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2 MSK > CORTEXT Pathology > Flashcards

CORTEXT Pathology Flashcards

1
Q

are malignant neoplasms of bone common or uncommon?

A

uncommon

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2
Q

commonest benign tumour of bone

A

osteochondroma

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3
Q

where do osteochondromas typically form?

A

epiphysis of long bones, particularly around the KNEE

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4
Q

do osteochondromas typically metastasise

A

no

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5
Q

associated symptoms with osteochondromas?

A

just local pain

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6
Q

where do enchondromas typically form?

A

small tubular bones of hands and feet

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7
Q

are enchondromas benign or malignant

A

benign

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8
Q

common sites of bone cysts?

A

talus
calcaneus
proximal humerus
femur

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9
Q

how are benign tumours usually treated

A

curettage
bone grafting
excisional biopsy

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10
Q

how does an aneursysmal bone cyst differ from a typical bone cyst?

A

contains chambers filled with blood and serum

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11
Q

name 2 locally aggressive benign tumours

A

giant cell tumour

aneurysmal bone cyst

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12
Q

where do giant cell tumours commonly arise?

A

knee

distal radius

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13
Q

which benign tumour commonly shows a “soap bubble” on x ray

A

giant cell tumour

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14
Q

which of the benign tumours involves a genetic mutation?

A

fibrous dysplasia

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15
Q

what does the genetic mutation cause in fibrous dysplasia?

A

lesions of fibrous tissue and immature bone

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16
Q

which is the most frequent site of fibrous dysplasia?

A

bones of head and neck

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17
Q

which benign tumour is common in adolescents and commonly appears on the proximal femur, long bones and vertebrae

A

osteoid osteoma

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18
Q

predominant clinical feature of osteoid osteoma

A

intense pain that is worse at night

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19
Q

what treatment would relieve the pain in osteoid osteoma

A

NSAIDs

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20
Q

what is a myeloma

A

tumour of plasma cells

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21
Q

clinical red flags of bone mets?

A

constant severe pain that is worse at night, weight loss, fatigue, loss of appetite

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22
Q

x ray features of malignant primary bone tumours

A

cortical destruction
periosteal reaction
new bone formation
extension into soft tissue

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23
Q

what is a periosteal reaction

A

raised periosteum producing bone

24
Q

most common form of primary malignant bone tumour

A

osteosarcoma

25
Q

what pathological process usually causes osteosarcomas?

A

mutations in retinoblastoma gene (tumour suppressor)

26
Q

most common areas where osteosarcomas arise?

A

MAINLY knee
proximal femur
proximal humerus
pelvis

27
Q

which is the more common place to metastasise to in osteosarcoma?

A

blood not bone

28
Q

who tends to get chondrosarcoma?

A

older age group -> 45 year olds

29
Q

where are chondrosarcomas typically found?

A

pelvis

proximal femur

30
Q

who gets ewings sarcoma?

A

teenagers

31
Q

associated symptoms of ewings sarcoma

A

fever
raised inflam markers
warm swelling

32
Q

staging investigations for bone tumours

A

bone scan
CT chest
MRI

33
Q

common tumours that metastasise to bone

A 
thyroid
breast
lung
renal cell
prostate
34
Q

which of the common tumours causing bone mets has the lowest survival? what is the prognosis?

A

lung, 6 months

35
Q

which primary tumours are most likely to cause sclerotic mets?

A

prostate

breast

36
Q

most common bones involved with mets

A 
vertebra
pelvis
ribs
skull
humerus
long bones of lower limb
37
Q

common blood tests used in diagnosing bone cancer and why they are used

A 
serum calcium (hypercalcaemia),
LFTs (liver mets),
plasma proteins (myeloma), FBC, U+E
38
Q

common diffuse soft tissue swellings?

A

oedema

synovitis

39
Q

common local soft tissue swellings

A

inflammatory eg bursitis
abscess
baker’s cyst
benign/malignant neoplasms

40
Q

4 S’s of lump examination

A

site
size
surface
skin changes

41
Q

other things to look for on examination of a lump

A

consistency (fluid?, hard?)
temperature (abscess?)
lymphadenopathy

42
Q

would extremely rapid neoplastic growth (1 week) be worrying?

A

no, its probably a pseudotumour

43
Q

what examination features would suggest a benign soft tissue neoplasm

A

small, solid and well defined neoplasm that fluctuates in size, usually cysty/soft

44
Q

what examination features would suggest a malignant soft tissue neoplasm?

A

large, solid, ill defined neoplasm with an irregular surface and systemic symptoms

45
Q

what would be described as a larger lump?

A

> 5cm

46
Q

what is a benign soft tissue tumour of smooth muscle called?

A

leiomyoma

47
Q

what is a benign soft tissue tumour of cartilage called?

A

chonromas

48
Q

what is a benign soft tissue tumour of blood vessels called?

A

haemangiomas

49
Q

which kind of joint does a ganglion cyst typically form on?

A

synovial

50
Q

what is a bursa?

A

small, fluid filled sac lined by synovium that prevents friction between bones etc

51
Q

common causes of bursitis

A

bacterial infection

gout

52
Q

most common site of avascular necrosis?

A

femoral head

53
Q

who typically gets avascular necrosis and why

A

chronic alcoholics
steroid users

both cause hypercoaguable blood

54
Q

what is avascular necrosis

A

ischaemic necrosis of bone

55
Q

treatment of avascular necrosis?

A

drilling under fluoroscopy (if articular surface hasnt collapsed), joint replacement (if artciular surface HAS collapsed)

2 MSK (61 decks)

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