direct entry
100
What is a sequestrum?
A segment of necrotic bone
101
What is the most common symptom of osteomyelitis?
Localized bone pain
102
What local signs are seen in osteomyelitis?
Swelling, redness, and warmth
103
What are sinus tracts in osteomyelitis?
Channels that drain pus from bone to skin
104
What may drain from sinus tracts?
Pus or necrotic tissue
105
What serious systemic complication can occur in osteomyelitis?
Septicemia
106
What joint complication is associated with osteomyelitis?
Septic arthritis
107
What is multiple myeloma?
A malignancy of plasma cells in bone marrow
108
What do malignant plasma cells produce in multiple myeloma?
Monoclonal immunoglobulins, M proteins
109
What happens in the bone marrow in multiple myeloma?
Malignant plasma cells crowd out normal blood cell production
110
What are osteolytic lesions in multiple myeloma?
Areas of bone destruction caused by increased osteoclast activity
111
Why does bone destruction occur in multiple myeloma?
Myeloma cells stimulate osteoclasts
112
What are major clinical features of multiple myeloma?
- Bone pain
- Anemia
- Renal dysfunction
- Hypercalcemia
- Infections
113
Why does anemia occur in multiple myeloma?
Bone marrow infiltration reduces RBC production
114
Why does renal failure occur in multiple myeloma?
M proteins damage renal tubules
115
What is ankylosing spondylitis?
A chronic inflammatory disease affecting the spine and sacroiliac joints
116
What genetic marker is strongly associated with ankylosing spondylitis?
HLA-B27
117
What is the hallmark pathological process in ankylosing spondylitis?
Chronic inflammation at entheses
118
What is syndesmophyte formation?
New bone formation that fuses vertebrae
119
What is bamboo spine?
Fused, rigid spine due to ossification
120
What is sacroiliitis?
Inflammation of sacroiliac joints
121
What type of back pain occurs in ankylosing spondylitis?
Inflammatory pain, worse in morning, improves with activity
122
What is enthesitis?
Inflammation at tendon or ligament insertion
123
What is osteomalacia?
Soft bones in adults due to defective mineralization
124
What is rickets?
Soft bones in children before epiphyseal closure
125
What deficiency most commonly causes osteomalacia and rickets?
Vitamin D deficiency
126
What are common causes of vitamin D deficiency?
Low intake
Low sunlight
Malabsorption
Liver or kidney disease
127
What are key clinical features in osteomalacia?
Bone pain, weakness, fractures
128
What deformities occur in rickets?
- Bowed legs
- Knock knees
- Chest deformities
129
What are the stages of fracture healing?
- Hematoma
- Inflammation
- Granulation tissue
- Callus formation
- Remodeling
130
What occurs during hematoma formation for fracture healing?
lood clot forms and recruits repair cells
131
What happens in the inflammatory phase for fracture healing?
mmune cells clean debris and release cytokines
132
What forms during granulation tissue stage for fracture healing?
Fibroblasts and chondroblasts form soft tissue matrix
133
What is a soft callus?
cartilage bridge stabilizing fracture
134
What is a hard callus?
Bone replaces cartilage to stabilize fracture
135
What is remodeled in final stage for fracture healing?
Woven bone replaced by lamellar bone
136
What gives bone tensile strength?
Type I collagen
137
What gives bone compressive strength?
Hydroxyapatite
138
How does osteoporosis affect fracture healing?
slower and less effective healing
139
What nutritional support improves fracture healing?
Calcium and vitamin D
140
What lifestyle factors improve healing?
- Weight-bearing exercise
- Smoking cessation
- Reduced alcohol intake
BMS 250
flashcards
Decks in class (37)
# Cards
-
Female Reproductive System63
-
Physiology and Endocrinology of Uterine and Ovarian Cycles106
-
Pathophysiology of PCOS and Complications29
-
Immunology of Skin132
-
Microbiology of Skin Infections92
-
Skin Pathologies119
-
Pathophysiology of dermatitis 126
-
Microbiology of STI and Vaginal Infections75
-
Pathophysiology of Uterus, Vagina, and Adnexa126
-
Lung Anatomy153
-
Pulmonary Circulation and Control of Breathing125
-
Ventilation and Respiration66
-
Allergic Rhinitis90
-
Pathophysiology of Restrictive and Obstructive Lung Diseases Part 1106
-
Pathophysiology of Major Neoplastic Diseases of the Lungs78
-
Pathophysiology of major restrictive and obstructive lung disease (part II) and major pulmonary vascular disorder70
-
Microbiology of Infections of Lower Respiratory Tract53
-
Respirology 479
-
Microbiology of the Genitourinary system and physiology of lower urinary tract and select pathologies100
-
Renal Anatomy75
-
Renal Physiology51
-
Renal Physiology 296
-
Kidney Pathology 1101
-
Kidney Pathology 2 Pt 188
-
Kidney Pathology 2 Pt 2130
-
Kidney Pathology 387
-
Kidney Pathology 472
-
Bone Anatomy154
-
Endrocrinology, Biochemistry and physiology of bone109
-
Physiology of Menopause and Temperature Regulation129
-
Bone Pathology140
-
Pregnancy144
-
Breast103
-
Anatomy, Spermatogenesis and Histology of the Male Reproductive System115
-
Pathophysiology of Major Conditions of the Male Reproductive Tract129
-
Physiology of ED65
-
Pathophysiology of Androgen Deficiency74
