clinical med musculoskeletal

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clinical med musculoskeletal
2012-05-20 17:45:41
clinical med musculoskeletal

clinical med musculoskeletal
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  1. osteogenesis imperfecta
    hereditary disorders -- bad type 1 collagen ---> fragile bones
  2. osteomalacia and rickets are due to what vitamin deficience?
    D, and also, lack of sunshine and malabsorption
  3. osteomalacia (adults) /rickets (kids) characterized by...
    • inadequate mineralization of bone matrix
    • pigeon breast, lumbar lordosis, bowed-legs

    there's no inital decrease in mass but decrease in density
  4. osteitis fibrosa cystica (von Ricklinghausen's disease)

    associated w...
    ass. w hyperparathyroidism

    early stage, osteitis fibrosa, osteitis fibrosa cystica "brown tumor"

    bone tissue becomes soft and deformed as there's a resorption of the bone tissue and a replacement w cyst-like brown tumors and fibrous tissue

    hits mandible and maxillary bones first, but goes everywhere
  5. osteitis deformans (paget's disease)
    mosaic pattern of bone (misshapen bones) leading to unexplained fractures
  6. osteomyelitis
    inflam of bone due to an infectious organism, such as staphylococcus aureus
  7. 2 routes of entry for infectious organisms wanting to give you osteomyelitis
    • 1 - hematogenous route - involves ends of long bones
    • 2 - direct bone penetration - thru wounds, fractures, surgery
  8. asymmetric cartilage growth
    happens in pts w knock-knees or bowed-legs -- one side of epiphyseal plate grows faster than the other

    usually hereditary, but forces like trauma near epiphysial plate may stim one side to grow faster
  9. scoliosis
    abnormal lateral curve of spine, usually affecting adolescent gals
  10. kyphosis
    abnormal anterioposterior curv of spine (old gals)
  11. fracture healing has three phases: inflammatory, reparative, remodeling. Describe inflam
    formation of granulation tissue callus at periphery of the post fracture hemorrhage clot
  12. fracture healing has three phases: inflammatory, reparative, remodeling. Describe reparative
    • differentiation of pluripotent cells into fibro and osteoblasts
    • process moves from perphery toward center of fracture to resorb blood clot and provide deovascularization
  13. fracture healing has three phases: inflammatory, reparative, remodeling. Describe remodeling
    reorganization and restoration
  14. osteoblastic tumors (bone-forming tumors)
    two types, which is benign, where each occur
    osteoid osteoma - benign, diaphyses of long bones (esp femur and tibia) in pts under 30

    osteosarcoma - malignant, in femur tibia and humerus (mostly by the knee) --->early pain and metastases

    both affect mostly folks <30 yo
  15. a benign and a malignant chondrogenci (cartilage forming) tumor
    endochondroma - benighn, usually in hands and feet of yong adults

    chondrosarcoma - malignant, usually after 35 yo, involves pelvic bones, ribs, and vertebrae ... has better prognosis than does osteosarcoma
  16. giant cell tumor
    • in pts > 20 yo
    • at end of long bones
    • agressive malignant neoplasm featuring big multinucleated fibroblast-like cells
  17. ewing sarcoma
    seen in whom?
    • rare malignant neoplasm
    • occurs in older kids
  18. pyogenic arthritis
    • monoarticular disorder
    • involves larger joints
    • result of a bacterial infection
  19. tuberculosus arthritis
    TB in intervertebral discs or joints
  20. osteoarthritis
    • most common disease of joints (esp wt bearing and interphalangeal jts)
    • degenerative, not inflammatory
    • caused by trauma or infection
  21. Heberden's nodes
    nodular swelling seen in osteoarthritis
  22. gout arthritis
    recurring attacks of acute arthritis due to precip of monosodium urate crystals creating inflammatory foci: tophi
  23. muscular dystrophies
    • genetically determined myopathies with progressive atrophy and/or degen of muscle fibers
    • ---> atrophy and loss of muscle fibers
  24. Duchenne's muscular dystrophy
    • common
    • x-linked recessive (boys get it, girls carry it)
    • due to lack of dystrophin (a sarcolemmal protein that strenthens muscle cells)
    • weakness starts at age 3, can't walk by age 10, death by age 20

    involved muscles appear hypertrophied bc they're replaced by fibrofatty tissue - pseudohypertrophy
  25. becker musclura dystrophy
    • x-linked recessive
    • milder than Duchenne's - later onset, pts live normal lifespan, drugs (glucocoritcoids) can inccrease prodcution of dystrophin
  26. myotonic dystrophy
    • autosomal dominant
    • 2 forms: a) from birth -real bad--->death soon
    • b) adult form - weakness in face and hands, balndensess testicular atrophy, dementia
  27. Duchenne's Becker's and myotonic dystrophy compared
    • Duchenne's - x-linked recessive, onset age 3, dead by age 20
    • Becker's - x-linked recessive, appears around age 25, treatable
    • Myotonic - autosomal dominant - if at birth, deadly. if as an adult, weakness
  28. facio-scapulo-humeral dystrophy
    what's the dom/recessive status?
    • autosomal dominant
    • not lethal
    • manifests during adolescnence
  29. limb-girdle dystrophy
    dom/recessive status?
    autosomal recessive, weaknedss in hips or shoulders leading to disability
  30. myesthenia gravis
    • acquired autoimmune remitting desease
    • antibodies attack the acetylcholine receptor of postsynaptic membrane of NMJ
    • usually seen in females about 20 yo, starting w eye trouble
  31. rhabdomyolysis
    • myoglobin leaks out of skeletal muscles - result of overdoing a work out or getting a crush injury, electrical injury, heat stroke, motor seizure, or acute systemic viral illness (ex - the flu)
    • myoglobin will appear in urine