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11. CP - Diseases of the musculoskeletal system > (57b) Diseases of the musculoskeletal system 1 part B > Flashcards

(57b) Diseases of the musculoskeletal system 1 part B Flashcards

1
Q

Soft tissue is derived from what?

A

Mesoderm

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2
Q

What is soft tissue?

A

Non-epithelial extra skeletal structures exclusive of supportive tissue of organs and lymphoid/haematopoietic tissue

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3
Q

Give some examples of soft tissue

A

Fibrous tissue, adipose tissue, skeletal muscle, blood and lymphatic vasculature, and peripheral nervous system

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4
Q

What is a benign tumour of fat tissue?

A

Lipoma

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5
Q

What is a benign tumour of fibrous tissue?

A

Fibroma

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6
Q

What is a benign tumour of smooth muscle?

A

Leiomyoma

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7
Q

What is a benign tumour of blood vessel?

A

Haemangioma

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8
Q

What is a benign tumour of lymphatics?

A

Lymphangioma

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9
Q

What is a benign tumour of peripheral nerves?

A

Neuroma

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10
Q

What is a MALIGNANT soft tissue tumour?

A

Sarcoma (accounts for 1% of malignancies)

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11
Q

What is the syndromes associated with neurofibroma?

A

Neurofibromatosis type 1

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12
Q

What is neurofibromatosis type 1?

A

A tumour disorder that is caused by the mutation of a gene on chromosome 17 that is responsible for control of cell division - causes tumours along the nervous system and can grow anywhere on the body. - causes benign skin tumors called neurofibromas

formerly known as von Recklinghausen disease

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13
Q

What is fibromatosis?

A

A group of benign soft tissue tumour which have certain characteristics in common, including absence of cytologic and clinical malignant features, a histology consistent with proliferation of well-differentiated fibroblasts, an infiltrative growth pattern, and aggressive clinical behavior with frequent local recurrence

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14
Q

Which syndrome is associated with fibromatosis?

A

Gardner’s syndrome

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15
Q

What is Gardner’s syndrome?

A

Also known as familial colorectal polyposis - presence of multiple polyps in the colon together with tumors outside the colon -extra-colonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, FIBROMAS and desmoid tumours

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16
Q

What is a myxoid tumour?

A

A connective tissue tumor with a “myxoid” background, composed of clear, mucoid substance

myxoma = a myxoid tumor of primitive connective tissue

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17
Q

Which syndrome is associated with myxoma and melanotic schwannoma?

A

Carney syndrome

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18
Q

What is a cystic hygroma?

A

This is the most common form of lymphangioma - contains large cyst-like cavities containing lymph

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19
Q

Cystic hygroma is associated with which syndrome?

A

Turner syndrome

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20
Q

What is Turner syndrome?

A

Also known as Ullrich–Turner syndrome, gonadal dysgenesis, and 45,X, is a condition in which a female is partly or completely missing an X chromosome

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21
Q

How are soft tissue tumours diagnosed?

A
  • ultrasound guided core biopsy
  • wide excision
  • cytogenetics (culture of fresh tissue and karyotypic analysis)
  • molecular genetics (FISH and PCR and RT-PCR)
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22
Q

What is RT-PCR?

A

Reverse transcription polymerase chain reaction (RT-PCR) is one of many variants of polymerase chain reaction (PCR) - commonly used in molecular biology to detect RNA expression

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23
Q

Name 2 benign bone tumours

A
  • osteoma

- osteoblastoma

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24
Q

What is an osteoma?

A

Bony growths, typically in the skull - it is a benign tumour

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25
Q

What is an osteoblastoma?

A

Rare primary neoplasm of bone, categorised as a benign bone tumor that is closely related to osteoid osteoma

26
Q

What is a benign cartilage tumour?

A

Chondroma

27
Q

What is a mixed bone/cartilage tumour?

A

Osteochondroma

28
Q

What is a malignant bone tumour?

A

Osteosarcoma

  • young age group
29
Q

Where is the commonest site for malignant bone tumour (osteosarcoma)?

A

Around the knee (60%)

30
Q

Name 3 other bone tumours

A
  • chondrosarcomas
  • Ewing’s sarcoma
  • giant cell tumours
31
Q

What is Ewing’s sarcoma?

A

A malignant small, round, blue cell tumour - cancer cells are found in the bone or in soft tissue. Most common areas = pelvis, femur, humerus, ribs and clavicle

32
Q

What is a giant cell tumour?

A

Rare, aggressive benign tumor -

characterised by presence of multinucleated giant cells (osteoclast-like cells).

33
Q

Which tumours can metastasise to the bone?

A

Lead kettle (PB-KTL)

  • prostate
  • breast
  • kidney
  • thyroid
  • lung
34
Q

What is SLE?

A

Systemic autoimmune disease (or autoimmune connective tissue disease) most often harms the SKIN, heart, joints, lungs, blood vessels, liver, kidneys, and nervous system
- female predominance

35
Q

What are the cutaneous effects of SLE?

A

Butterfly rash (bridge of nose and cheeks)

36
Q

What are the cardiac effects of SLE?

A
  • cardiomegaly

- endocarditis

37
Q

What are the CNS effects of SLE?

A
  • convulsions

- hemiplegia

38
Q

What is hemiplegia?

A

Paralysis of one side of the body

39
Q

What are some potential renal effects of SLE? (45% of patients)

A
  • nephrotic syndrome

- glomerulonephritis

40
Q

What is systemic sclerosis/systemic scleroderma?

A

An autoimmune disease of the connective tissue - thickening of the skin caused by accumulation of collagen, and by injuries to vessels (=inflammatory response and cytokines)

2 forms - limited cutaneous scleroderma = skin on face, hands and feet.
Diffuse cutaneous scleroderma = more skin, kidneys, heart, lungs and GI tract (poor prognosis)

41
Q

What happens with osteoarticular involvement in systemic sclerosis?

A
  • arthralgia (joint pain)

- arthritis

42
Q

What is CREST syndrome?

A

Also known as the limited cutaneous form of systemic sclerosis (lcSSc) is a multisystem connective tissue disorder. The acronym “CREST” refers to its five main features

43
Q

What are the 5 features of CREST syndrome?

A
  • calcinosis
  • Raynaud’s phenomenon
  • oesophageal dysfunction
  • sclerodactyly
  • telangiectasia
44
Q

What is calcinosis?

A

The formation of calcium deposits in any soft tissue

45
Q

What is sclerodactyly?

A

Localised thickening and tightness of the skin of the fingers or toes - often leads to ulceration of the skin of the distal digits and is commonly accompanied by atrophy of the underlying soft tissues

46
Q

What is telangiectasia?

A

Spider veins - small dilated blood vessels near the surface of the skin or mucous membranes - can develop anywhere on the body but are commonly seen on the face around the nose, cheeks, and chin

47
Q

What is polymyalgia rheumatica?

A

Syndrome of stiffness, weakness, aching and pain in the muscles of the neck, shoulders and upper arms

48
Q

Polymyalgia rheumatica is associated with what?

A

Giant cell arteritis

49
Q

What is giant cell arteritis?

A

Inflammatory disease of large and medium arteries of the head, and neck - also called temporal arteritis

Affects occipital or facial arteries

50
Q

What are the symptoms of giant cell arteritis/temporal arteritis?

A
  • pyrexia
  • headache
  • severe scalp pain
51
Q

What is myopathy?

A

Muscle disease unrelated to any disorder of innervation or neuromuscular junction

52
Q

What is myositis?

A

Inflammation and degeneration of muscle tissue - muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness

53
Q

What is muscular dystrophy?

A

A heterogenous group of hereditary conditions marked by progressive severe weakening and wasting of the muscles - begins in childhood

54
Q

What is malignant hyperthermia?

A

An inherited disease that causes a fast rise in body temperature and severe muscle contractions when given general anaesthesia

55
Q

What is rhabdomyolysis?

A

Destruction of skeletal muscle causing release of muscle fibre content into the blood (myoglobin) - may cause kidney damage

56
Q

Why do you get brown urine in rhabdomyolysis?

A

Myoglobin is release into the blood and filtered through the kidney - it enters the urine = myoglobulinuria = brown

57
Q

What are the potential causes of rhabdomyolysis?

A
  • trauma/ crush injuries
  • drugs eg. cocaine, amphetamine
  • extreme temperature
  • severe exertion eg. marathon running
  • lengthy surgery
  • severe dehydration
58
Q

What is an important complication of rhabdomyolysis?

A

Acute renal failure

59
Q

What are metabolic myopathies?

A

Group of hereditary muscle disorders caused by specific enzymatic defects - heterogeneous conditions that have common abnormalities of muscle energy metabolism that result in skeletal muscle dysfunction

eg. glycogen synthesis and degradation/disorders of mitochondrial metabolism

60
Q

What are the signs/symptoms of malignant hyperthermia?

A
  • bleeding
  • dark brown urine
  • muscle rigidity
  • quick rise in body temp to 105 F or higher
  • discovered during anaesthesia
  • may have family history

11. CP - Diseases of the musculoskeletal system (4 decks)

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