high yield bone, joints, soft tissue Path Flashcards
1
Q
radiograph: decreased cortical thickening
A
Osteoporosis
2
Q
radiograph: diffuse, dense bone
A
Osteopetrosis
3
Q
Radiograph: thickening of calvarium
A
Osteitis deformans (Paget disease of bone)
4
Q
Xray: irregular lucencies with adjacent sclerosis
MRI: dark serpiinous necrotic bone
A
Osteonecrosis
5
Q
bamboo spine
A
Ankylosing spondylitis
6
Q
X ray: Soap bubble appearance
A
Giant cell tumor
7
Q
X ray: Exotosis of bone
A
Osteochondroma
8
Q
X ray: sun burst pattern/Codman triangle around metaphysis of long bones
A
Osteosarcoma
9
Q
X ray: “onion skin” around diaphysis of long bone
A
Ewing sarcoma
10
Q
Osteoporosis is dysfunction of what cell
A
osteoblast
11
Q
Dowager’s hump: increased cervical lordosis and dorsal kyphosis
A
osteoporosis
12
Q
Osteopetrosis is dysfunction in what cells
A
osteoclasts
13
Q
Gene for osteopetrosis
A
Carbonic anhydrase
14
Q
gene for Paget Disease
A
SQSTM1
15
Q
what labs elevated in Paget disease of bone
A
Alk Phos
16
Q
increase in hat size
A
Paget disease
17
Q
Osteonecrosis of femoral head. what artery
A
medial circumflex femoral artery
18
Q
HLA associated with Ankylosing spondylitis
A
HLA-27
19
Q
cartilage capped tumor that is attached to underlying skeleton by bony stalk
A
osteochondroma
20
Q
Herbeden nodes and Bouchard nodes
A
OA
21
Q
Swan neck deformity and Boutonneire’s deformity
A
RA
22
Q
genetic factors for RA
A
- HLA-DRB1
- PTPN22
23
Q
antibodies against citrullinated peptides
A
RA
24
Q
highlights for Juvenile idiopathic arthritis
A
- before 16
- lasts at least 6 weeks
- more common in large joints
- Absent RF and rheumatoid nodules
- ANA+
25
Seronegative spondyloarthropathies are pathologic changes of what?
Give the general highlights
ligamentous attachments, not synovium
- SI joints
- Absence of RF
- HLA-B27 association
26
what are the seronegative spondyloarthropathies?
- Ankylosing spondylitis
- Reactive arthritis
- Enteritis associated arthritis
- Psoriatic arthritis
27
arthritis + non-gonococcal urethritis or cervicitis + conjunctivitis
reactive arthritis
28
what probably causes reactive arthritis
autoimmune reaction initiated by prior infection of GU system by chlamydia
29
clinical finding in reactive arthritis
- synovitis of digital tendon sheath-->sausage finger/toe
- ossification of tendoligamentous insertion sites -->calcaneal spurs/bony outgrowths
- Extraarticular findings: conjunctivitis, inflammatory balanitis, aortic regurg
30
pencil in cup deformity
psoriatic arthritis
31
association with different organisms and suppurative arthritis: children < 2?
Adults?
Sickle cell disease?
Sexually active individuals?
- H. flu (gram-neg coccobacillus)
- S. aureus (gram-pos cocci)
- Salmonella (gram-neg rod)
- N gonorrhea (gram neg diplococcus)
32
tophi
gout
33
rhomboid crystals with positive birefringence
Calcium pyrophosphate deposition disease (pseudo-gout; chondrocalcinosis)
34
age for gout?
| age for calcium pyrophosphate deposition disease?
- men>30
| - over 50
35
osteosarcoma gene
p53 and RB
36
key features of Ewing sarcoma
- boys <15
- malignant
- diaphysis of long bones
- destructive lytic tumor that extends into surrounding soft tissue
- periosteal reaction
37
Diaphysis tumors
- Ewing
- myeloma
- osteoid osteoma
38
Metaphysis tumors
- Osteosarcoma
| - osteochondroma
39
Epiphysis tumors
Giant cell tumor
40
Homer wright rosettes
Ewing sarcoma
41
spongiosa filling the medullary canal with no mature trabeculae
osteopetrosis
42
Trabecular thinning with fewer interconnections
osteoporosis
43
Lemellar bone structure resembling mosaic
paget disease
44
inheritance of osteopetrosis
AD
45
sandwich vertebrae: dense bands of sclerosis parallel to endplates?
Osteopetrosis
46
pancytopenia
osteopetrosis
47
what besides fracture can cause osteonecrosis
-Corticosteroid use
48
- Crescent sign
- Double line sign
- Rim sign
osteonecrosis
49
biopsy of non neoplastic osteoclasts and their precursors
Giant cell tumor
50
biopsy of primitive round cells without obvious differentitation
Ewing
51
biopsy of cells with increased osteoid production
osteosarcoma
52
defective mineralization of osteoid
Osteomalacia
53
what are the skull deformities seen in paget disease
- diploic thickening of inner and outer calvarium
- cotton wool appearance: mixed lytic and sclerotic lesions
- Frontal bone enlargement
54
key features for osteochondroma
- can transform into chondrosarcoma
- most in males < 25
- bones of endochondral origin and arise from metaphysis near the growth plate of long tubular bones
- slow growing
- can be painless or painful if they impinge on nerve or if stalk is fractured
- pedunculated bony outgrowth at proximal tibial metaphysis
- uniform cargilagenous cap with stippled calcifications
55
subchondral cysts
OA
56
hitchhikers thumb
RA
57
asymmetric joint space narrowing
OA
58
Salter Harris fracture classification
```
-involves growth plate
I-S (slip straight across)
II-A (Above the physis)
III-L (Lower than physis)
IV-T (through everything)
V- R (Rammed-crushed physis)
```
59
Central area of necrosis surrounded by epithelioid macrophages
Rheumatoid nodule
60
- RA
- intrapulmonary nodules within lung
- Pneumoconiosis
Caplan syndrome
61
- RA
- Splenomegaly
- Neutropenia
Felty Syndrome
62
things that can precipitate uric acid
- thiazide diuretics
| - Tumor Lysis syndrome: Leukemia, Lymphoma
63
joint and age for chondrocalcinosis
- >50
| - knee
64
radiographs: eaten out
Ewing
65
- multiple fractures
- decreased hearing
- weakness of facial muscles
- thickened bones
0steopetrosis
66
Gene for Brachydactyly
HOXD13
67
Gene for Cleidocranial dysplasia
RUNX2
68
describe Cleidocranial dysplasia
- patent fontanelles
- delayed closure of cranial sutures
- Wormian bones
- delayed eruption of secondary teeth
- primitive clavicles
- short height
69
Gene for Achondroplasia and Tanatophoric dwarfism
FGFR3
70
which type of OI is fatal in utero
type 2
71
gene for OI
type I collagen (COL1A1)
72
- too little bone
- skeletal fragility
- blue sclera
- hearing loss
- dental imperfections
OI
73
other names for osteopetrosis
- Marble bone disease
| - Albers-Schonberg disease
74
- Diffuse skeletal sclerosis but bone is brittle (woven)
- No medullary canal
- Narrowed neural foramina
Osteopetrosis
75
most common types of osteoporosis
- senile
| - post menopausal
76
average age for Pagets disease of bone
70 . . old person disease
77
mutation for Paget
-SQSTM1 --> increase in NF-kB
78
diagnosis of osteoporosis
- decrease bone mass 2.5 standard dev below mean peak bone mass
- Any traumatic or vertebral compression fracture
- NO labs help
- 30-40% loss to see it on plain xray
79
osteomyelitis develops how in children?
| adults?
- hematogenous in long bones
| - open fractures, surgical procedures, diabetic infections of feet
80
Brodie abscess
osteomyelitis
81
sequestrum and involucrum
osteomytlitis
82
disease with multiple enchondromas (enchondromatosis)
-Ollier disease
83
where are chondromas found
tubular bones in hands and feet
84
chondromas with spindle cell hemangiomas
Maffucci syndrome
85
Gene for chondrosarcoma
IDH1 and IDH2
86
what does a chondrosarcoma present as
painful enlarging mass
87
severe nocturnal pain
| relieved by aspirin
osteoid osteomas (<2 cm)
88
site for osteoid osteoma
femur or tibia
89
site for osteoblastoma
posterior spine
90
Malignant osteoid
osteosarcoma
91
gene for fibrous dysplasia
GNAS1
92
polystotic fibrous dysplasia and soft tissue myxomas (intramuscular)
Mazabraud syndrome
93
polystotic fibrous dysplasia associated with café-au-lait skin pigmentations and endocrine abnormalities, especially precocious puberty
McCune-Albright syndrome
94
what cells are prominent in RA
plasma cells
95
synovial cyst that forms in popliteal space in setting of RA
baker cyst
96
firm fluctuant pea sized mass that is translucent
ganglion cyst
97
genetics for tenosynovial giant cell tumor
-t(1;2) . . fusion of type VI collagen . . .leads to over expression of M-CSF
98
what soft tissue tumor involved translocation of X chromosome
synovial sarcoma
99
location of lipoma?
| liposarcoma?
- superficial extremeties and trunk
| - Deep soft tissue proximal extremities and retroperitoneum
100
genetics for liposarcoma
- t(12,16)
| - amplification of MDM2
101
highlights for SUPERFICIAL fibromatosis
- an infiltrative fibroblastic proliferations that can cause local deformity but has an innocuous clinical course
- M>G
- Palmar (Dupuytrn contracture)
- Plantar
- Penile (Peyronie disease)
102
highlights for DEEP fibromatoses
- large, infiltrative masses that frequently recur but do not metastasize
- Teens to 302 in women
- Abdominal wall, limb girdle, mesentery
- APC or B-catenin mutations
- Gardner syndrome
103
translocated genes for Rhabdomyosarcoma
PAX and FOX
104
Hereditary leiomyomatosis and renal cell cancer syndrome
-LOF of fumarate hydratase gene on 1q
105
Morphology of synovial sarcoma
positive for epithelial markers . . keratins
106
genes for synovial sarcoma
SS18-SSX1
