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OITE Prep Fredericks > Pathology > Flashcards

Pathology Flashcards

1
Q

What Cancers is Chemo used for ?

A 
ROPEL
Rhabdomyosacroma
Osteosarcoma
PNET
Ewings
Lymphoma
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2
Q

Most common agents in treatment of sarcomas?

A

Most common agents used in the treatment of sarcomas are ifosfamide and doxorubicin

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3
Q

What is the most locally invasive benign soft tissue tumor?

A

Desmoid tumor

- Wide excision with Glevac (imatinib)

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4
Q

Non_Ossifying Fibroma Appearence?

A

Bubbly, sclerotic borders, eccesntrically based

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5
Q

What study will differentiate synovial chondromatosis from PVNS?

A

Gradient ECHO. Iron will drop out signal in PVNS

- Giant cell tumor of tendon sheath is analogous to PVNS when not intra-articular

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6
Q

Parosteal osteosarcoma typical location?

A

Posterior femur, common in females

- only wide resection if not HIGH grade, 25% invade in intramedullary canal

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7
Q

Sunburst or Hair on end osteosarcoma?

A

Periosteal sarcoma

- multiagent chemo and limb salvage

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8
Q

Treatment for PAgets sarcoma?

A

Chemotherapy, Wide resection, Reconstruction

- Will be hot on bone scan

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9
Q

What are also on differntial for UBC looking lesion?

A

ABC _lakes of blood, fibrous stroma
Telangetatic Osteosarcoma
UBC is never large (more wide) than the physis

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10
Q

Likely to Met to SPINE in rank order:

A

Breast>prostate>lung>kidney>thyroid

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11
Q

CD138 stain?

A

Myeloma

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12
Q

CD1A stain?

A

Eosinophilic granuloma

Langherhan Cell histiocytoma

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13
Q

CD20/CD45

A

Lymphoma

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14
Q

CD 99 Stain?

A

Ewings sarcoma

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15
Q

Herringbone pattern with pleomorphic cells?

A

Fibrosarcoma

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16
Q

Tibial diaphysis lesion?

A
  • Adamantinoma
  • Osteofibrous Dysplasia
    Bowing of tibia and palpable mass is commong
    Adamantinoma soap bubble appearence, sclerosis
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17
Q

What are most soft tissue sarcomas treated with?

A

Wide resection and radiotherapy

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18
Q

Pagets disease of bone lab findings

A

Elevated N-telopeptides, alpha-C-telopeptides, and urinary hydroxyproline l

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19
Q

What are the common primary tumors found in the spine?

A
  • Osteoid osteoma
  • Osteoblastoma
  • EG
  • GCT of bone
  • Hemangiomas
  • ABC
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20
Q

Hand-Shullen-Christian diesase traid
(Langerhanns cell histocytosis)- is specturm 1. EG if one lesion, HSC disease (boney and visceral), 3. Latter-siwe fatal in young

A
  • Exopthalmosis
  • Diabetes insipidus
  • multiple lytic skull lesions
    E
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21
Q

Preopertive versus Post operative radiation theraypy?

A
  • No difference in recurrance
  • Post operative usually high dose, large field therefore increase fibrosis/lymphadema
  • Preoperative- increase rates of wound complications
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22
Q

Osteofibrous Dysplasia Tpical Pattern?

A

Usually anterior COrtex of Tibia

  • Mild anterior bowing
  • Usually in Kids less than 10
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23
Q

Significant change in SSEPs intra op are?

A

> 50% loss in amplitude

>10% increase in latency

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24
Q

What appears in Poland Syndrome?

A

Absence of sternocostal head of Pec Major

- Syndactyly, symbrachydactyly

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25
Q

Langheranns cells Histocutosis

A

CD1a stain

Vertebra plana

Young kid

Skull findings

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26
Q

Polyostotic Tumors

A

Langerhans cell histiocytosis

Fibrous dysplasia (Gnas) 
(McCabe Albright , Mazzarad)

MHE

Enchondromatosis (olliers and mafucci)h

Vascular tumors (angiosarc cd34)

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27
Q

GCT expresses what Ligand

A

RankL

Denosumab- can help treat : RankL inhibitor

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28
Q

Denosumab MOA

Uses?

A

RANKL inhibitor

Unresectable GCT, Hypercalcemia of malignancy, osteoprosis

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29
Q

Schwanoma Histo SLide Look ?

A

Biphasic Antonia A and Antoni B

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30
Q

Tumors by Anatomic Location?

Tibia Tumors?

A 
Osteofibrious Dysplasia ( young child)
Adamantinoma
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31
Q

Osteofibrious dysplasia versus Fibrious Dysplasia ?

A

Osteofibrious- Anteiror tibia, Cortical rimming, OSTEOBLASTIC RIMMING

Fibrious Dysplasia- in medullary cavity, NO osteoblastic rimming

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32
Q

Surface Tumors ?

A

Osteochondroma
Periosteoal Chondroma - No bone formation on Histo and no medullary continuity
Parosteal Osteosarc
Periosteal Osteosarc

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33
Q

Parosteal Osteosarc?

A

Low grade surface tumors
Implied lower grade that Periosteal
SURGERY ONLY TUMORS

Can differentiate from osteochondroma by LACK of medullary canal continuity

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34
Q

Fluid Fluid Levels on Cross Section? Differential

A

Primary ABC
Secondary ABC
– UBC, GCT
Telangietatic Osteosarc

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35
Q

Differentiate between ABC versus UBC?

A

ABC the width of the lesion or bone is wider than the phsysis

This is not the case in UBC

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36
Q

Most Common Sarcomas with ossifications

A
  1. Synovial Sarcoma

2. Extra-articular Osteosarc

37
Q

Inta-articular Tumors

A
  1. Synovial Chondromatosis
  2. Synovial Hemangioma 9 skelatllly imature
  3. PVNS: Dark on T1, Dark on T2 ( tenosynovail gian cell tumor
38
Q

Painful Sub-Ungal Mass cuasing nail deformity?

A

Glomus Tumor

39
Q

Most Common soft tissue sarcoma of hand?

A

Epitheliod sarcoma

2nd- synovial

40
Q

Which soft tissue sarcoma require sentinel node biopsy as part of staging?

A 
Epitheliod sarcoma ( lung) 
Rhabdomyosarcoma ( lung) 
These sarcomas goes to lymph nodes
41
Q

ONly couple of things ( tumors) are Dark on T1 and Dark on T2

A 
PVNS
Desmoid Tumor ( fibromatosis )
42
Q

Schawanoma versus Neurofibroma?

A

Schanomas on TOP of tumor

Schwanomas- Antoni a and Antoni B

43
Q

MDM2+ ?

A

Atypical Lipomatous Tumor

44
Q

Myxoid Tumors Appearance on MRI?

A

t1 hyper intest
t2 FS- Hyper intese

Myxoma
Myxoid Liposarcoma
Myxofibrosarcoma

45
Q

Most Commone Soft Tissue Sacroma by Age
5yo?
30yo?
80yo?

A

5yo- Rhabdomyosarcoma
30- Synovial Sarcoma
80- UPS ( undifferenentied pleomorphic sarcoma

46
Q

12:16

A

Myxoid Liposarcoma

47
Q

2:13

A

Alveolar Rhabdoymyosarcoma

48
Q

11:22

A

Ewings sarcoma

CD 99 +

49
Q

Actin ( SMA) Smooth Muscle

A

Leiomysosarcoma ( smooth muscle)

50
Q

s-100 ( stans for a lot but on test)

A

Malignant peripheral nerve sheath tumor

51
Q

Brachyury Stain ?

A

Chordoma

52
Q

Dose of Pre Op radiation versus Post op in Sarcomas ?

A

PRE OP- Smaller does that Post op

53
Q

Radiation? For Soft Tissue Sarcomas

A

Large high grade tumors
Decreases LR by 25%
Pre Op Dose 50Gy
Post Op Dose 66Gy

54
Q

Imatinib ( Gleevac) Targeted therapy for What?

A

Tyrosine Kinase INhibitor

PVNS

55
Q

What staging portion is unique for ewings versus osteosarcoma?

A

Bone Marrow Biopsy

56
Q

12:16

A

Myxoid Liposarcoma

57
Q

12:22

A

Clear Cell Sarcoma

58
Q

9:22

A

Myxoid Chondrosarcoma

59
Q

Adamantinoma Location?

A

Usually Tibia
Looks a lot like osteofibrous dysplasia
BIPHASIC

60
Q

What malignancy may be cold on bone scan?

A

Multiple myeloma
CD 138 (plasma cells)
Associated with hypercalcemia of malignancy

61
Q

CD1A

A

Langerhanns Cells

62
Q

Mutations in Fibrous Dysplasia?

A

GNAs mutation

Ground glass

63
Q

Polyostotic Fibrous Dysplasia Association?

A

McCune Albright

  • Polyostotic Fibrious Dysplasia
  • Endocrine abnormalities
  • Cafe-Au Lait spots

Mazabrauds Syndrome

  • Polyostotic Fibrous Dysplasia
  • Multiple Myxomas
64
Q

End of Bone Lesions? Epiphyseal?

A
  • Giant Cell Tumor of Bone (adults)
  • Chondroblastoma ( children) - checken wire calcification, edema in side bone
  • Clear Cell Chondrosarcoma

ALL THREE METS TO LUNGS

65
Q

Lytic Destructive Lesion in Distal Radius?

A

Giant Cell Tumor

66
Q

Is renal cell carcinoma radiosensitive?

A

NO

67
Q

Rates of recurrance of patients with chondrosarcoma most directly related to what sample characteristic?

A

Telomerase activity ( elongates chromosomes leading to cellular growth and porliferation)

68
Q

Osteoid Osteoma in the Spine NEAR neural elements treatment?

A

Surgical resection is preferred to radiofrequency ablation

69
Q

Typical Adamantinoma location and histo?

A 
Anterior Tibia ( 
Epithelial cells in fibrous stroma
70
Q

What tumors are most liley to metastasis to spine?

A
  1. Breast
  2. Prostate
  3. Lung
  4. Kidney
  5. Thyroid
71
Q

Fibrodysplasia Ossificans Gene?

A

ACVR1

- Minor trauma or surgery results in BAD HO or ankylosing

72
Q

EMA?

A

Epitheliod Membrane Antigen
Epitheliod Sarcoma Stain
Common in hands ( amputations for non-healing ulcers)

73
Q

Ossification center of the Hand

A
  1. Capitate 1-3 mo
  2. Hamate 2-4month
  3. Triquetrum
  4. Lunate
  5. Scaphoid
  6. Trapezium
  7. Trapezoid
  8. Pisiform 8-12 years
74
Q

Nerves in Tendons

A
  • Golgi, Pacinian Corpusules with proprioceptive ability in myotendinous JXN
  • Free nerve endings and nociceptic fibers- at Enthesis- bone interface
75
Q

Collagen fibril size ?

A

Decorin

76
Q

What has been link to growth/development of PVNS?

A

CSF-1

77
Q

SIRS Criteria: ( 2 or more)

A
  1. Temp >38.0
  2. HR >90 bbpm
  3. RR >20
  4. ABG Co2 <32
  5. WBC >12
78
Q

What is the shelf life of Freeze dried bone?

A

INfinite- only limited by its sterility

79
Q

RCT >80% follow up?

A

Level 1

80
Q

RCT <60% FU?

A

Level III

81
Q

Level III studies

A

Case-control

82
Q

What commonly used metal is most suseptible to pitting corrosion ?

A

Stainless steel

83
Q

Portals and risk in ankle

A

1sst: AM portal- TA is at risk. You can trasnillumante to avoid SPN
2nd. AL port- SPN at risk

84
Q

9:22 Translocation?

A

Mixoid Chondrosarcoma

85
Q

Klippel Feil Manifestations?

A

Sprengels Deformity
Scoliosis
Auditory ( deafness)
Cardiac Abnormalities

86
Q

What portion of the UCL is isometric throughout

A

Anterior Band of the Anterior Bundle

87
Q

Peroneal Tendon Tears Type I

: Small Tears in each?

A

Tubularization and debridement

88
Q

Peroneal Tendon Tears Type II :

A

One is irreprabably torn and other is fine

TENODESIS to the Good One

89
Q

Peroneal Tendon Tears Type III

A

Both Irreprabably torn
DECISION IS HINGED ON EXCURSION OF proximal muscle belly
Exurcsion Good- Allograft tendon
No Excursion: FHLl Transfer

OITE Prep Fredericks (15 decks)

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