pearljam59
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An elderly woman has had generalized bone pain and a loss of height over the last 5 years. Complete blood count is normal. Serum calcium, phosphate, and creatinine concentrations and serum alkaline phosphatase activity are within the reference range. Serum protein electrophoresis shows no abnormalities. X-ray films of the spine show generalized loss of bone density and a compression fracture of T-8. Which of the following is most likely to be seen in tissue obtained on biopsy of the iliac crest?
A) Cysts filled with fibroblasts and giant cells
B) Disorderly osteoblastic and osteoclastic activity
C) Sheets of plasma cells
D) Thin trabeculae with low osteoclastic activity
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| robin082006
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D, this patient has osteoporosis
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| fleuve
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but robbins said it ishigh osteoclast activity in osteoporosis
so, how about B
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| r_albayunen
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B?
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| fruit
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probably D
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| pearljam59
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fleuve is right...in postmenopausal women the decrease in ESTROGEN result in increase secretion of IL-1, IL-6 and TNF-alpha which are all STIMULATORS of osteoclast recruitment and activity.
The answer is B.
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| robin082006
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Are you sure the answer Pearjam?
I saw this question somewhere and the answer is D, It seems to be in Goljan Pathology questions
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| pearljam59
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The first part of D is right but osteoclasts are INCREASED AS PER ROBBINS, it says it in black and white. So there is no way D can be the answer since it says LOW osteoclasts. That is why I am choosing B.
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| krsna
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but isnt B a feature of paget's diseae?
correct me if im wrong
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| surgery
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I go with B
because In osteoporosis there is decreased in osteoblastic (bone forming) activity and increased in osteoclastic (bone resporption) activity. So D cant be answer
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| ts97
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I vote for D - nothing can have increased activity in elderly (at least for step 1)
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| chazan
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I'd go with D. Normally estrogen increases osteoblastic activity and decreases osteoclastic activity. So, in elderly women, with deficiency of estrogen ==> decreased osteoblastic activity and increased osteoclastic activity. In osteoporosis there is decreased bone mass...increased osteoclastic bone resorption
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| twesting2173
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so that menas you'd pick b, git chazan?
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| fox
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Yes probably he meant B 
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| Musuq
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Guys, this is clinic of "OSTEOPOROSIS", if you check kaplan pg 272 (2006 edit) in Lab we have no abnormalities in Ca++, PO4=, and alkaline phosphatase, the Micro: Thinned cortical and trabecular bone.
Estrogen: inhibits production of osteoclasts: enhances osteoblasts
Thus, B) would be my choice, cause this is a postmenopause patient, so estrogens are messing with the normal bone formation.
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| fongch
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B seems to me like a typical description for Paget's disease though.
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| Addicudo
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Yes ... Ppl the ANswer is B) Looked it up in Kaplan Patho ... MSK section .. ... !! Option D) is crrect in its first part only .. i.e Thin trabecuale .. BUT Osteoclastic activity is INCREASED in Post menopausal women .. therefore ... D) is not the correct response .. !! B) It iss !!!
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| ssrpk
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well, osteoclastic activity is increased even in athletes or heavy weight lifters, why???because of increase turn over of the bone mass, however they don't develop osteoporosis because osteoblastic activity keeps up with the bone resolution, this whole process slows down as the age advances, shifting more in the favor of osteoclastic activity [particularly after menopause in females], which is a relative increase as compared to osteoblast, not an absolute increase.
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| nierss
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d
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| genes
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b b b b b b and b
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| DRFP
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An elderly woman has had generalized bone pain and a loss of height over the last 5 years. Complete blood count is normal. Serum calcium, phosphate, and creatinine concentrations and serum alkaline phosphatase activity are within the reference range. Serum protein electrophoresis shows no abnormalities. X-ray films of the spine show generalized loss of bone density and a compression fracture of T-8. Which of the following is most likely to be seen in tissue obtained on biopsy of the iliac crest?
A) Cysts filled with fibroblasts and giant cells
B) Disorderly osteoblastic and osteoclastic activity
C) Sheets of plasma cells
D) Thin trabeculae with low osteoclastic activity
It cannot be D because osteoclastic activity would increase when losing bone, it breaks down bone, so B is the answer,
Osteoclasts break down bone
Osteoblasts Make bone
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