Pathology

Question 1

Do bone tumours generally metastasise?

Answer 1

no, other cancers can metastasise to the bone easily though

Question 2

What is osteochondroma

Answer 2

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

Question 3

What is enchondroma

Answer 3

itramedullary and metaphyseal cartilaginous tumour caused by failure of enchondral ossification at the growth plates. Bone can weaken.

Question 4

What is a simple bone cyst

Answer 4

a single, fluid filled cyst. May be incidental but cause weakening of the bone leading to potential fracture.

Question 5

What is an aneurysmal bone cyst

Answer 5

several cavities filled with blood or serum seen on an X-ray. Can be quite painful. Treatment is bone grafting, cement and or curette

Question 6

What does a giant cell tumour look like on X-ray?

Answer 6

soap bubble

Question 7

How do you treat a giant cell tumour

Answer 7

excision with phenol, cement or liquid nitrogen. Bone may need replaced if too aggressive

Question 8

Can giant cell tumour metastasise?

Answer 8

Yes 5%

Question 9

What is fibrous dysplasia

Answer 9

an adolescent, genetic mutation. Stress fractures can occur. Bisphosphonates reduce pain, internal fixation, bone grafts

Question 10

What is osteoid osteoma and treatment

Answer 10

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

Question 11

What type of pain is most common in metastatic cancer?

Answer 11

constant pain, especially at night. Weight loss, fatigue loss of appetite may be present also

Question 12

what is the most common type of malignant bone tumour?

Answer 12

osteosarcoma

Question 13

What age group and where is the most common presentation of an osteosarcoma?

Answer 13

age: youth, presentation- around the knee

Question 14

how is osteosarcoma most commonly spread?

Answer 14

Via blooooood

Question 15

what is a chondrosarcoma

Answer 15

a cartialge producing bone tumour, occurs in 45 yo, and slow to metastasise (malignant chondrocytes)

Question 16

Which age group does fibrosarcoma affect?

Answer 16

young

Question 17

What is Ewings sarcoma

Answer 17

Affects 10-20 year olds, is 2nd most aggressive bone cancer, occurs in the bone marrow. Fever, swelling, inflammatory markers increased.

Question 18

What is the most appropriate removal of tumour method

Answer 18

surgery, CT or MRI used for staging. Radio and chemotherapy can also be used.

Question 19

What commonly metastasises to bone?

Answer 19

Breast cancer, prostate, lung, thyroid, kidney

Question 20

What is a lipoma

Answer 20

neoplastic proliferation of soft tissue to fat

Question 21

where does a ganglion cyst arise?

Answer 21

synovial joint or tendon sheath

Question 22

WHERE DOES AVASCULAR NECORSIS TAKE PLACE?

Answer 22

around the femur

Question 23

What are the 2 main causes of Avascular Necrosis?

Answer 23

Alcohol and steroids

Question 24

Is an adults quadriceps made up of single fibre types or both

Answer 24

both- should be a checkered board appearance

Question 25

What can you see from a muscle biopsy

Answer 25

muscle disease, vascular disorders, neuropathy

Question 26

What does a high CK indicate

Answer 26

dystrophies (200x)

Question 27

what does intermiediate CK represent

Answer 27

(20x) inflammatory myopathy

Question 28

Wht does low CK level suggest

Answer 28

neurogenic disorders (2-5x)

Question 29

what are the two types of muscle pathology

Answer 29

those affecting the muscles or those affecting muscles due to nerve damage

Question 30

What kind of dystrophic changes are ther?

Answer 30

muscle fibre size, fibrosis of endomysial, fatty infiltrate and myocyte hyperplasia

Question 31

What is duchenne muscular dystrophy

Answer 31

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

Question 32

What is different about the Becker MD

Answer 32

later onset in life, slower progression, variant of DMD

Question 33

What mutation is myotonic dystrophy

Answer 33

autosomal dominant. Effects the face and distal limbs in adolescents and effects the resp muslces later in life

Question 34

What would you find histologically about myotonic dystrophy?

Answer 34

Atrophy of type 1 fibres, ring fibres and fatty replacement

Question 35

What is polymyositis

Answer 35

chronic inflam disease with muscular weakness, pain and tenderness resulting in fibre necrosis (cell mediated immune response, lymphocytic infiltrate

Question 36

What is dermatomyositis

Answer 36

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

Question 37

What is motor neuron disease

Answer 37

progressive degeneration of anterior horn cells. Denervation atrophy and weakness

Question 38

What is spinal muscular atrophy

Answer 38

autosomal recessive condition where degeration of anterior horn cells in spinal cord

Question 39

Is myasthenia gravis immune or not?

Answer 39

yes, its immune

Question 40

does myasthenia gravis affect women or men more?

Answer 40

women

Question 41

what do 25% of people get with myasthenia gravis?

Answer 41

thymoma

Question 42

What is the breakdown of skeletal muscle called

Answer 42

Rhabdomyolysis

Question 43

What can result from rhabdomyalysis

Answer 43

Acute renal failure/ metabolic acidosis, hyperkalaemia

Question 44

What antibodies are involved in sLE

Answer 44

ANA

Question 45

what kind of rash would you see with SLE?

Answer 45

butterfly

Question 46

Is SLE multisystem or restricted to resp system?

Answer 46

Multisystem

Question 47

wHAT DOES pan STAND FOR

Answer 47

POLYARTERIOSUS NODOSA

Question 48

what would you find in the serum for PAN>

Answer 48

pANCA

Question 49

In what population would you find polymyalgia rheumatic?

Answer 49

elderly- pain and stiffness in pelvic girdles and shoulders. great response to corticosteroids

Question 50

What is temporal arteritis

Answer 50

inflammation of the cranial vessels

Question 51

what symptoms would you get with temporal arteritis

Answer 51

headache, scalp tenderness and potential blindness

Question 52

What is scleroderma

Answer 52

excessive fibrosis of organs and tissues due to collagen build up. Multisystem. CREST- calcinosis, raynauds, oesophageal dysfunction, sclerodactyly, telangectasia

Question 53

can scleroderma cause death

Answer 53

yes

Question 54

What is Ollier's Disease

Answer 54

developmental disorder of enchondromas unilaterally. Not hereditory or familial

Question 55

Which disease can theoretically become more malignant? Ollier's or Maffuccis?

Answer 55

MAffuccis

Question 56

What is a chondroblastoma

Answer 56

benign cartilage tumour in bone, found at epiphysis of long bones in age group of 10-20. Chicken wire calcification on histology

Question 57

How would you treat a chondroblastoma?

Answer 57

biopsy and curette and liquid nitrogen

Question 58

What is the treatment of osteoblastoma??

Answer 58

excision, curettage and then resection

Question 59

What is a myeloma

Answer 59

Malignant tumour of the bone marrow

Question 60

What age group does myeloma affect?

Answer 60

old age

Question 61

What are the effects of myeloma?

Answer 61

renal failure, bone destruction of axial skeleton