Bone and Soft tissue Quiz
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Questions and Answers

Which component makes up two-thirds of the extracellular matrix of bone?

  • Type I collagen
  • GAG
  • Inorganic hydroxyapatite (correct)
  • Osteoid

    • Where are osteocytes located within the bone?

  • In lacunae (correct)
  • On the surface of the matrix
  • In the Haversian canal
  • On the surface of bone

    • Which cells are responsible for bone resorption?

  • Osteocytes
  • Osteoclasts (correct)
  • Osteoblasts
  • Chondrocytes

    • During embryogenesis, how do long bones develop?

    <p>By endochondral ossification</p> Signup and view all the answers

    What type of bone is rapidly formed, more cellular, and has a random orientation?

    <p>Woven bone</p> Signup and view all the answers

    How is compact (cortical) bone organized?

    <p>As parallel columns known as Haversian systems</p> Signup and view all the answers

    What is the function of the Haversian canal in bone?

    <p>To transport nutrients and waste</p> Signup and view all the answers

    What is the function of osteoblasts in bone?

    <p>To synthesize, transport, and assemble bone matrix</p> Signup and view all the answers

    How do osteocytes communicate with the Haversian canal?

    <p>Through canaliculi</p> Signup and view all the answers

    What is the organic component of the extracellular matrix of bone known as?

    <p>Osteoid</p> Signup and view all the answers

    Which condition is characterized as a group of inherited diseased caused by impaired maturation of type I collagen and fragile bones that fracture easily?

    <p>Osteogenesis Imperfecta</p> Signup and view all the answers

    What is the most common skeletal dysplasia?

    <p>Achondroplasia</p> Signup and view all the answers

    Which condition is caused by mutations in the FGFR3 gene and is characterized by extremely short limbs and folds of extra skin on the arms and legs?

    <p>Thanatophoric dysplasia</p> Signup and view all the answers

    Which condition is characterized by abnormal dentine structure affecting either the primary or both the primary and secondary dentitions, resulting in discolored teeth with structural defects?

    <p>Dentinogenesis Imperfecta</p> Signup and view all the answers

    What is the main defect in Achondroplasia?

    <p>Defect in FGF receptor 3 (FGFR3)</p> Signup and view all the answers

    Which condition is inherited in an autosomal dominant manner?

    <p>All of them</p> Signup and view all the answers

    Which condition is characterized by short limbs, a normal trunk, and a large head?

    <p>Achondroplasia</p> Signup and view all the answers

    Which condition is fatal in utero in its type 2 form?

    <p>Osteogenesis Imperfecta</p> Signup and view all the answers

    Which condition can result in hearing loss due to damage to middle ear bones?

    <p>Osteogenesis Imperfecta</p> Signup and view all the answers

    Which condition is characterized by blue sclerae?

    <p>Osteogenesis Imperfecta</p> Signup and view all the answers

    Which type of bone development is responsible for the development of flat bones?

    <p>Intramembranous ossification</p> Signup and view all the answers

    What connects the parallel Haversian canals to one another in bone?

    <p>Perpendicular Volkmann's canals</p> Signup and view all the answers

    What cells are responsible for creating the lamellae of the Haversian systems in bone?

    <p>Osteoblasts</p> Signup and view all the answers

    What happens to osteoblasts as they secrete matrix in bone?

    <p>They become trapped in lacunae and become osteocytes</p> Signup and view all the answers

    What is the main defect in Achondroplasia?

    <p>Defect in FGF receptor 3 (FGFR3)</p> Signup and view all the answers

    What is the main cause of death in most infants with Thanatophoric dysplasia?

    <p>Respiratory failure</p> Signup and view all the answers

    Which condition is characterized by abnormal dentine structure affecting the teeth?

    <p>Dentinogenesis Imperfecta</p> Signup and view all the answers

    Which condition is caused by mutations in the FGFR3 gene and is characterized by short limbs and folds of extra skin on the arms and legs?

    <p>Thanatophoric dysplasia</p> Signup and view all the answers

    What is the main treatment for osteoporosis?

    <p>Vitamin D and bisphosphonates</p> Signup and view all the answers

    Which factor can contribute to decreased vitamin D production?

    <p>All of the above</p> Signup and view all the answers

    What is the radiological finding in osteomalacia?

    <p>Osteopenia and stress fractures</p> Signup and view all the answers

    What is the primary cause of osteopenia in hyperparathyroidism?

    <p>Increased osteoclast activity</p> Signup and view all the answers

    Which X-ray finding is NOT associated with hyperparathyroidism?

    <p>All of the above</p> Signup and view all the answers

    What is the histopathological finding in hyperparathyroidism?

    <p>All of the above</p> Signup and view all the answers

    What can hyperparathyroidism cause in bone?

    <p>All of the above</p> Signup and view all the answers

    What is the main defect in osteogenesis imperfecta?

    <p>Impaired maturation of type I collagen</p> Signup and view all the answers

    Which condition is characterized by a defect in osteoclastic activity, resulting in thickened and heavily mineralized bones?

    <p>Osteopetrosis</p> Signup and view all the answers

    What is the most common form of osteoporosis?

    <p>Senile osteoporosis and Postmenopausal osteoporosis</p> Signup and view all the answers

    Which condition is caused by mutations in the genes for type I collagen, leading to defective bone formation and skeletal fragility?

    <p>Osteogenesis imperfecta</p> Signup and view all the answers

    Which condition is characterized by defects in one bone or a group of bones?

    <p>Dysostosis</p> Signup and view all the answers

    Which condition is characterized by global defects of the skeleton, affecting both bone and cartilage?

    <p>Dysplasia</p> Signup and view all the answers

    Which gene mutations are responsible for achondroplasia and thanatophoric dysplasia, both of which manifest as dwarfism?

    <p>FGFR3</p> Signup and view all the answers

    Which condition is characterized by hard but brittle bones?

    <p>Osteopetrosis</p> Signup and view all the answers

    What is the rate of bone loss per year in senile osteoporosis?

    <p>0.7%</p> Signup and view all the answers

    Which condition is characterized by a net gain in bone due to minimal resorption, resulting in thickened and brittle bones?

    <p>Osteopetrosis</p> Signup and view all the answers

    Which form of osteopetrosis is characterized by mutations in CA2 or TCIRG1 and is severe since infancy with extramedullary hematopoiesis and ultimately death?

    <p>Autosomal recessive</p> Signup and view all the answers

    Which condition is characterized by defective bone formation and skeletal fragility, and is caused by mutations in the genes for type I collagen (DGI1)?

    <p>Osteogenesis imperfecta</p> Signup and view all the answers

    Which condition is characterized by insufficient mineralization of bone due to vitamin D deficiency or its abnormal metabolism?

    <p>Osteomalacia</p> Signup and view all the answers

    What is the primary cause of osteopenia in hyperparathyroidism?

    <p>Increased PTH levels</p> Signup and view all the answers

    Which factor can contribute to decreased vitamin D production?

    <p>All of the above</p> Signup and view all the answers

    Which condition is characterized by impaired mineralization of bone matrix and deficient mineralization at the cartilage of growth plates in children?

    <p>Rickets and osteomalacia</p> Signup and view all the answers

    Which condition is characterized by insufficient mineralization of bone due to vitamin D deficiency or its abnormal metabolism?

    <p>Rickets</p> Signup and view all the answers

    What is the function of the Haversian canal in bone?

    <p>Blood vessel and nerve supply</p> Signup and view all the answers

    Bone loss predisposes to microfractures and secondary hemorrhages that elicit an influx of macrophages and an ingrowth of reparative fibrous tissue, creating a mass of reactive tissue known as a __________??

    <p>Brown tumor</p> Signup and view all the answers

    What is the most common cause of osteomyelitis in children?

    <p>Hematogenous spread (Haemophilus)</p> Signup and view all the answers

    What is the most common cause of osteomyelitis in adults?

    <p>Open fracture or contiguous extension</p> Signup and view all the answers

    Which organism is commonly associated with osteomyelitis in children with sickle cell anemia?

    <p>Salmonella</p> Signup and view all the answers

    Which organism is commonly associated with 80-90% pyogenic osteomyelitis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which term refers to dead bone in osteomyelitis?

    <p>Sequestrum</p> Signup and view all the answers

    Which term refers to a shell of fibrous tissue and cells around dead bone in osteomyelitis?

    <p>Involucrum</p> Signup and view all the answers

    Which condition is characterized by pain, increased size of bone, and bowing or deformity?

    <p>Paget disease-osteitis deformans</p> Signup and view all the answers

    What is the term used to describe the stage of Paget disease-osteitis deformans where there is a gain in bone mass, but the bone is disordered?

    <p>Burnt out osteosclerotic stage</p> Signup and view all the answers

    What is the histology finding in Paget disease-osteitis deformans?

    <p>Woven bone, mosaic pattern of lamellar bone-jigsaw puzzle</p> Signup and view all the answers

    What is the sequence of fracture healing stages in bone?

    <p>Hematoma and inflammation, soft callus, hard callus, remodeling</p> Signup and view all the answers

    What is the main characteristic of polyostotic Paget disease-osteitis deformans?

    <p>Affects 85% of individuals</p> Signup and view all the answers

    Which condition is characterized by joint effusion, osteopenia, and cartilage erosion on X-ray?

    <p>RA</p> Signup and view all the answers

    Which condition is characterized by ulnar deviation and swan neck deformity?

    <p>RA</p> Signup and view all the answers

    Which condition is characterized by systemic arthritis affecting small joints-hands and feet, MCP, PIP and has synovial hyperplasia?

    <p>Rheumatoid arthritis (RA)</p> Signup and view all the answers

    Which condition is characterized by joint destruction and may lead to instability or ankylosis?

    <p>Septic arthritis</p> Signup and view all the answers

    Which condition is characterized by joint involvement in adults and is commonly caused by Staphylococcus aureus?

    <p>Septic arthritis</p> Signup and view all the answers

    Which condition is characterized by joint involvement in adults and is commonly caused by Neisseria gonorrhoeae?

    <p>Septic arthritis</p> Signup and view all the answers

    Which condition is characterized by joint involvement and migratory arthritis, and can be caused by Borrelia burgdorferi?

    <p>Septic arthritis</p> Signup and view all the answers

    Which condition is characterized by fever, malaise, and elevated Erythrocyte Sedimentation Rate (ESR)?

    <p>Acute osteomyelitis</p> Signup and view all the answers

    What is the histological finding in acute osteomyelitis?

    <p>Pus and abscess formation</p> Signup and view all the answers

    Which condition is characterized by the possibility of bone destruction, sequestrum, and involucrum if the conditions do not stop?

    <p>Acute osteomyelitis</p> Signup and view all the answers

    Which condition can result in limb length discrepancies and extension into joints along with amyloidosis and epithelialization of tracts and squamous carcinoma?

    <p>Chronic osteomyelitis</p> Signup and view all the answers

    Which condition is characterized by degenerative changes in weight-bearing joints, such as hips and knees?

    <p>Osteoarthritis</p> Signup and view all the answers

    What is the main cause of osteoarthritis?

    <p>Repeated trauma</p> Signup and view all the answers

    Which condition is characterized by symmetric arthritis affecting small joints, such as hands and feet and genetic factors HLA II?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the histological finding in rheumatoid arthritis?

    <p>Dense inflammatory infiltrate with lymphocytes and plasma cells</p> Signup and view all the answers

    Which condition is characterized by fibrous and bony ankylosis and the formation of rheumatoid nodules?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Which condition is commonly confused with osteoarthritis, rheumatoid arthritis, and gout?

    <p>Pseudogout</p> Signup and view all the answers

    What type of crystals are characteristic of pseudogout?

    <p>Rhomboid crystals</p> Signup and view all the answers

    Which condition is characterized by chronic tophaceous gout?

    <p>Gout</p> Signup and view all the answers

    Which condition is characterized by fibrous and bony ankylosis and the formation of rheumatoid nodules?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the main treatment for osteoarthritis?

    <p>Exercise/stretching, massage, weight control</p> Signup and view all the answers

    Which condition is characterized by joint effusion, osteopenia, and cartilage erosion on X-ray?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Which type of joint is characterized by a synovial lining with synoviocytes and lacks a basement membrane?

    <p>Cavitated joint</p> Signup and view all the answers

    Which type of cartilage lacks blood vessels, lymphatics, and nerves, and is composed of water, hyaluronic acid, proteoglycans, and collagen type II?

    <p>Hyaline cartilage</p> Signup and view all the answers

    Which condition is characterized by attacks of acute arthritis, tophi at different sites, and nephropathy caused by MSU precipitation?

    <p>Gout</p> Signup and view all the answers

    Which condition is characterized by needle-shaped, slender crystals and negative birefringence?

    <p>Gout</p> Signup and view all the answers

    Which condition is commonly confused with gout and is characterized by deposition of calcium pyrophosphate dihydrate crystals?

    <p>Pseudogout</p> Signup and view all the answers

    Which condition is characterized by chalky deposits, less inflammation, and can present as acute, subacute, chronic, or asymptomatic?

    <p>Pseudogout</p> Signup and view all the answers

    Which condition is characterized by hyperuricemia, with uric acid levels above 6.8 mg/dL, and can be primary or secondary?

    <p>Gout</p> Signup and view all the answers

    Which condition is characterized by crystals and tophi formed by monosodium urate (MSU) deposition?

    <p>Gout</p> Signup and view all the answers

    Which condition is characterized by attacks of acute arthritis, tophi at different sites, and can affect knee, wrists, elbows, and shoulders in a mono- or polyarticular pattern?

    <p>Gout</p> Signup and view all the answers

    Which type of joint is characterized by fibrous and cartilaginous/synchondrosis? Where fibrous referees to the cranial sutures, bonds between roots of teeth and jawbones and cartilaginous/synchondrosis refers to symphysis between strenum and ribs, pelvis bone?

    <p>Non-Synovial joint (solid joint)</p> Signup and view all the answers

    What is the main treatment for Rheumatoid Arthritis (RA)?

    <p>All of the above</p> Signup and view all the answers

    Which condition is characterized by a herniation of the synovium through the joint capsule?

    <p>Synovial cyst</p> Signup and view all the answers

    Which condition is characterized by a reciprocal somatic chromosomal translocation t (1;2) (p13; q37) and also is brown with finger like projections, numerous macrophages with hemosiderin, scattered multinucled cell?

    <p>Tenosynovial Giant Cell Tumor</p> Signup and view all the answers

    Which condition is characterized by a characteristic focus known as a nidus cortical lesion and more than half occurring intibia and femur?

    <p>Osteoid osteoma</p> Signup and view all the answers

    Which condition is histologically similar to osteoid osteoma, but is larger than 2 cm?

    <p>Osteoblastoma</p> Signup and view all the answers

    Which condition is characterized by a predilection for vertebrae (40%)?

    <p>Osteoblastoma</p> Signup and view all the answers

    Which condition is characterized by occurring more than half of the time in the tibia and femur?

    <p>Osteoid osteoma</p> Signup and view all the answers

    Which condition is characterized by being painful and responding to NSAID/aspirin?

    <p>Osteoid osteoma</p> Signup and view all the answers

    Which location is most commonly associated with conventional osteosarcoma?

    <p>Metaphysis of long bones and 50% around bone</p> Signup and view all the answers

    What is the diagnostic feature of osteosarcoma?

    <p>Formation of osteoid matrix</p> Signup and view all the answers

    Which genetic anomaly is most commonly associated with osteosarcoma?

    <p>Mutations in RB</p> Signup and view all the answers

    Which type of osteosarcoma is characterized by a prominent extracortical calcified mass that encircles the bone?

    <p>Parosteal osteosarcoma</p> Signup and view all the answers

    What is the recommended treatment approach for osteosarcoma?

    <p>Multimodality approach</p> Signup and view all the answers

    Which cell cycle regulator is overexpressed in low-grade osteosarcoma?

    <p>MDM2 and CDK4</p> Signup and view all the answers

    Which condition is characterized by a cartilage capped bony projection on the surface of bone, often seen in autosomal dominant hereditary syndromes?

    <p>Osteochondroma</p> Signup and view all the answers

    What is the typical size of the cartilaginous cap in an osteochondroma?

    <p>Few millimeters</p> Signup and view all the answers

    Which condition is characterized by a cartilaginous cap that is less than 2 centimeter and trabecular bone and medullary cavity?

    <p>Osteochondroma</p> Signup and view all the answers

    Which condition is characterized by painless, small, no fracture, can be central or periosteal, and can cause Ollier's or maffucci?

    <p>Chondroma</p> Signup and view all the answers

    Which condition is characterized by a mutation in EXT1 and EXT2?

    <p>Osteochondroma</p> Signup and view all the answers

    Which type of tumor produces cartilage and is considered malignant?

    <p>Chondrosarcoma</p> Signup and view all the answers

    Where do chondroblastoma typically occur?

    <p>In the epiphysis</p> Signup and view all the answers

    Which type of chondrosarcoma arises from a benign precursor?

    <p>Secondary chondrosarcoma</p> Signup and view all the answers

    How are chondrosarcomas graded?

    <p>Based on cellularity and cytologic atypia</p> Signup and view all the answers

    What is the 5-year survival rate for Grade 3 chondrosarcomas?

    <p>43%</p> Signup and view all the answers

    What is the recommended treatment approach for chondrosarcomas?

    <p>Chemotherapy</p> Signup and view all the answers

    Which grade of tumors has high cellularity, extreme pleomorphism with bizarre tumor giant cells, mitoses, and necrosis?

    <p>Grade 3</p> Signup and view all the answers

    What is the characteristic of Grade 1 tumors?

    <p>Low cellularity</p> Signup and view all the answers

    Which type of bone tumor is characterized by the lack of bone and cartilage and have multinucleated cells with 100+ nuclei?

    <p>Giant Cell Tumor</p> Signup and view all the answers

    Which chromosome rearrangement is associated with the development of Aneurysmal Bone Cyst (ABC)?

    <p>17p13</p> Signup and view all the answers

    Which type of bone tumor is characterized by a t(11;22) translocation and CD99 positivity?

    <p>Ewing Sarcoma</p> Signup and view all the answers

    Which type of cancer is most commonly metastatic to bone in adults?

    <p>All of the above</p> Signup and view all the answers

    Which type of tumor is the most common benign lipomatous tumor?

    <p>Lipoma</p> Signup and view all the answers

    Which malignancy is associated with the MDM2 and CDK4 genes?

    <p>Liposarcoma</p> Signup and view all the answers

    Which type of tumor is characterized by a t(12, 16) translocation?

    <p>Liposarcoma</p> Signup and view all the answers

    Which type of tumor is characterized by highly atypical cells?

    <p>Liposarcoma</p> Signup and view all the answers

    Which condition is characterized by a somatic gain-of-function mutation in the GNAS1 gene and is composed of curvilinear trabeculae of woven bone surrounded by a moderately cellular fibroblastic proliferation?

    <p>Fibrous Dysplasia</p> Signup and view all the answers

    Which gene fusion is associated with the overexpression of USP6 in aneurysmal bone cyst (ABC)?

    <p>Fusion of the coding region of USP6 leading to USP6 overexpression</p> Signup and view all the answers

    What is the consequence of increased USP6 expression in aneurysmal bone cyst (ABC)?

    <p>Enhancement of NF-κB activity</p> Signup and view all the answers

    How does increased NF-κB activity contribute to the pathogenesis of aneurysmal bone cyst (ABC)?

    <p>Upregulation of matrix metalloproteases, leading to cystic resorption of bone in aneurysmal bone cyst (ABC).</p> Signup and view all the answers

    Which condition is characterized by a mutation in the CTNNB1 or APC gene? They recur but do not metastasize.

    <p>Desmoid tumor</p> Signup and view all the answers

    Which tumor is composed of cellular fibrous tissue and metaplastic bone, and is commonly seen in young, active males with a history of trauma?

    <p>Myositis ossificans</p> Signup and view all the answers

    Which tumor is a benign smooth muscle tumor commonly found in the uterus, gastrointestinal tract, and subcutaneous tissues?

    <p>Leiomyoma</p> Signup and view all the answers

    Which tumor is a malignant smooth muscle tumor that accounts for 10-20% of all sarcomas?

    <p>Leiomyosarcoma</p> Signup and view all the answers

    Which tumor is a malignant skeletal muscle tumor that is commonly seen in children (embryonal and alveolar types) and adults (pleomorphic type)?

    <p>Rhabdomyosarcoma (embryonal and alveolar)</p> Signup and view all the answers

    Which tumor is a benign vascular tumor commonly seen in infants and children?

    <p>Hemangioma</p> Signup and view all the answers

    Which tumor is an intermediate vascular tumor commonly seen in immunocompromised individuals, such as those with HIV/AIDS?

    <p>Kaposi sarcoma</p> Signup and view all the answers

    Which tumor is a malignant vascular tumor that arises from the lining of blood vessels and can occur in any age group?

    <p>Angiosarcoma</p> Signup and view all the answers

    Which tumor is a benign peripheral nerve tumor commonly associated with neurofibromatosis type 1 (NF1) and has the potential to transform into a malignant tumor?

    <p>Neurofibroma</p> Signup and view all the answers

    Study Notes

    Bone Structure and Composition

    • Type I collagen constitutes two-thirds of the extracellular matrix of bone.
    • Osteocytes are located within lacunae, small cavities within the bone.
    • Osteoclasts are responsible for bone resorption.
    • Long bones develop through endochondral ossification during embryogenesis.
    • Trabecular bone, or spongy bone, is characterized by rapid formation, higher cell density, and random orientation.
    • Compact (cortical) bone is organized into Haversian systems (osteons) consisting of concentric lamellae surrounding a central Haversian canal.

    Bone Functions and Cellular Activity

    • The Haversian canal provides a pathway for blood vessels and nerves, facilitating communication within the bone.
    • Osteoblasts are responsible for bone formation and mineralization.
    • Osteocytes communicate with the Haversian canal through dendritic processes.

    Extracellular Matrix and Bone Disorders

    • The organic component of the extracellular matrix is primarily type I collagen.
    • Osteogenesis imperfecta is associated with impaired maturation of type I collagen leading to fragile bones.
    • Osteopetrosis is characterized by defects in osteoclast activity, resulting in abnormally dense but brittle bones.
    • Achondroplasia stems from mutations in the FGFR3 gene and results in short stature and disproportionate limb growth.

    Conditions and Syndromes

    • Osteogenesis imperfecta and achondroplasia are inherited in an autosomal dominant manner.
    • Osteoporosis is the most common condition resulting in reduced bone density and strength.
    • Osteomalacia is characterized by insufficient mineralization of bone due to vitamin D deficiency.
    • Paget's disease involves bone remodeling leading to disordered bone formation and sometimes increased mass.

    Radiological and Histological Findings

    • Osteopenia in hyperparathyroidism is caused by increased bone resorption.
    • Osteomyelitis, the infection of bone, is most commonly caused by Staphylococcus aureus in adults.
    • The histological finding of acute osteomyelitis includes neutrophilic infiltration.
    • Paget's disease exhibits thickened bone with abnormal histological patterns such as mosaic bone.

    Joint Disorders

    • Rheumatoid arthritis is characterized by symmetrical joint involvement, synovial hyperplasia, and destruction of cartilage.
    • Osteoarthritis results from degenerative changes in weight-bearing joints, leading to pain and impaired function.
    • Gout is marked by attacks of acute arthritis due to uric acid crystal deposition, specifically monosodium urate (MSU).
    • Pseudogout involves calcium pyrophosphate dihydrate crystal deposition, differing from gout in both presentation and underlying causes.

    Treatment and Management

    • The main treatment for osteoporosis involves bisphosphonates to reduce bone resorption.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for managing pain in osteoarthritis.
    • Disease-modifying antirheumatic drugs (DMARDs) are crucial in the treatment of rheumatoid arthritis.

    Special Notes on Cartilage and Joints

    • Synovial joints possess a synovial membrane with synoviocytes, lacking a true basement membrane.
    • Hyaline cartilage serves as a cushion and lacks blood vessels, facilitating smooth movement at joints.
    • Conditions like synovial herniation and joint deformities often arise from underlying inflammatory processes.

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    Test your knowledge on the components of bone! This quiz will cover the extracellular matrix, specialized cells, and inorganic components that make up bone tissue. Challenge yourself and see how well you understand the composition of this important skeletal structure.

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