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MSK > Pathology > Flashcards

Pathology Flashcards

1
Q

Where does lupus affect?

A

Often structural parts of DNA

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2
Q

Where does Scleroderma affect?

A

Anti centromere, antitelomere

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3
Q

Where does Sjogrens affect?

A

Anti Ro La

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4
Q

Where does dermatomyositis affect?

A

Anti jo

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5
Q

Sphyillis results in a nasty case of vasculitis, what is the name of the organism

A

Treponema pallidum

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6
Q

Name an antiendothelial disease

A

Kawasaki’s disease

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7
Q

What does ANCA stand for?

A

Anti neutrophil cytoplasmic antibodies

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8
Q

Tell me about cANCA

A

c for cytoplasmic, now known to react with proteinase 3 so also known as PR3

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9
Q

Tell me about pANCA

A

p for perinuclear, reacts with myeloperoxidase and known as MPO

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10
Q

Tell me about Giant Cell arteritis

A

Affects temporal artery, skip lesions, negative biopsy doesn’t rule it out as it might just be a normal part of the artery
Can experience scalp tenderness, can go blind
Granulomas

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11
Q

Tell me about Polyarteritis Nodosa

A 
Medium vessel
ANCA negative 
1/3 of patients have Hep B 
Renal involvement 
Transmural necrotising inflammation
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12
Q

Tell me the diseases which effect the small vessels

A

Wegener’s - granulomatosis with polyangiitis
Churg strauss - eosinophilic granulomatosis with polyangiitis
Henoch schonlein purpura
Cryoglobulinaemia
Good pastures syndrome

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13
Q

What is the other name for Gout

A

Crystal athropathy - uric acid is the end product of purine synthesis, adenine and guanine are purine bases

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14
Q

Name another condition related to excess uric acid

A

Lysch Nyhan syndrome - compulsive self mutilation of the head and hands with learning difficulties - almost exclusively in males

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15
Q

Name a drug which reduces urate excretion

A

Thiazide diuretics

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16
Q

What does birefringence mean

A

Bending the light twice

Negative doesn’t mean its dark, its the orientation of the crystal

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17
Q

What is pagets disease?

A

Abnormal bone turnover

Increased osteoclastic activity - more bone but abnormally structured

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18
Q

What is RANKL

A

Osteoclast receptor activator

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19
Q

Name another bone overgrowth disease

A

Leontiasis ossea (lion face)

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20
Q

What is platybasia?

A

Skull base abnormality, flattening of the base of the skull

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21
Q

What is sabre tibia

A

Malformation in the tibia, extreme bowing

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22
Q

What is creeping substitution

A

Creeping substitution, the process of bone remodeling by osteoclastic resorption and creation of new vascular channels with osteoblastic bone formation resulting in new haversian systems

23
Q

What is avascular necrosis

A

The death of bone tissue due to a lack of blood supply

24
Q

What is it called when the surface of the bone becomes polished?

A

eburnation

25
Q

What carries out remodelling?

A

Osteophytes

26
Q

What is the commonest benign bone tumour?

A

Osteochondroma - produces a bony outgrowth with a cartilaginous cap
Can produce local pain
Multiple can occur as an autosomal dominant hereditary disorder

27
Q

Tell me about enchondroma

A

Intramedullary

Usually metaphyseal cartilaginous tumour caused by failure of normal enchondral ossification at the growth plate

28
Q

When can enchondromas occur?

A

Femur, humerus, tibia, small bones of the hands and feet

29
Q

What are simple bone cysts a growth defect of?

A

The physis - can cause weakness leading to pathological fracture

30
Q

Tell me about an aneurysmal bone cyst

A

Contains lots of chambers which are filled with blood or serum

31
Q

Where can aneurysmal bone cysts occur?

A

Metaphases of many different long bones, flat bones and vertebral bodies - lesion is locally aggressive causing cortical expansion

32
Q

Tell me about a giant cell tumour

A

Can be locally aggressive
metaphyseal region and epiphysis. Can extend to the subchondral bones
Most commonly occur around the knee and distal radius
“soap bubble appearance”
Painful

33
Q

What is fibrous dysplasia

A

Occurs in adolescence, genetic mutation results in lesions of fibrous tissue and immature bone. Can affect one bone (monostotic) or more (polyostotic)
Defective mineralization may result in angular deformities and the affected bone is wider with thinned cortices
Proximal femur involvement can produce a shepherd’s crook
Biphosphonates may reduce pain

34
Q

What is osteoid osteoma

A

Small nidus of immature bone surrounded by an intense sclerotic halo
Common sites include proximal femur, diaphysis of long bones and vertebrae
Intense constant pain, worse at night

35
Q

What is Brodie’s abscess

A

Subacute osteomyelitis

36
Q

What can cause Brown Tumours

A

Hyperparathyroidism

37
Q

What do malignant primary bone tumours show on xray

A

Coritcal destruction, a periosteal reaction (raised periosteum producing bone), new bone formation and extension into surrounding soft tissue

38
Q

What is the most common form of primary bone tumour

A

Malignant Osteosarcoma - mostly around the knee - younger age group

39
Q

Tell me about chondrosarcoma

A

Malignant Cartilage producing primary bone tumour - older age group - pelvis, proximal femur - not radiosensitive

40
Q

Tell me about Malignant fibrous histiocytoma

A

Tend to occur in abnormal bone (bone infarct e.g.) Younger age group

41
Q

Tell me about Ewing’s Sarcoma

A

Malignant tumour of primitive cells in the marrow - young age group
Fever, raised CRP, warm swelling
Radio and chemo sensitive

42
Q

Tell me about lymphoma

A

Cancer of round cells of the lymphocytic system / macrophages

43
Q

Tell me about Myeloma

A

Arises from the marrow - older people
Weakness, back pain, bone pain, fatigue, weight loss, marrow suppression resulting in anaemia
Diagnosis is plasma protein electrophoresis (high levels of paraprotein)

44
Q

What is it called when the lesion is in the joint?

A

Pigmented Villonoular synovitis (PVNS)

45
Q

What are soft tissue tumours arising from the connective tissues called?

A

Sarcomas
(Angiosarcoma - blood vessels, Fibrosarcoma and malignant fibrous histiocytoma - fibrous tissue, Rhadbomyosarcoma - skeletal muscle
Synovial - synovial lining of joints or tendons)

46
Q

Where does a ganglion cyst occur?

A

Occurs around a synovial joint or synovial tendon - could be herniation or out pouching of a weak portion of joint capsule or tendon sheath (Baker’s cyst)

47
Q

What is bursitis?

A

A small fluid filled sac lined by synovium around a joint, preventing friction (pre-patellar, olecranon and bunions (over the medial 1st metatarsal head in hallux valgus)
Gout may cause bursitis

48
Q

What does Osteochondritis and Avascular necrosis lead to?

A

An area of bone undergoing localised necrosis as a result of ischaemia from a reduction of blood supply

49
Q

Tell me about osteochondritis

A

Usually in children and young adults - repetitive stress
Compression - pain and progression to arthritis
Common sites include the 2nd metatarsal head (Freiburg’s disease), the navicular bone (Kohler’s disease), lunate of the carpus (Kienbock’s disease) Capitellum of the elbow (Panner’s disease)
Vertebral compression (Scheuermann’s disease)
Traction -
Occurs at an apophysis, tibial tubercle (Osgood Schlatter disease) and the calcaneus (Sever’s disease)

50
Q

Fragmentation with separation of bone and cartilage is known as?

A

osteochondritis dissecans

51
Q

What can cause avascular necrosis?

A

Alcohol and steroids - alters fat metabolism, moves fat into the circulation can sludge up the capillary system
Rare cause is Caisson’s disease

52
Q

Tell me about Chondrolastoma

A

Bengin cartilage tumour
Found at epiphysis of long bones
Closely packed polygonal cells plus areas of immature chondroid
Distinct cytoplasmic borders with foci of “chicken wire” calcification

53
Q

What is the giant cell tumours cell of origin?

A

Osteoclast

54
Q

What are the three histological variants of osteosarcoma

A

Osteoblastic, chondroblastic and fibroblastic

MSK (11 decks)

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