2-Pathopharm > Module 12 > Flashcards

Module 12 Flashcards

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1
Q

What are the primary functions of bones, and how do they contribute to overall body homeostasis?

A
  • Structural support of the body
  • Mineral Storage
  • Production fo RBCs
  • Protection of body organs
  • Provides structure for leverage and movement
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2
Q

How do the structural components of cortical - function and composition?

A

Outside layer, very solid and dense

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3
Q

How do the structural components of trabecular bone- function and composition?

A

Outside of the bone
- Mesh work or lattice of bone, allows for bone to be solid but light
- Bones like wrist and vertebra/upper femur

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4
Q

What is the Periosteum

A

Membrane of blood vessels and nerves that wrap around most bones

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5
Q

What is the Endosteum

A

The center of most long bones, an area for bone marrow

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6
Q

What is an osteoprogenitor cell

A

undifferentiated bone cells, found in the epiphyseal plate, can become activated due to a fracture

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7
Q

What is an Osteocyte

A

actual bone cells that maintain the bony intracellular matrix

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8
Q

What roles do osteoblasts and osteoclasts play in bone remodeling and repair?

A

Osteoblast: Cells that form bone matrix, secrete alkaline phosphatase locally which causes precipitation of calcium and phosphate

Osteoclasts: cells that breakdown bone for repair

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9
Q

How does the hormone parathyroid hormone (PTH) regulate calcium levels and bone health?

A

Increases serum calcium level, lowers phosphate level, works in the kidneys to change rates of reabsorption and increases release of calcium from the bones

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10
Q

How does hormone vitamin D regulate calcium levels and bone health?

A

Decreases serum calcium level by lowering parathyroid levels and increasing bone absorption of calcium

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11
Q

How does hormone calcitonin regulate calcium levels and bone health?

A

Decreases serum calcium level by inhibiting osteoclast activity which reduces the release of calcium from the bone

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12
Q

What are the clinical effects of hypercalcemia and hypocalcemia on the nervous and muscular systems?

A

Sodium permeability decreases across cell membranes causes mental slowness like malaise, weakness and confusion

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13
Q

What are the clinical effects of hypocalcemia on the nervous and muscular systems?

A

Facilitates sodium transport, results in hyperexcitibility of neurons that can be seen as tremors and seizures

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14
Q

What are tendons and what are common injuries associated?

A
  • Made of tough fibrous CT
  • Attaches muscle to bone
  • Weakening or inflammation can lead to rupture
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15
Q

What are ligaments and what are common injuries

A
  • Made of tough fibrous CT
  • Attaches bone to bone
  • Can gradually lengthen when under tension but can rupture if pulled too far
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16
Q

What are the different types of joints, and how do their structures determine their range of motion?

A

Synovial- Freely moveable
Cartilaginous- Slightly moveable
Fibrous- Immovable

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17
Q

What is the ABCDE approach in trauma assessment, and how is it applied during patient evaluation?

A

A- Airway/ C spine protection
B- Breathing and ventilation
C- Circulation and hemorrhage control
D- Disability and neurological evaluation
E- Exposure and environment control

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18
Q

How can fractures lead to complications such as compartment syndrome, neurovascular injury, or infection?

A

CS: Due to the increased pressure, reduced BF, Ischemia

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19
Q

What are the stages of bone healing, and what factors can enhance or delay the process?

A
  1. Fracture and inflammatory Phase
  2. Granulation Tissue Forms
  3. Callus Formation
  4. Lamellar bone
  5. Remodeling Phase
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20
Q

What is the fracture and Inflammatory phase of bone healing

A
  • Hematoma develops a few hrs later
  • Inflammation increases vascular permeability and attracts WBCs
  • Peaks at 48 hrs post injury and lasts for a week
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21
Q

What is the Callus formation stage of bone healing

A
  • Callus or early bone form, consists of osteoblasts an granulation tissue is formed
  • New mineralized bone is formed 6 week post injury
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22
Q

What is the Granulation Tissue formation stage of bone healing

A
  • Fibroblasts are attracted to the area
  • Angiogenesis
  • Requires a lot of O2 and nutrients
  • Lasts for 2 weeks
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23
Q

How do sprains and strains differ in terms of anatomy, severity, and treatment?

A

Sprain: overstretched ligament with a possible tear
Strain: tendon or muscle pull, usually from a quick twist
Both cause pain and weakness and limited ROM

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24
Q

What is an Avulsion Fracture

A
  • Fragment pulled away by ligament or tendon traction
  • Common in athletes and adolescents. Involves both bone and soft tissue; management includes treating tendon/ligament injury as well
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25
What is a transverse fracture
- Line runs perpendicular to the long axis of the bone. - Often from direct blow. Generally stable but can displace; usually needs immobilization.
26
What is a spiral fracture
- Fracture spirals around the bone’s axis. - Twisting mechanism. Can indicate non-accidental trauma in children. Often unstable due to rotational pull on fragments.
27
What is an Comminuted Fracture
- Bone breaks into ≥3 fragments. - High-energy trauma. Healing is complex; frequently requires surgical fixation.
28
What is a linear fracture
- Line runs parallel to the bone’s long axis. - Often from blunt trauma. Typically stable; worry more about associated soft-tissue injury (common in skull fractures).
29
What is an Oblique fracture, both Displaced and non-displaced
- Line occurs at an angle to the long axis - Caused by rotational forces. More prone to displacement and may require fixation.
30
What is a green stick fracture
- One cortex breaks while the other bends. - Seen in children due to bone flexibility. May appear stable but can angulate; requires careful alignment and follow-up.
31
How does osteoporosis develop, and what are the risk factors and clinical manifestations of the disease?
- Low bone density and structural deterioration of bone tissue which leads to fragility - Risks are falls and fractures - Clinical Manifestations- hip fracture, mortality increase
32
What are the key differences between osteoarthritis and rheumatoid arthritis in terms of pathophysiology and clinical presentation?
Osteoarthritis-slowly progressive, degenerative, inflammatory disease. It is increased stress on the joints causing damage to the chondrocytes. RA- Chronic, autoimmune, inflammatory disorder SEE TABLE
33
What are some food sources for Calcium
- Milk, soy milk, yogurt, cheese, broccoli, cucumber, silverbeat, bok choy - Rice and oat milk
34
What are Heberden’s and Bouchard’s nodes, and how do they help diagnose osteoarthritis?
Heberden’s Nodes- swelling at the DISTAL interphalangeal joint Bouchard’s Nodes- swelling at the PROXIMAL interphalangeal joint
35
How does rheumatoid arthritis progress, and what systemic symptoms can accompany the disease?
fever, myalgias, and fatigue
36
What are the key diagnostic tools and treatment strategies for osteoporosis, including pharmacologic options?
- X- rays, no labs are helpful - Medications and joint replacement
37
How do bisphosphonates like alendronate work, and what are the specific administration guidelines to follow?
- Suppress osteoclast activity, thereby increasing bone density by about 50% and reducing fractures - Administer after the patient has risen for the day - Should be sitting or standing. - Do not administer while the patient is lying down or 30 mins after admin - Administer with 8oz plain water only and at least 30 minutes before the first food, beverage, or other medications of the day
38
What is the significance of bone density testing, and how are T-scores used to classify bone health?
Bone mineral density (BMD) measurement results are compared with a reference population of young, healthy adults of approximately age 30 years
39
What are the stages of Lyme disease
1. Early localized 2. Early disseminated 3. Late disseminated
40
What is the first stage of lyme disease- Early Localized
Get erythema margins and flu like symptoms about 2 weeks post exposure
41
What is the second stage of lyme- Early Disseminated
3-12 weeks after bite, headache, neck stiffness, visual changes, cardiac rhythm abnormalities
42
What is the third stage of lyme disease- Late Disseminated
Months to years after bite, swelling and pain of large joints, encephalopathy, blindness (relapsing illness)
43
How does gout develop, and what are the primary symptoms for this condition?
The body makes too much uric acid, or the body is not excreting it. - throbbing, sharp, awful pain, eryhthematic, edematous, warm joint
44
How does osteomyelitis occur, and why is it challenging to diagnose and treat?
Infection in the bone from a bacteria, from trauma, surgery, foreign body - Challenging as x-rays and labs are normal till it is more advanced - Treat with 2-6 weeks of ATBs
45
What is septic arthritis, and how is it differentiated from other types of joint infections?
- Microorganisms in the joint space, synovial membrane becomes infected - Diagnosis requires aspiration and culture of the fluid
46
What is the mechanism of action for disease-modifying antirheumatic drugs (DMARDs), such as adalimumab?
- Targets the mAb that targets necrosis factor alpha - Modify's immune and inflammatory response
47
How do xanthine oxidase inhibitors like allopurinol prevent gout attacks, and what are their common side effects?
- Reduces the amount of uric acid being made by the body cells. - Rash, SJS
48
What lifestyle modifications can help manage or prevent musculoskeletal degenerative diseases?
- Ensure calcium intake is good - NO smoking - Avoid caffeine and alcohol excessively - Improve posture
49
How do degenerative disc diseases lead to nerve compression, and what symptoms are associated with this condition?
- Osteoarthritis of the vertebral discs, causes compression of spinal nerve - Pain that radiates down leg/arm from back
50
What are the key differences in treatment approaches for acute versus chronic musculoskeletal injuries?
- Acute injuries require protection, ice, and short-term rest to reduce inflammation. - Chronic injuries require rehabilitation, strengthening, heat therapy, and long-term biomechanical correction.
51
How does vitamin D supplementation assist in the treatment and prevention of bone-related disorders?
Vitamin D supplementation improves calcium absorption, stabilizes serum calcium levels, and supports proper bone mineralization. It prevents bone breakdown and enhances the effectiveness of osteoporosis treatments, making it essential for both prevention and management of bone-related disorders.
52
How does rheumatoid arthritis affect extra-articular systems, and what are the potential complications?
Fatigue Anorexia Weight Loss Vasculitis Low grade fever
53
What is the role of physical therapy in the recovery of joint and bone injuries, such as rotator cuff injuries?
Can help with strength as well as keeping it mobile to avoid frozen shoulder.
54
How do dietary calcium intake and weight-bearing exercise contribute to bone strength and health?
calcium helps to make bones strong, if u exercise after callus formation it improves bone strength and density
55
What are the diagnostic criteria for compartment syndrome, and why is it considered a medical emergency?
diagnosed by severe, disproportionate pain—especially with passive stretch—plus swelling, paresthesias, and impaired circulation. It is a medical emergency because increased pressure in a closed muscle compartment cuts off blood supply, causing rapid ischemia, irreversible nerve and muscle necrosis, and potential limb loss unless fasciotomy is performed immediately.
56
How does the pathophysiology of tendonitis differ from that of bursitis, and what treatments are most effective?
- Tendonitis is inflammation or irritation of a tendon, the fibrous tissue that connects muscle to bone - Bursitis is inflammation of the bursae, the small fluid-filled sacs that cushion bones, tendons, and muscles. Treat with NSAIDs and rest
57
What are the potential complications of fat embolism syndrome, and how is it linked to fractures?
- Fat globules from the marrow of the fractured bone enter the circulation - Fat emboli obstruct the pulmonary vasculature or the brain
58
How does the progression of degenerative joint diseases vary between weight-bearing and non-weight-bearing joints?
- Weight-bearing joints degenerate faster because mechanical forces accelerate cartilage breakdown, chondrocyte death, and bone remodeling - Non-weight-bearing joints deteriorate more slowly since they experience less compressive stress, so degeneration is driven more by age, genetics, or repetitive motion than by load.
59
What are the benefits and risks associated with monoclonal antibody therapies for musculoskeletal conditions?
An antibody produced from a cell lineage made by cloning a unique B-cell. Monoclonal antibodies bind only to one epitope.
60
What is the Lammellar bone deposition phase of bone healing
- Additional calcium and minerals are placed in the callus, forms stronger bone - Sheets of stronger bone are formed - Takes a few weeks after the callus formation to be completed
61
What is the remodeling phase of bone healing
- Osteoclasts and blasts rebuild the bone back to its strength, scuplt and refines the bone. - Takes about 6 months to finish this phase
62
How do you treat an open reduction
Make an incision and manipulate bones back into place. Apply fixation device
63
How do you treat a closed reduction
bone is realigned and a cast or other splint is applied
64
What is often the cause of hip fractures
due to stress not a fall, typically osteoporosis
2-Pathopharm
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