Ortho

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Anonymous
ID:
4284
Filename:
Ortho
Updated:
2010-01-15 22:20:00
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basic science
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Ortho basic science
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  1. Osteoblasts produce Type __ Collagen
    1
  2. What controls normal OB differentiation?
    cbfa (core binding factor alpha)
  3. __ downregulates osteoblasts
    • PTH
    • Glucocorticoids
    • PG
    • leptin
  4. __ upregulates OB
    Estrogen
  5. __ & __ expressed during late stages of OB differentiation
    • osteocalcin
    • osteopontin
  6. Describe blood supply to bone
    • Outer 1/3: periosteal arteries
    • Inner 2/3: nutrient arteries
  7. Which enzyme helps create Howship's Lacunae?
    carbonic anhydrase
  8. OC stain for ___
    tartrate-resistant acid phosphatase
  9. Half-life of OC's
    10 days
  10. vitamin d requirements
    • 400 IU
    • 600 IU if >70yo
    • (1mcg = 40 IU)
  11. How does PTH dosing have an anabolic effect on bone? resorptive effect on bone?
    • Intermittent dosing
    • Continuous dosing
  12. Origin of calcitonin?
    clear cells of thyroid
  13. Ca requirements in kids, adult men, lactating women, pregnant women, post menopausal women with healing fx?
    • kids 500-700mg/d
    • adult men 750 mg
    • lactating women 2000 mg
    • pregnant women 1400 mg
    • postmenopausal women 1500 mg
  14. Osteocytes:
    - life span?
    - stains for __?
    - location?
    • - decades
    • - OC-specific monoclonal Ab
    • - in lacunae within mineralized matrix of both cortical and lamellar bone
  15. Process of downregulating OC stimulation?
    OPG binds to rank-L (on OB), which blocks rank-L to rank (on OC precursor)
  16. describe rank-rank-L relationship
    • rank is receptor on OC precursor
    • when rank-L (on OB) binds rank, OC precursor differentiates in OC
  17. Definition of osteoporosis
    • decreased thickness & # of trabecular struts
    • T score >2.5SD = osteoporosis (compares to normal young females)
  18. What is the Z score in osteoporosis?
    • Z score is vs. own age-matched controls
    • If >1.5 SD, look for secondary causes
  19. Target of bisphosphnates
    farnesyl pyrophosphate synthase (FPPS)
  20. MOA of bisphosphonates
    apoptosis
  21. Type I vs Type II senile osteoporosis
    • Type I postmenopausal: trabecular bone, distal radius & vertebral fxs
    • Type II senile: trabecular & corticla bone, hip & pelvis fxs, uncoupling of bone formation and resorption
  22. Painful hip, MRI with DIFFUSE osteoporosis. Dx? Tx? Px?
    • Idiopathic Transient Osteoporosis
    • unknown etiology affecting pregnant females or late-middle aged males
    • Tx: protected WB +/- calcitonin
    • Resolves with time
  23. Steps of Fx repair
    • Inflammation
    • Mesenchymal stem cells, fibroblasts
    • Chondrocytes
    • Soft callus
    • Hard callus
    • Remodeling
  24. Osteomalacia is a quantitative or qualitative problem?
    Qualitative
  25. Types of ossification: (3)
    • enchondral (bone replaces cartilage)
    • embryonic (cartilage precursor converted to bone)
    • intramembranous (no cartilage model, occurs with true rigid fixation)
  26. What is Groove of Ranvier? function?
    supply chondrocytes to periphery of physis, allows widening of physis
  27. What is the perichondrial ring of LaCroix?
    fibrous, support/anchors physis to diaphysis
  28. What type of collagen appears early in unstable fracture repair? Later?
    Type I --> Type II
  29. BMP is part of the ___ family
    TGF beta
  30. Host repair after AVN is _____
    creeping substitution
  31. Name the physeal zones
    • Reserve/Resting
    • Proliferative
    • Hypertrophic
    • Metaphysis
  32. Reserve zone diseases
    • "Reserve place kicker has good distance"
    • pseudoachondroplasia
    • kneist
    • gaucher
    • DD
  33. Diseases in proliferative zone
    • GPA (big and small)
    • Gigantism
    • Achondroplasia
  34. Diseases in Hypertrophic zone
    • MORE Sex Please
    • Muchopolysaccharidoses
    • Ostomalacia
    • Rickets (provisional calcification zone)
    • SCFE & Scurvy
    • Physeal Fx
  35. How is regular SCFE different that endocrinopathy SCFE in terms of location of involvement in the physis?
    • regular SCFE: Hypertrophic
    • endocrinopathy SCFE: Metaphysis
  36. Weakest part of the physis?
    hypertrophic

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