Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Plastic Surgery( Grabb)Ali jasim > Hand Tumors > Flashcards

Hand Tumors Flashcards

1
Q

Epidermal inclusion cysts in the fingertip can mimic infective or malignant conditions

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most ganglions can be managed conservatively.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

majority oftumors that arise in the hand and wrist are benign,

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tumors arising from the hand and wrist usually present as a painless mass

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Transillumination is an
invaluableclinical sign when assessing forganglions.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tumors that arise from tendons or tendon sheaths are usually mobile
sideways

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

For lesions
involving the nail complex, abnormal nail pigmentation and deformity
(e.g., ridging, loss ofadherence) should be looked for.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The main modality
for evaluating hand tumors

A

plain radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CT scans, which provide better resolution and
three-dimensional bone anatomy, are frequently needed to augment
X-rays to properly assess bony changes

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ultrasound is a low-cost and readily available modality that can
help to assess the nature of the mass (solid versus cystic), the vascularity, and the relative location of the mass.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

it is difficult to differentiate between benign and
malignant masses on ultrasound alone

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the main modality for imaging complex soft tissues
masses

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Benefit of MRI in evaluating soft tissue ,mass

A

characterization of tumor activity(heterogeneouscontrast enhancement as well as perilesional edema suggesting a locally aggressive tumor).
assess response to adjuvant therapy
look for local recurrence in a surgical bed
MRI can also delineate soft tissue compartments and relationship of the mass to neurovascular structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nuclear medicine scans are not specific and cannot differentiate between infection, trauma, and neoplasms

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When nuclear medicine scans are coupled with
anatomical imaging such as CT and MRI scans, their utility is further
enhanced

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

18-FDG positron emission tomographyscans can also help
to monitor the response to neoadjuvant treatment such as chemotherapy, and can be used as a tool to help prognosticate patients

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

myxoid liposarcomas can be evaluated with 18-FDG scan

A

F tumors, such as myxoid liposarcomas, may not be metabolic and have low 18-FDG uptake, which will limit the utility of these scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

size should not be the only criterion to rule out malignancy

A

Because a majority (77%) of patients with soft tissue sarcomas present with tumors less than 5 cm in greatest dimension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

majority of malignant tumors in the hand are detected when they are small

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The standard for diagnosis is biopsy

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Marginal excision is sufficient for almost all benign soft tissue tumors.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

. Wide excision, which involves excision
of the tumor through a margin of normal tissue, may be required for
some benign but locally aggressive tumors such as desmoid tumors.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

For locally aggressive bone tumors such as
giant cell tumors, local adjuvant treatment using techniques such
as cryosurgery or phenol are added to reduce local recurrence rates.

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Safety margin for sarcoma excision?

A

For sarcomas, there is no universally agreed margin, but in
general, 1 cm of soft tissue, or an appropriate anatomic layer such as fascia, is accepted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In the hand, the margins are invariably narrow due to the closeness
of critical structures.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the down side of neoadjuvant treatment

A

there is a risk of tumor progression during neoadjuvant treatment, and higher wound infection rates are seen in patients that have undergone preoperative
radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Postoperative radiotherapy indication ?

A

should be considered for patients
following resections with close margins or microscopically positive margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Postoperative chemotherapy can also be considered

A

for
selected patients with large, high-grade tumors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The biopsy track should be excised en bloc together with the main
tumor during the definitive resection.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dissection should be done
through normal tissue that is not contaminated by tumor

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Critical vessels and nerves that are not grossly involved by the tumor can be preserved by dissecting through the adventitia or epineurium

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Most patients with soft tissue sarcoma loss their hand

A

F Hand preservation is possible for most patients with soft tissue
sarcomas of the hand, even those with relatively large tumors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

well-performed ray
amputation can result in a more functional hand thana reconstructed
digit that is painful, poorly padded, and stiff

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Functional reconstruction can be delayed until
all other treatment has been completed

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

most common soft tissue tumors seen in the hand

A

Ganglions are the most common soft tissue tumors seen in the handthey are mucin-filled cysts and are not true neoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

At wich age ganglion can occur?

A

Ganglions
can occur at any age, though they are more commonly seen between
the second to fourth decade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

They can arise from………

A

any joint within the
hand and wrist, as well as from tendon sheaths

38
Q

Most common site of ganglion

A

The most commonly
encountered are dorsal wrist ganglions (~70%), followed by volar wrist ganglions (~20%), then ganglions arising from the flexor tendon sheaths and mucous cysts arising from the distal interphalangeal joints

39
Q

the main constituents of the ganglion fluid

A

hyaluronic acid, glucosamine, albumin, and globulin

40
Q

The diagnosis of a ganglion can be established on careful clinical
evaluation-a cystic, occasionally multilobulated, mass that transilluminate

A

T

41
Q

X-rays are helpful in evaluating underlying joint
changes

A

T

42
Q

MRis can confirm the diagnosis, as well as identify occult
ganglions that may be symptomatic but not clinically detectable

A

T

43
Q

The most common treatment for ganglion

A

observation should be considered because up to 50% resolve without
treatment

44
Q

the rate of spontaneous resolution even higher
in children

A

T

45
Q

substances such as steroids” or hyaluronidase26 have been injected
following aspiration of the ganglion in an attempt to reduce the
recurrence rate,

A

T

46
Q

Injection of sclerosants
should be avoided due to the risk of articular cartilage damage

A

T

47
Q

Excision of ganglions can be done using open or arthroscopic
techniques

A

T

48
Q

Recurrence
rates

A

between 0.6% and 40% have been reported following open surgery.

49
Q

Arthroscopic resection, advantage

A

though technically more difficult,
has the advantage of better visualization of the joint and a better surgical scar, with similar recurrence rates to open surgery

50
Q

pigmented villonodular synovitis (PVNS), fibrous xanthoma, and localized nodular synovitis. They are the second most
common soft tissue tumors were seen in the hand after ganglions

A

T

51
Q

Giant cell tumour always arise from the tendons sheath

A

Despite the name, these tumors do not always arise from the
tendon sheath or contain giant cells

52
Q

The tumors are firm and nodular, and tender

A

F The tumors are firm and nodular, and generally are nontender

53
Q

actual bone invasion.occure with this tumour

A

F They can cause pressure erosions
ofthe underlying bone or rarely, actual bone invasion

54
Q

Marginal excision is the treatment of choice, with recurrence
rates of9% to 27%

A

T

55
Q

Factors associated with local recurrence

A

presence of degenerative joint disease
involvement of the distal interphalangeal joint
radiographic evidence of bone pressure erosion
involvement of the flexor or extensor tendons, or joint capsule
satellite nodules that are not completely excised
during surgery

56
Q

Malignant transformation of giant cell tumors of
tendon sheath has not been reported

A

T

57
Q

epidermal cysts traumatic implantation ofepithelial cells into the soft tissue, or even into bone

A

T

58
Q

Epidermal cysts are frequently seen
over the fingertips and at times even in the stumps of
amputated fingers

A

T

59
Q

Patients most frequently present with a painless mass that has
been growing slowly over months to years

A

T

60
Q

Occasionally, the mass
may be painful and erythematous

A

T

61
Q

cysts in the soft tissue will
be firm, well circumscribed, and slightly mobile

A

T

62
Q

Those that involve
the bone will be fixed; and they may have a lytic appearance on X-ray

A

T

63
Q

patients with lytic lesions involving the
distal phalanx should undergo biopsy to confirm the diagnosis

A

T

64
Q

Treatment

A

Epidermal inclusion
cysts can be treated with a marginal excision with a minimal risk of
local recurrence.

65
Q

Schwannomas are commonly seen in the upper extremity

A

T

66
Q

It is painful mass

A

Patients often present with a painless mass, though they can occasionally present with radiating pain that occurs when the lesion is
traumatized, or even neurological deficits

67
Q

Most usefull investigation for shwanoma

A

MRI is the most useful investigation in delineating the lesion, and to identifying the nerve of origin

68
Q

often difficult to differentiate a schwannoma from other nerve
tumors such as neurofibromas, or even malignant peripheral nerve
sheath tumors on MRI alone

A

T

69
Q

Postoperative loss of function has been
reported in 2.5% to 30% of patients

A

T

70
Q

Local recurrence following tumor excision is common

A

F Local recurrence following tumor excision is rare

71
Q

there have been cases of malignant
transformation reported

A

T

72
Q

It has been described that schwannomas can be easily dissected
and shelled out from the nerve fibers

A

t

73
Q

Enchondromas are the most common primary bone tumor seen in
the hand.

A

T

74
Q

They are thought to develop from residual nests ofcartilage
originally arising from physis

A

T

75
Q

Incidental lesions can be observed

A

T

76
Q

Most common site of enchondroma

A

In the hand, enchondromas are most
frequently seen in the proximal phalanges, followed by metacarpals
and middle phalanges.

77
Q

The small finger ray is the most commonly
involved, whereas carpal involvement is rare

A

t

78
Q

They are usually
solitary, and are found in the diaphysis of the bone, though larger
lesions can occupy almost the entire bone

A

T

79
Q

Multiple enchondromas where can occures

A

Multiple enchondromas
can be seen in patients with Oilier disease and Maffucci syndrome

80
Q

Patients are often asymptomatic, and present with pain and swelling due to a pathological fracture

A

T

81
Q

Digital deformity can be seen in
patients with multiple enchondromatosis

A

T

82
Q

The diagnosis

A

be made with plain radiographs

83
Q

Finding in plain radiograph

A

which will show a lytic diaphyseal
lesion, with lobulated margins and endosteal scalloping; the matrix is clear with a chondroid calcification pattern

84
Q

Increased pain and swelling may be a sign of malignant change,

A

T

85
Q

malignant change,
frequently seen in patients with Oilier disease (25%)
and Maffucci syndrome (100%)

A

T

86
Q

Features suggestive of malignant
change in xray

A

cortical destruction, loss of matrix mineralization,
periosteal reaction, and a soft tissue mass.

87
Q

techniques for reconstruction of the bone defect that have been described include leaving it
alone, cement, bone substitute, allograft, and autograft

A

T

88
Q

For patients who present following pathological fractures, there is the option ofearly definitive treatment with intralesional curettage, bone grafting and internal fixation, staged treatment with closed treatment ofthe fracture followed by delayed surgery once fracture union
has occurred

A

T

89
Q

Sarcomas originate from the embryonic mesodermal layer

A

T

90
Q

Soft tissue sarcomas of the hand were initially thought to have a poorer prognosis than tumors arising elsewhere in the extremities

A

T

91
Q

Continuing improvements in imaging techniques such as
MRI allow better imaging and delineation of the tumor,

A

T

92
Q
A

Plastic Surgery( Grabb)Ali jasim (92 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions