Mm/Nn/Bone Buzzin Flashcards

Question

FGFR3 mutation

Answer 1

achondrolplasia = short stature, short limbs, frontal bossing

Answer 2

osteogeneisis imperfecta --> bone fragility "brittle bone disease" problem w/ type 1 collagen poor teeth, blue sclera, fractures

Answer 3

prob. w/ metabolic pathway --> bad fn. in osteoclasts = oste0petrosis chalky bones w/ earl myer flask shape see anemia, thrombocytopenia, leukopenia d/t CA2 mutation = no carbonic anydrase = inability for osteoclasts to produce acidic environment

Answer 4

idiopathic, postmenopause, hypothyroid overtreatment (too much T4)

Answer 5

paget disease = overworking osteoclasts, osteoblasts can't keep up see mosaic pattern of lamellar bone = "cement lines" pain in affected bone, d/t microfractures, increased heat "saber bone" increased risk of sarcoma

Answer 6

rickets in kids, osteomalacia in adults

Answer 7

hyperPTH - "brown tumor" most commonly PTH adenoma

Answer 8

1. uremic neuropathy = distal, symm. neuropathy | 2. renal osteodystrophy = d/t acidosis --> osteopenia ; no vit D --> osteomalacia

Answer 9

1. type II mm. atrophy 2. avascular necrosis/ osteonecrosis - w/ avascular necrosis see saponification and the head of the femur looks yellow

Answer 10

** systemic sx ** staph aureus in cases where organism can be isolated ; another less common cause is TB (pott disease) sequestrum = inflamm. --> dead bone involcrum = osteoblasts surround infected bone, wall it off

Answer 11

i. Mets ii. Multiple Myeloma iii. osteosarcoma – younger than 25 iv. chondrosarcoma – older than 40 v. Ewing sarcoma most tumors arise from metaphysis (Giant cells from epiphysis, Ewing sarcoma from diaphysis)

Answer 12

giant cell tumor

Answer 13

ewing sarcoma

Answer 14

osteoid osteoma = tumor in the heel, 2 cm - can become large, not much relief from NSAIDs - seen in spine Morphology: • round-to-oval masses of hemorrhagic gritty tan tissue • well circumscribed and composed of randomly interconnecting trabeculae • benign cytologic features

Answer 15

most common primary bone malig. younger than 20 years metaphysis, knee - or other larger bones painful "codman triangle" spread to lungs!!!!!!!

Answer 16

chondrosarcoma

Answer 17

osteochondroma - bone follows the mm. line, resected and have bone covered w/ cartilage almost always benign

Answer 18

benign tumors of hyaline cartilage that usually occur in bones of enchondral origin. enchondromas = arise within the medullary cavity (seen on right) - most common of the intraosseous cartilage tumors and are usually diagnosed in individuals 20 to 50 years of age. - Typically, they appear as solitary metaphyseal lesions of tubular bones of the hands and feet. juxtacortical chondromas = surface of bone - The radiographic features consist of circumscribed lucencies with central irregular calcifications, a sclerotic rim and an intact cortex. well circumscribed! mafuccii syndrome: lots of endchondromas

Answer 19

chondrosarcoma - 40 years + - see cartilage malignant tumors - calcified matrix with flocculent densities "scalloping with flocculent densities" axial skeleton grade 3 --> spread to lungs

Answer 20

ewing sarcoma - small round blue cell tumor in "rosetic balls" "onion skinning" diaphysis of long bones often have systemic findings as well! onion skinning/starburst pattern - stain shows its rich in glycogen

Answer 21

giant cell tumor - epiphyseal location

Answer 22

aneurysmal bone cyst - metaphysis of long bones

Answer 23

Fibrous Cortical Defect and Nonossifying Fibroma (same tumor): • Fibrous cortical defects (also known as metaphyseal fibrous defects) are extremely common, present in 30% to 50% of children older than 2 years. • The vast majority arise eccentrically in the metaphysis of the distal femur and proximal tibia, and almost half are bilateral or multiple. • Fibrous cortical defect: most common, they are small, about 0.5 cm in diameter. • Nonossifying fibroma: Those that grow to 5 or 6 cm in size; these are usually not detected until adolescence or adulthood asymptomatic, biopsy rarely necessary

Answer 24

chinese character pattern = fibrous dysplasia thats intramedullary and well circumscribed localized develop. arrest - see hazy on xray monostotic fibrous dysplasia: boys and girls, femur, tibia, jaw bones, usually stops enlarging and cured by curettage polyostotic fibrous dysplasia: seen at younger age, femur, craniofacial involved, results in severe progressive disease and deformities --> sometimes goes to sarcoma rarely

Answer 25

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

Answer 26

ewing sarcoma vs. onion bulbing - chronic inflammatory demyelinating polyneuropathy

Answer 27

muscular dystrophy/ Becker/Duchenne = enlargement of the lower leg note: duchenne is more common that Becker's

Answer 28

= dermatomyositis - proximal mm. weakness perfifascicular inflammation gottron's papules - can lead to interstitial lung disease or cardiac failure

Answer 29

think multiple myeloma - bence jones proteins in urine, lytic lesions in the back, bone marrow biopsy shows "clock faced nuclei"

Answer 30

problem of repair, seen in late 50's, insiduous articular cartilage looks rough, bony spur, subchondral cysts, subchondral sclerosis, osteophyte, thinned cartilage affects hips, knees, large joints first

Answer 31

clinical course: slowly insidious malaise, fatigue, MSK pain, smmetric involvement of small joints inflammation, pannus, fibrous/bony ankylosis, eroding cartilage AI disorder of CD4 T helper cells - TNF plays major role!!! symmetric arthritis of small joints in hands and feet: large PIPs, ulnar deviated fingers looks red and ragged - turbid synovial fluid its a systemic disease: have skin granulomas (nodule on elbow) and developing vasculitis high RF = high chance of vasculitis CCP test = screening for RA

Answer 32

RA ** NOTE: TNF plays a major role and antagonists of TNF are central to tx!

Answer 33

think juvenile idiopathic arthritis OR SLE - in JIA - see systemic disease,

Answer 34

multiple enchondromas - hyaline cartilage thats benign w/in the finger joints also worry about ollier disease

Answer 35

fibrous dysplasia - see ground glass appearance - see fibrous tissue w/in the bone

Answer 36

think PNET - Ewing sarcoma

Answer 37

think seronegative spondyloarthropathies - involve SI joint - absence of rheumatoid factor - ankylosing spondylitis - reactive arthritis (reiter syndrome)

Answer 38

ankylosing spondylitis - HLAB27 - bamboo spine - destruction of articular cartilage, starts at SI joints

Answer 39

think reactive arthritis - reiter syndrome HLAB27 arthritis in PIPs, and dips conjunctivitis, urethritis, arthritis think chalmydia, shiella, salmonella, campylobater --- assoc. w/ GB

Answer 40

enteritis associated arthritis yersinia, salmonelal, shigella, campylobacter arthritis involves knes and ankles

Answer 41

psoriatic arthritis - see psoriasis over the wrists - DIPs are first to be affected symmetrically

Answer 42

infectious/suppurative arthritis - see leukocytosis and elevated sed rate - joint aspiration is purulent - think staph aureus in adults (or gonorrhea) - salmonella (SS disease), or pneumococcal in kids

Answer 43

lyme arthritis - borrelia burgdorferi arthritis of large joints that migrates

Answer 44

acute arthritis d/t monosodium urate (MSU) --- always see elevated plasma urate levels!!! - see overproduction in leukemia, with very elevated levels - see normal levels in CKD, with decreased uric acid excretion YIPA think alcohol, older, obese, metabolic syndrome defined x-linked HGPRT

Answer 45

less symptomatic - see calcium pyrophosphate dehydrate ** older than 50 years, can be confused w/ osteoarthritis * rhomboid dimension - effects knes, wrists, elbows, shoulders, ankles

Answer 46

involve SI and vertebral joints - often assoc. w/ HLAB-27 1. ankylosing spondylitis = bamboo spine, HLA b27 2. Reactive arthritis = chlamydia 3. enteritis arthritis = GB 4. psoriatic arthritis = psoriasis on wrist

Answer 47

ganglion/synovial cyst - small cyst lacking a cell lining near joint capsule/tendon sheath synovial cyst = herniation of synovium through a joint capsule baker cyst = synovial cyst in popliteal fossa, with RA

Answer 48

tenosynovial giant cell tumor - benign neoplasm of joint - diffuse type - see tiger striping - larger joints - localized type - see discrete nodule tx: M-CSF antagonist

Answer 49

= undifferentiated pleomorphic sarcoma = malignant fibrous histiocytoma ***** most often seen tumor in older patient in deep thigh - presents w/ nodule or pain TUMOR CELLS LACK DIFFERENTIATION ALONG NORMAL LINES!! gray white fleshy mass, shows pinwheel formation and things that looks like weird giant cells.

Answer 50

fibrosarcoma tumor - 52 y/o man, poweterior arm large, ugly, gray

Answer 51

synovial sarcoma - occurs usually around knee w/ dystrophic calcification and spindle cells kiss of death. 25% survival

Answer 52

lipoma = benign fat tumor

Answer 53

liposarcoma

Answer 54

nodular fasciitis - go along anterior fascial plane - circumscribed, benign

Answer 55

superficial fibromatosis = nodular thickening of palmar fascia on biopsy see lots of fibroblasts

Answer 56

deep fibromatosis - desmoid tumor - infiltrate but DONT metastastasize gray, white, rubbery, histology has lots of collagen

Answer 57

rhabdomyosarcoma = malignant mesenchymal tumor 1. alveolar 2. embryonal - small round blue cells = sarcoma bortyroides (vagina) adult form = pleomorphic rhabdomyosarcoma - always bad!!!

Answer 58

leiomyoma = smooth mm. tumor

Answer 59

leimoyosarcoma = deep soft tissues, retroperitoneal tumor painless firm mass mets to lungs

Mm/Nn/Bone Buzzin Flashcards

(83 cards)