other Flashcards
Most common tumour causing bone metastases (in descending order)
prostate
breast
lung
most common site for metastases
Most common site (in descending order) spine pelvis ribs skull long bones
symptoms fo metasstases to the bone
pathological fractures
hypercalcaemia
raised ALP
drainage LN of ntiero two thirds of tongue
posterior third
tip of tongue
mid portion of tongue
The lymphatic drainage of the anterior two-thirds metastasis to the ipsilateral nodes is usual.
The lymphatic drainage of the posterior third of the tongue bilateral nodal metastases
tip of the tongue deep cervical nodes.
Lymphatics from the mid portion of the tongue usually drain to the submandibular nodes and then to the deep cervical nodes.
Mid tongue tumours that are laterally located will usually drain to the ipsilateral deep cervical nodes, those from more central regions may have bilateral deep cervical nodal involvement.
difference between drainage of superficial and deep Ln
superficial lymphatic vessels drain the skin and follow venous drainage
superficial lymphatic vessels + drainage of internal organs → deep lymphatic vessels that follow the arteries
risk of tranfusing blood out of date
Hyperkalaemia is a significant risk associated with out-of-date units. Potassium is an intracellular ion which is released upon lysis of cells, something which happens to old red cells in storage.
Mr Ball, a 68-year-old man, attends the emergency department having fractured his humerus bone. His wife states that his arm broke very easily, having only walked into a door.
The X-ray of the bone shows an area of deficiency around the site of the fracture and, on the edge of the film, a cavitating lung lesion in the right middle zone. His blood tests are all within normal ranges, apart from a raised calcium and ALP.
What is the most likely diagnosis?
squamous cell carcinoma
Hassall’s corpuscles
thymic medulla
