Non-Neoplastic Pathology Flashcards
Dr N Kernohan
name some non-neoplastic MSK pathology
Connective tissue diseases
Metabolic diseases
Fractures
Degenerative Disease
what type of condition is connective tissue disease?
autoimmune condition
what factor is seen in rheumatoid arthritis?
rheumatoid factor
auto ab against Fc IgG
what autoantibody is seen in scleroderma?
anti centromere
what autoantibody is seen in dermatomyositis?
anti Jo
in rheumatoid arthritis’ acute phase, the term given to inflammatory granulation tissue is what?
pannus formation
what is seen in rheumatoid arthritis on X-ray?
destroyed cartilage resulting in loss of joint space
what 2 autoantibodies are important in SLE?
ANA and Anti Double Stranded DNA
list 3 metabolic diseases
Pagets
Osteomalacia
Crystal arthropathies
what is the other name for crystal arthropathy?
gout
what is the end-product of purine synthesis?
uric acid
what 2 things can cause hyperuricaemia?
increased production or reduced excretion
what is the known enzyme defect resulting in increased production of urate?
HGPRT deficiency
name the rare condition with HGPRT deficiency
Lysch Nyhan syndrome
what skin manifestation is also seen in increased production of urate?
psoriasis
what is the most common cause of gout? increased production or reduced excretion?
reduced excretion
name the drug which reduced urate excretion
thiazide diuretics
deposition of crystals in soft tissues is known as…
gouty tophus
name the main clinical manifestation of gout which is serious
renal disease
what do you use to visualise crystals in gout?
cross-polarised light
what are the crystals shaped like in gout?
needle shaped
what chemical makes up the crystals in gout?
pyrophosphate
what chemical makes up the crystals in pseudogout?
calcium
in whom is pseudogout more common?
older individuals in large joints
what shape are the crystals in pseudogout?
rhomboid shaped
what is Paget’s an abnormality in?
bone turnover
there is increased __________ activity in Paget’s disease
osteoclastic
what is the net result in Paget’s disease?
more bone - not normally structured
thick excess bone with abnormal reversal lines – mosaic pattern
name the genetic elements important in Paget’s disease
SQSTMI/p62
RANKL
viral infection is important in Paget’s disease
true or false?
true
measles
what bones does Paget’s primarily affect?
axial
leontiasis ossea and platybasia and sabre tibia refer to what?
enlargement and abnormal shaped bones
is there pain in Paget’s?
yes - micro fracture or nerve compression
are you at increased risk to a secondary malignancy like osseosacoma in Paget’s?
yes
what is osteomalacia due to?
abnormal vitamin D metabolism
what is osteomalacia related to?
sun exposure
what is seen in the young related to osteomalacia?
rickets - bowed legs
what are the initial phases in bone fracture?
haematoma - fibrin mesh
influx of inflammatory cells
cytokine release
callus and remodelling at bone ends after 1 week
what is seen in weeks 2-3 post fracture?
callus
woven bone deposited perpendicular to cortical bone
what can cause a pathological fracture?
osteoporosis
tumours - benign or malignant
metastatic disease in bone are __________ - resorbed bone and appear radiolucent
osteolytic
what type of metastatic disease appears as areas of opacity on x ray?
prostate
osteosclerotic
what is avascular necrosis?
bone infarction
what causes avascular necrosis?
asymptomatic
trauma
alcohol
what us seen histologically in avascular necrosis?
creeping substitution
loss of joint space is due to loss of…
cartilage
subchondral sclerosis is due to…
eburnation
subchondral cysts are due to…
synovial fluid accumulation
osteophytes are due to…
disorganised bone remodelling
Who makes more money a drug dealer or a prostitute?
Mhairi Millar the hooker cause she can wash her crack and reuse it ;)
