Exam 1 Page 1-3 (PDF)

Page 5 Saturday, September 21, 2024 8:14 PM - Miscellaneous bone diseases ○ Paget disease ▪ Aka osteitis deformans ▪ This condition results in larger bone than normal □ Normally seen in older adults ▪ This disease is due...

Page 5 Saturday, September 21, 2024 8:14 PM - Miscellaneous bone diseases ○ Paget disease ▪ Aka osteitis deformans ▪ This condition results in larger bone than normal □ Normally seen in older adults ▪ This disease is due to osteoclasts □ Stage 1 has resorption outweighing deposition of bone Will see increased blood Ca levels and alkaline phosphatase □ Stage 2 has resorption halted and deposition continues □ Stage 3 has decreased cellular activity which leads to disorganized bone ○ Fibrous dysplasia ▪ This condition results in larger bone than normal □ Normally seen earlier in life ▪ Defined as replacement of bone by cellular connective tissues which are then replaced by increased cancellous bone □ The new laid down bone is not mineralized ▪ Proximal femur has a "shepherd's crook" ○ McCune-Albright Syndrome ▪ Presents with fibrous dysplasia that occurs with pigmentation of the skin and endocrine symptoms - Pediatric bone diseases ○ Juvenile osteochondrosis ▪ Defined as aseptic ischemic necrosis ○ Legg-Calve-Perthes disease ▪ Defined as osteonecrosis of proximal femoral epiphysis ▪ Usually affects unilateral at early years of life of childhood ○ Osgood Schlatter disease ▪ Defined as microfractures of tibial tuberosity where the patellar ligament inserts to the tibia ▪ Most commonly seen in young boys and girls in adolescence and early puberty ○ Slipped femoral epiphysis ▪ Defined as a disorder of the growth plate of the femoral head ○ Scoliosis ▪ More common in females with female to male ratio of 8:1 ▪ Postural scoliosis □ Defined as a small curve that can be corrected on bending and exercises ▪ Structural scoliosis □ Defined as a curve that cannot be corrected with bending □ Types Congenital ◊ Caused by disturbances during development Neuromuscular ◊ Caused by neuropathic or myopathic diseases like cerebral palsy and Duchenne's muscular dystrophy Idiopathic ◊ This is the most common form of structural scoliosis - Joint diseases Congenital Exam 1 Page 1  ○ Congenital ▪ Congenital dislocation of the hip □ Characterized by the acetabulum not being formed properly and allows the femoral head to dislocate out of the socket ▪ Clubfoot □ Talipes equinovarus Most common type of all babies born with clubfoot Foot is turned medial with plantarflexion, aka inversion □ Calcaneovalgus Foot is turned lateral with dorsiflexion, aka eversion ○ Infectious ▪ Suppurative arthritis □ Aka pyogenic arthritis or septic arthritis □ Defined at a bacterial infection that produces a lot of pus and leads to sepsis Most common cause is Staphylococcus aureus ▪ Lyme disease □ Defined as an infection from a tick bite carrying Borrelia burgdorferi □ Symptoms include erythema migrans which is a papular skin rash ○ Immunological ▪ Rheumatoid arthritis □ Characterized by a pannus formation with ulnar deviation of fingers □ Types Felty syndrome ◊ Defined as chronic R.A. with splenomegaly and hypersplenism Still disease ◊ Defined as juvenile R.A. that contains a rash, fever, and lymphadenopathy Sjogren syndrome ◊ Defined as having R.A. with dry mouth and eyes ▪ Reactive arthritis □ Defined as having an infection that causes arthritis, conjunctivitis, and non- gonococcal urethritis or cervicitis □ ~80% of cases of reactive arthritis is associated with the HLA-B27 antigen ○ Degenerative ▪ Ankylosing spondylitis □ ~95% of cases of A.S. is associated with the HLA-B27 antigen ▪ Osteoarthritis □ Most common form of joint disease ○ Metabolic ▪ Gouty arthritis □ Primary Gout Defined as being genetic which causes an enzyme defect that causes abnormal purine metabolism □ Secondary gout Defined as the inability to excrete uric acid due to renal disease which leads to an accumulation of uric acid in the joints, kidneys, and soft tissues □ Hyperuricemia is needed for gout to manifest Muscle disorders - Muscle atrophy ○ Type 1 myofiber atrophy ▪ Defined as neuro atrophy due to loss of nerve supply ○ Type 2 myofiber atrophy ▪ Defined as a disuse atrophy and those who are on glucocorticoids ▪ This type only affects the fast-twitch type 2 muscle fibers Exam 1 Page 2  ▪ This type only affects the fast-twitch type 2 muscle fibers - Myasthenia gravis ○ This is an autoimmune condition where the patient produces an antibody that destroyed the neuromuscular junction ▪ The antibodies destroy the acetylcholine receptor sites ▪ Patients wake up fine and then as the day goes on, they get increased weakness ○ Eaton-Lambert syndrome ▪ Aka myasthenic syndrome ▪ The antibody is destroying the calcium channels, so the more the patient uses their muscles the more the disease manifests Exam 1 Page 3