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Clin Med MSKII > high yield bone, joints, soft tissue Path > Flashcards

high yield bone, joints, soft tissue Path Flashcards

1
Q

radiograph: decreased cortical thickening

A

Osteoporosis

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2
Q

radiograph: diffuse, dense bone

A

Osteopetrosis

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3
Q

Radiograph: thickening of calvarium

A

Osteitis deformans (Paget disease of bone)

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4
Q

Xray: irregular lucencies with adjacent sclerosis
MRI: dark serpiinous necrotic bone

A

Osteonecrosis

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5
Q

bamboo spine

A

Ankylosing spondylitis

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6
Q

X ray: Soap bubble appearance

A

Giant cell tumor

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7
Q

X ray: Exotosis of bone

A

Osteochondroma

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8
Q

X ray: sun burst pattern/Codman triangle around metaphysis of long bones

A

Osteosarcoma

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9
Q

X ray: “onion skin” around diaphysis of long bone

A

Ewing sarcoma

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10
Q

Osteoporosis is dysfunction of what cell

A

osteoblast

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11
Q

Dowager’s hump: increased cervical lordosis and dorsal kyphosis

A

osteoporosis

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12
Q

Osteopetrosis is dysfunction in what cells

A

osteoclasts

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13
Q

Gene for osteopetrosis

A

Carbonic anhydrase

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14
Q

gene for Paget Disease

A

SQSTM1

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15
Q

what labs elevated in Paget disease of bone

A

Alk Phos

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16
Q

increase in hat size

A

Paget disease

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17
Q

Osteonecrosis of femoral head. what artery

A

medial circumflex femoral artery

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18
Q

HLA associated with Ankylosing spondylitis

A

HLA-27

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19
Q

cartilage capped tumor that is attached to underlying skeleton by bony stalk

A

osteochondroma

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20
Q

Herbeden nodes and Bouchard nodes

A

OA

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21
Q

Swan neck deformity and Boutonneire’s deformity

A

RA

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22
Q

genetic factors for RA

A
  • HLA-DRB1

- PTPN22

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23
Q

antibodies against citrullinated peptides

A

RA

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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+
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25
Q

Seronegative spondyloarthropathies are pathologic changes of what?
Give the general highlights

A

ligamentous attachments, not synovium

  • SI joints
  • Absence of RF
  • HLA-B27 association
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26
Q

what are the seronegative spondyloarthropathies?

A
  • Ankylosing spondylitis
  • Reactive arthritis
  • Enteritis associated arthritis
  • Psoriatic arthritis
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27
Q

arthritis + non-gonococcal urethritis or cervicitis + conjunctivitis

A

reactive arthritis

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28
Q

what probably causes reactive arthritis

A

autoimmune reaction initiated by prior infection of GU system by chlamydia

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29
Q

clinical finding in reactive arthritis

A
  • synovitis of digital tendon sheath–>sausage finger/toe
  • ossification of tendoligamentous insertion sites –>calcaneal spurs/bony outgrowths
  • Extraarticular findings: conjunctivitis, inflammatory balanitis, aortic regurg
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30
Q

pencil in cup deformity

A

psoriatic arthritis

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31
Q

association with different organisms and suppurative arthritis: children < 2?
Adults?
Sickle cell disease?
Sexually active individuals?

A
  • H. flu (gram-neg coccobacillus)
  • S. aureus (gram-pos cocci)
  • Salmonella (gram-neg rod)
  • N gonorrhea (gram neg diplococcus)
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32
Q

tophi

A

gout

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33
Q

rhomboid crystals with positive birefringence

A

Calcium pyrophosphate deposition disease (pseudo-gout; chondrocalcinosis)

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34
Q

age for gout?

age for calcium pyrophosphate deposition disease?

A
  • men>30

- over 50

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35
Q

osteosarcoma gene

A

p53 and RB

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36
Q

key features of Ewing sarcoma

A
  • boys <15
  • malignant
  • diaphysis of long bones
  • destructive lytic tumor that extends into surrounding soft tissue
  • periosteal reaction
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37
Q

Diaphysis tumors

A
  • Ewing
  • myeloma
  • osteoid osteoma
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38
Q

Metaphysis tumors

A
  • Osteosarcoma

- osteochondroma

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39
Q

Epiphysis tumors

A

Giant cell tumor

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40
Q

Homer wright rosettes

A

Ewing sarcoma

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41
Q

spongiosa filling the medullary canal with no mature trabeculae

A

osteopetrosis

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42
Q

Trabecular thinning with fewer interconnections

A

osteoporosis

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43
Q

Lemellar bone structure resembling mosaic

A

paget disease

44
Q

inheritance of osteopetrosis

A

AD

45
Q

sandwich vertebrae: dense bands of sclerosis parallel to endplates?

A

Osteopetrosis

46
Q

pancytopenia

A

osteopetrosis

47
Q

what besides fracture can cause osteonecrosis

A

-Corticosteroid use

48
Q
  • Crescent sign
  • Double line sign
  • Rim sign
A

osteonecrosis

49
Q

biopsy of non neoplastic osteoclasts and their precursors

A

Giant cell tumor

50
Q

biopsy of primitive round cells without obvious differentitation

A

Ewing

51
Q

biopsy of cells with increased osteoid production

A

osteosarcoma

52
Q

defective mineralization of osteoid

A

Osteomalacia

53
Q

what are the skull deformities seen in paget disease

A
  • diploic thickening of inner and outer calvarium
  • cotton wool appearance: mixed lytic and sclerotic lesions
  • Frontal bone enlargement
54
Q

key features for osteochondroma

A
  • 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
Q

subchondral cysts

A

OA

56
Q

hitchhikers thumb

A

RA

57
Q

asymmetric joint space narrowing

A

OA

58
Q

Salter Harris fracture classification

A 
-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
Q

Central area of necrosis surrounded by epithelioid macrophages

A

Rheumatoid nodule

60
Q
  • RA
  • intrapulmonary nodules within lung
  • Pneumoconiosis
A

Caplan syndrome

61
Q
  • RA
  • Splenomegaly
  • Neutropenia
A

Felty Syndrome

62
Q

things that can precipitate uric acid

A
  • thiazide diuretics

- Tumor Lysis syndrome: Leukemia, Lymphoma

63
Q

joint and age for chondrocalcinosis

A
  • > 50

- knee

64
Q

radiographs: eaten out

A

Ewing

65
Q
  • multiple fractures
  • decreased hearing
  • weakness of facial muscles
  • thickened bones
A

0steopetrosis

66
Q

Gene for Brachydactyly

A

HOXD13

67
Q

Gene for Cleidocranial dysplasia

A

RUNX2

68
Q

describe Cleidocranial dysplasia

A
  • patent fontanelles
  • delayed closure of cranial sutures
  • Wormian bones
  • delayed eruption of secondary teeth
  • primitive clavicles
  • short height
69
Q

Gene for Achondroplasia and Tanatophoric dwarfism

A

FGFR3

70
Q

which type of OI is fatal in utero

A

type 2

71
Q

gene for OI

A

type I collagen (COL1A1)

72
Q
  • too little bone
  • skeletal fragility
  • blue sclera
  • hearing loss
  • dental imperfections
A

OI

73
Q

other names for osteopetrosis

A
  • Marble bone disease

- Albers-Schonberg disease

74
Q
  • Diffuse skeletal sclerosis but bone is brittle (woven)
  • No medullary canal
  • Narrowed neural foramina
A

Osteopetrosis

75
Q

most common types of osteoporosis

A
  • senile

- post menopausal

76
Q

average age for Pagets disease of bone

A

70 . . old person disease

77
Q

mutation for Paget

A

-SQSTM1 –> increase in NF-kB

78
Q

diagnosis of osteoporosis

A
  • 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
Q

osteomyelitis develops how in children?

adults?

A
  • hematogenous in long bones

- open fractures, surgical procedures, diabetic infections of feet

80
Q

Brodie abscess

A

osteomyelitis

81
Q

sequestrum and involucrum

A

osteomytlitis

82
Q

disease with multiple enchondromas (enchondromatosis)

A

-Ollier disease

83
Q

where are chondromas found

A

tubular bones in hands and feet

84
Q

chondromas with spindle cell hemangiomas

A

Maffucci syndrome

85
Q

Gene for chondrosarcoma

A

IDH1 and IDH2

86
Q

what does a chondrosarcoma present as

A

painful enlarging mass

87
Q

severe nocturnal pain

relieved by aspirin

A

osteoid osteomas (<2 cm)

88
Q

site for osteoid osteoma

A

femur or tibia

89
Q

site for osteoblastoma

A

posterior spine

90
Q

Malignant osteoid

A

osteosarcoma

91
Q

gene for fibrous dysplasia

A

GNAS1

92
Q

polystotic fibrous dysplasia and soft tissue myxomas (intramuscular)

A

Mazabraud syndrome

93
Q

polystotic fibrous dysplasia associated with café-au-lait skin pigmentations and endocrine abnormalities, especially precocious puberty

A

McCune-Albright syndrome

94
Q

what cells are prominent in RA

A

plasma cells

95
Q

synovial cyst that forms in popliteal space in setting of RA

A

baker cyst

96
Q

firm fluctuant pea sized mass that is translucent

A

ganglion cyst

97
Q

genetics for tenosynovial giant cell tumor

A

-t(1;2) . . fusion of type VI collagen . . .leads to over expression of M-CSF

98
Q

what soft tissue tumor involved translocation of X chromosome

A

synovial sarcoma

99
Q

location of lipoma?

liposarcoma?

A
  • superficial extremeties and trunk

- Deep soft tissue proximal extremities and retroperitoneum

100
Q

genetics for liposarcoma

A
  • t(12,16)

- amplification of MDM2

101
Q

highlights for SUPERFICIAL fibromatosis

A
  • 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
Q

highlights for DEEP fibromatoses

A
  • 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
Q

translocated genes for Rhabdomyosarcoma

A

PAX and FOX

104
Q

Hereditary leiomyomatosis and renal cell cancer syndrome

A

-LOF of fumarate hydratase gene on 1q

105
Q

Morphology of synovial sarcoma

A

positive for epithelial markers . . keratins

106
Q

genes for synovial sarcoma

A

SS18-SSX1

Clin Med MSKII (16 decks)

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