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flashcards of path guide 2018 > bone > Flashcards

bone Flashcards

1
Q

osteosarcoma xray appearance

A

elevated periostium (codmans triangle) sunburst appearance

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2
Q

histology of osteosarcoma

A

ALP+Ve mesenchymal malignant cells

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3
Q

who gets osteosarcoma and where

A

young people often in the knee

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4
Q

Xray appearance of chondrosarcoma

A

lytic lesion with fluffy calcification

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5
Q

histology of chondrosarcoma

A

malignant chondrocytes

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6
Q

who gets chondrosarcoma and where

A

elderly in the femur/ pelvis

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7
Q

Ewings sarcoma xray appearance

A

onion skinning of periostium

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8
Q

genetic translocation in ewings sarcoma

A

t11:22

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9
Q

histology of ewings sarcoma

A

sheets of small round CD99+ve cells

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10
Q

who gets ewings and where

A

children in the long bones

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11
Q

giant cell bone tumour xray appearance

A

lytic lesions up to articular surface

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12
Q

histology of giant cell bone tumour

A

osteoclast type multinucleate giant cells on background of spindle/ ovoid cells

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13
Q

who gets giant cell bond tumour and where

A

middle aged woman and knee

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14
Q

osteoarthrituis

A

degeerative joint condition affecting hips, vertebrae and knee

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15
Q

when do you see bouchards and heberdens nodes

A

oseoarthritis

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16
Q

where do bouchards nodes affect

A

PIPJ

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17
Q

where do heberdens nodes affect

A

DIPJ

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18
Q

rheumatoid arthritis deformities

A

boutonniere swan neck Z thumb radial deviation of wrist ulnar deviation of fingers

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19
Q

what joint is spared in RA

A

DIPJ

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20
Q

biochemistry of osteoporosis

A

normal calcium, phosphate and AKP

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21
Q

histology of osteoporosis

A

loss of cancellous bone

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22
Q

diagnosis of osteopososis

A

DEXA scan: T score <2.5

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23
Q

RF/ causes of osteopososis

A

menopause advancing age low BMI drugs

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24
Q

dexa scan T score for osteopenia

A

1-2.5

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25
Q

symptoms of osteopososis

A

low impact fractures back pain

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26
Q

common fractures in osteoporosis

A

colles vertebral NOF

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27
Q

pathology of osteomalacia

A

defective bone mineralisation

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28
Q

histology of osteomalacia

A

excess osteoid (unmineralised bone)

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29
Q

biochemistry of osteomalacia

A

normal or low calcium low phosphate raised ALP

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30
Q

findings of osteomalacia on xray

A

Looser’s zones splaying of metaphysis

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31
Q

symptoms of osteomalacia in children

A

rachetic rosary bowing of legs frontal bossing pigeon chest delayed walking

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32
Q

symptoms of osteomalacia in adults

A

bone pain or tenderness proximal muscle weakness

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33
Q

causes or RF for osteomalacia

A

vit D deficiency: poor diet, lack of sunlight, malabsorption, CKD, liver disease

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34
Q

defect in primary hyperparathyroidism

A

overproduction of PTH hypercalcaemia

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35
Q

causes of primary hyperparathyroidism

A

parathyroid adenoma, hyperplasia or carcinoma MEN secondary to vit D malabsorption or secondary hyperparathyroidism

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36
Q

symptoms of primary hyperparathyroidism

A

hypercalcaemia- bones moans stone and groans

37
Q

xray signs of primary hyperparathyroidism

A

osteitis fibrosa cystica browns tumours salt and pepper skull subperiostial resorption of the phalanges

38
Q

biochemistry of hyperparathyroidism

A

raised calcium raised or normal ALP low or normal phosphate

39
Q

histology of hyperparathyroidism

A

osteitis fibrosa cystica (bone cysts and marrow fibrosis) browns tumour

40
Q

pathology of paget’s disease

A

disorder of bone turnover with lytic and scerotic lesions

41
Q

histology of paget’s disease

A

mosaic pattern of lamellar bone huge osteocalsts with> 100 nuclei

42
Q

xray findings on pagets disease (skull, vertebrae and pelvis)

A

skull: osteoporosis circumscripta, cotton wool skull vertebrae: ivory vertebrae, picture frame vertebrae pelvis: sclerosis and lucency

43
Q

symptoms of pagets disease

A

bone pain nerve compression microfractures skull changes- deafness high output cardiac failure

44
Q

biochemistry of pagets disease

A

high ALP normal calcium and phosphate

45
Q

what is renal osteodystrophy

A

bone changes in patients with CKD

46
Q

biochemistry of renal osteodystrophy

A

low calcium high phosphate metabolic acidosis secondary hyperparathyroidism

47
Q

risk factors for gout

A

increased dietry purine diuretics

48
Q

joints affected in gout

A

MTP of great toe- podagra

49
Q

crystals in gout

A

negatively bifringent needle shaped urate crystals

50
Q

treatment of gout

A

acutely give colchacine then allopurinol longterm

51
Q

risk factors for psuedogout

A

DM, hypothyroidism, secondary hyperparathyroidism, wilsons disease

52
Q

crystals in pseudogout

A

positivly bifringent rhomboid calcium pyrophosphate crystals

53
Q

joints affected in pseudogout

A

knee and shoulder

54
Q

treatment of psuedogout

A

NSAIDS and intra-articular steroid injections

55
Q

features of a joint with gout

A

acutely hot swollen joint PAIN tophi

56
Q

features of joint with pseudogout

A

hot swollen joint effusion

57
Q

greenstick fracture

A

paeds fracture one side of bone is bent and other side is broken

58
Q

simple fracture

A

bone breaks but doesn’t pierce skin

59
Q

compound fracture

A

bone breaks and is exposed because peirces skin

60
Q

comminuted fracture

A

bone breaks into two or more fragments

61
Q

impacted fracture

A

the broken bone is forced together by force of the injury

62
Q

stages of fracture repair

A
  1. formation of haematomoa 2. formation of fibrocartilaginous callous 3. mineralisation of fibrocartilaginous callous 4. remodeling of bone along weight bearing lines
63
Q

pathogens resposible for osteomyelitis

A

adults: staph aureus children: group B strep, haemophilus influenzae

64
Q

pathogenesis of osteomyelitis

A

local infection: trauma, dental surgery, PVD haematogenous spread TB syphilis

65
Q

bones affected in osteomyelitis

A

adults: distal joints e.g. toes/ jaw children: long bones

66
Q

symptoms of osteomyelitis

A

bone pain, fever, leukocytosis

67
Q

xray changes of osteomyelitis

A

10 days after infection lytic destruction of bone

68
Q

osteoid osteoma pathology

A

beingn bone lesion relieved by aspirin

69
Q

who gets osteoid osteoma and where

A

adolescants femur

70
Q

appearance of osteoid osteoma on xray

A

radiolucent nidus with a sclerotic rim

71
Q

what is gardners syndrome

A

multiple osteoms + epidermoid cysts + GI polyps

72
Q

what is an osteoma

A

boney outgrowth attached to normal bone BENIGN on head/ neck

73
Q

what is olliers syndrome

A

multiple endochondromas

74
Q

what is maffuci’s syndrome

A

multiple endochondromas and haemangiomas

75
Q

x ray findings for endochondroma

A

lytic lesion cotton wool calcification O ring sign expansile

76
Q

histology of endochondroma

A

normal histology

77
Q

who gets endochondromas and where

A

middle ages in hands

78
Q

osteochondroma pathology

A

benign cartilidge capped bony outgrowth

79
Q

appearance of osteochondroma on xray

A

well defined boney protuberance frorm bone

80
Q

who gets osteochondroma and where

A

adolescants in long bones

81
Q

what is diaphyseal aclasis

A

short stature+ multiple exostoses and bone deformities

82
Q

what is albright syndrome

A

cafe au lait spots + precocious puberty + polyosteotic dysplasia

83
Q

what is fibrous dysplasia

A

part of bone is replaced with fibrous tissue

84
Q

histology of fibrous dysplasia

A

chinese letters misshapen bone trabecculae

85
Q

what is seen on xray of fibrous dysplasia

A

soap bubble osteolysis shepherds crook deformity

86
Q

how does a simple bone cyst look on xray

A

lytic lesion

87
Q

what is a simple bone cyst and where is it found

A

fluid filled unilocular lesion on humerus/ femur

88
Q

how does osteoblastoma look on xray

A

speckled mineralisation

flashcards of path guide 2018 (15 decks)

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