Pathology Flashcards
Do bone tumours generally metastasise?
no, other cancers can metastasise to the bone easily though
What is osteochondroma
a benign bone tumour which produces a bony outgrowth forming a cartilaginous cap. Rarely causes problems or malignancy, and can be part of a autosomal dominant condition
What is enchondroma
itramedullary and metaphyseal cartilaginous tumour caused by failure of enchondral ossification at the growth plates. Bone can weaken.
What is a simple bone cyst
a single, fluid filled cyst. May be incidental but cause weakening of the bone leading to potential fracture.
What is an aneurysmal bone cyst
several cavities filled with blood or serum seen on an X-ray. Can be quite painful. Treatment is bone grafting, cement and or curette
What does a giant cell tumour look like on X-ray?
soap bubble
How do you treat a giant cell tumour
excision with phenol, cement or liquid nitrogen. Bone may need replaced if too aggressive
Can giant cell tumour metastasise?
Yes 5%
What is fibrous dysplasia
an adolescent, genetic mutation. Stress fractures can occur. Bisphosphonates reduce pain, internal fixation, bone grafts
What is osteoid osteoma and treatment
found in children, immature bone which attaches to sites like proximal femur, Get worse at night due to the inflammation and NSAIDS help relieve the pain. Bone scans and CT scans confirm diagnosis. Some may need excisied
What type of pain is most common in metastatic cancer?
constant pain, especially at night. Weight loss, fatigue loss of appetite may be present also
what is the most common type of malignant bone tumour?
osteosarcoma
What age group and where is the most common presentation of an osteosarcoma?
age: youth, presentation- around the knee
how is osteosarcoma most commonly spread?
Via blooooood
what is a chondrosarcoma
a cartialge producing bone tumour, occurs in 45 yo, and slow to metastasise (malignant chondrocytes)
Which age group does fibrosarcoma affect?
young
What is Ewings sarcoma
Affects 10-20 year olds, is 2nd most aggressive bone cancer, occurs in the bone marrow. Fever, swelling, inflammatory markers increased.
What is the most appropriate removal of tumour method
surgery, CT or MRI used for staging. Radio and chemotherapy can also be used.
What commonly metastasises to bone?
Breast cancer, prostate, lung, thyroid, kidney
What is a lipoma
neoplastic proliferation of soft tissue to fat
where does a ganglion cyst arise?
synovial joint or tendon sheath
WHERE DOES AVASCULAR NECORSIS TAKE PLACE?
around the femur
What are the 2 main causes of Avascular Necrosis?
Alcohol and steroids
Is an adults quadriceps made up of single fibre types or both
both- should be a checkered board appearance
What can you see from a muscle biopsy
muscle disease, vascular disorders, neuropathy
What does a high CK indicate
dystrophies (200x)
what does intermiediate CK represent
(20x) inflammatory myopathy
Wht does low CK level suggest
neurogenic disorders (2-5x)
what are the two types of muscle pathology
those affecting the muscles or those affecting muscles due to nerve damage
What kind of dystrophic changes are ther?
muscle fibre size, fibrosis of endomysial, fatty infiltrate and myocyte hyperplasia
What is duchenne muscular dystrophy
x linked condition in dystrophin gene, progressive weakness and hypertrophy of calves. CK is raised. Anchorage of cytoskeleton to membrane altered. Ca++ entry into cells
What is different about the Becker MD
later onset in life, slower progression, variant of DMD
What mutation is myotonic dystrophy
autosomal dominant. Effects the face and distal limbs in adolescents and effects the resp muslces later in life
What would you find histologically about myotonic dystrophy?
Atrophy of type 1 fibres, ring fibres and fatty replacement
What is polymyositis
chronic inflam disease with muscular weakness, pain and tenderness resulting in fibre necrosis (cell mediated immune response, lymphocytic infiltrate
What is dermatomyositis
immune complex and complement deposition within and around capillaries around muscle. end result of polymyositis. upper body erythema, swelling of eye lids. Can sometimes not appear for at least a few years
What is motor neuron disease
progressive degeneration of anterior horn cells. Denervation atrophy and weakness
What is spinal muscular atrophy
autosomal recessive condition where degeration of anterior horn cells in spinal cord
Is myasthenia gravis immune or not?
yes, its immune
does myasthenia gravis affect women or men more?
women
what do 25% of people get with myasthenia gravis?
thymoma
What is the breakdown of skeletal muscle called
Rhabdomyolysis
What can result from rhabdomyalysis
Acute renal failure/ metabolic acidosis, hyperkalaemia
What antibodies are involved in sLE
ANA
what kind of rash would you see with SLE?
butterfly
Is SLE multisystem or restricted to resp system?
Multisystem
wHAT DOES pan STAND FOR
POLYARTERIOSUS NODOSA
what would you find in the serum for PAN>
pANCA
In what population would you find polymyalgia rheumatic?
elderly- pain and stiffness in pelvic girdles and shoulders. great response to corticosteroids
What is temporal arteritis
inflammation of the cranial vessels
what symptoms would you get with temporal arteritis
headache, scalp tenderness and potential blindness
What is scleroderma
excessive fibrosis of organs and tissues due to collagen build up. Multisystem. CREST- calcinosis, raynauds, oesophageal dysfunction, sclerodactyly, telangectasia
can scleroderma cause death
yes
What is Ollier’s Disease
developmental disorder of enchondromas unilaterally. Not hereditory or familial
Which disease can theoretically become more malignant? Ollier’s or Maffuccis?
MAffuccis
What is a chondroblastoma
benign cartilage tumour in bone, found at epiphysis of long bones in age group of 10-20. Chicken wire calcification on histology
How would you treat a chondroblastoma?
biopsy and curette and liquid nitrogen
What is the treatment of osteoblastoma??
excision, curettage and then resection
What is a myeloma
Malignant tumour of the bone marrow
What age group does myeloma affect?
old age
What are the effects of myeloma?
renal failure, bone destruction of axial skeleton
