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MSK lectures > CORTEXT Pathology week 1 > Flashcards

CORTEXT Pathology week 1 Flashcards

1
Q

What are the 5 causes of benign bone tumours?

A 
Neoplastic
Developmental
Traumatic
Infectious
Inflammatory
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2
Q

What is the most common benign bone tumour?

A

Osteochondroma

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3
Q

What is an osteochondroma and what are the symptoms?

A

A bony outgrowth on the external surface with a cartilagenous cap
Can cause localised pain

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4
Q

What is an enchondroma and what are the symptoms?

A

An intramedullary and usually metaphyseak cartilaginous tumor caused by failure of normal enchondral ossification at the growth plate
Many are incidental findings but can result in weakness and pathological fractures

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5
Q

What is a simple bone cyst and what are the symptoms?

A

A single cavity cyst filled with benign fluid in a bone likely a growth defect
Asymptomatic but can cause weakness or pathological fracture

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6
Q

What is an aneurysmal bone cyst and what are the symptoms?

A

Lots of chambers in a bone that may be filled with blood or serum
Usually painful
Risk of pathological fracture

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7
Q

What are the treatments for aneurysmal and simple bone cysts?

A

Curettage and bone grafting with or without stabilization

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8
Q

Where do giant cell tumours occur?

A

Around the knee and distal radius but can occur elsewhere

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9
Q

What are the symptoms of GCT?

A

Pain

Pathological fractures

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10
Q

What is the treatment for a GCT?

A

Intralesional excision with use of phenol, bone cement or liquid nitrogen
Very aggresive lesions may need joint replacement

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11
Q

What is fibrous dysplasia and what are the symptoms?

A

Disease of a bone usually occuring in adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone
Stress fractures

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12
Q

What is an osteoid osteoma and what are the symptoms?

A

Small nidus of immature bone surrounded by an intense sclerotic halo
Intense constant pain
Worse at night
May resolve spotaneously

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13
Q

What is a Brodie’s abscess?

A

Subacute osteomyelitis

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14
Q

Are malignant bone tumours common?

A

No very rare

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15
Q

What does metastatic bone cancer tend to produce?

A 
Constant pain
Worse at night
Weight loss
Loss of appetite
Fatigue
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16
Q

What do malignant primary bone tumours show on x-ray?

A 
Aggressive and destructive signs
Cortical destruction
A periosteal reaction
New bone formation
Sclerosis
Extension into surrounding soft tissue
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17
Q

What is the most common form of primary bone tumour?

A

Osteosarcoma

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18
Q

Who and where do osteosarcomas tend to affect?

A

Young people

Around the knees

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19
Q

Are osteosarcomas radiosensitive?

A

No

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20
Q

What is a chondrosarcoma?

A

A cartilage producing primary bone tumour

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21
Q

What are Fibrosarcomas and Malignant Fibrous Histiocytomas?

A

Fibrous malignant primary bone tumours which tend to occur in normal bone

22
Q

What is the treatment of primary bone tumours?

A

Surgery to remove tumour and surrounding tisue
Amputation
Adjuvant chemotherapy and radiotherapy

23
Q

What is used in the staging of primary bone tumours?

A

Bone scan
CT
MRI
Biopsy

24
Q

What is Ewing’s sarcoma and what are the symptoms?

A

Malignant tumour of primative cells in the marrow
Fever
Raised inflammatory markers
Warm Swelling

25
Q

What cancers are likely to metastasize to bone and are they slerotic or lytic?

A 
Breast - sclerotic or lytic
Prostate - Sclerotic
Lung - Lytic
Renal - Large lytic
Thyroid
26
Q

What are the two types of soft tissue swellings?

A

Diffuse

Local

27
Q

What are examples of diffuse soft tissue swellings?

A

Synovitis

Oedema

28
Q

What are examples of local soft tissue swellings?

A

Bursitis
Rheumatoid nodules
Infection
Cystic lesions

29
Q

What are the 11 findings to look for on examination of soft tissue swellings?

A 
Site
Size
Definition – well defined or ill defined
Consistency – cystic, solid, soft, hard
Surface – smooth or irregular
Mobility or Fixity – to skin or deep tissues
Temperature – abscess
Transilluminable – fluid filled
Pulsatility
Overlying skin changes
Local lymphadenopathy
30
Q

What are features suggestive of benign soft tissue neoplasms?

A 
Smaller size
Fluctuation of size
Cystic lesion
Well-defined lesions
Fluid-filled lesions
Soft/fatty lesions
31
Q

What are features suggestive of malignant soft tissue neoplasms?

A 
Larger lesions
Rapid groeth
Solid lesion
Ill-defined lesion
Irregular surface
Lymphadenopather
Systemic upset
32
Q

What imaging is used for soft tissue swellings?

A

MRI
Ultrasounds
Biopsy

33
Q

What is the commonent benign soft tissue tumour?

A

Lipoma - neoplastic proliferation of fat

Found in the subcutaneous fat and can be large and ill-defined

34
Q

What are malignant soft tissue tumours arising from connective tissues known as?

A

Sarcomas

35
Q

What are 5 types of sarcoma and where do they orignate from?

A 
Angiosarcoma - blood vessels
Fibrosarcoma - Fibrous tissue
Liposarcoma - fat
Rhabdomyosarcoma - skeletal muscle
Synovial sarcoma - synovial lining
36
Q

Where does a ganglion cyst occur?

A

Around a synovial joint or tendon sheath

37
Q

What are the characteristics of a ganglion cyst?

A

Well-defined
Firm
Readily transilluminate

38
Q

What is a bursa?

A

A small fluid filled sac lined by synovium around a joint

39
Q

What is bursitis?

A

Inflamed bursae

40
Q

Why do abscesses on a limb occur?

A

Cellulitis
Bursitis
Penetrating wound
Infected sebaceous cysts

41
Q

What is the end result of Osteochondritis and Avascular necrosis?

A

Localized necrosis of the bone as a result of ischaemia from a reduction in blood supply

42
Q

Who gets osteochondritis?

A

Children and young adults

43
Q

What may be the causes of osteochondritis/

A

Repeated physical activity with stress
Familial predispostion
Impact injuries

44
Q

What does bone necrosis cause?

A 
Compression
Fragmentation or separation of the bone
Flattening of a joint
Pain
Arthritis at young age
45
Q

Where are common sites affected by compression?

A 
2nd metatarsal head
Navicular bone
Lunate of the carpus
Keinbock's disease
Capitellum of the elbow
Perthes disease of the hip
46
Q

What is fragmentation with separation of bone and cartilage within a joint known as?

A

Osteochondritis dissecans

47
Q

How is osteochondritis treated?

A

Osteotomy (surgical reallignment of the bone)
Pinning of unstable fragments
Removal of detached fragments

48
Q

Who does Avascular necrosis usually affect and where?

A 
Adults 
Femoral head
Femoral condyles
Head of humerus
Capitellum
Proximal pole of scaphoid
49
Q

What can AVN be secondary to?

A

Fractures of the femoral neck, proximal humerus and talar neck
When the fracture disrupts the blood supply to an entire piece of bone

50
Q

What are other causes of AVN?

A 
Idiopathic
Alcoholism
Steroid abuse
Primary hyperlipidaemia
Thrombophilia
Sickle cell disease
Antiphospholipid deficiency in SLE
Caisson's disease
51
Q

What is the pathogenesis of AVN?

A 
Necrosis of a bone segment
Patchy sclerosis
Subchondral collapse
Irregularity of articular surface 
Secondary Osteoarthritis
52
Q

What is the treatment of AVN?

A

Drilling under fluroscopy to decompress bone
Joint replacement
Fusion

MSK lectures (50 decks)

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