Pathology

Question 1

radiological features of OA (LOSS)

Answer 1

Loss of joint space (cartilage loss)
Osteophytes (disorganised bone remodelling)
Subchondral sclerosis (eburnation)
Subchondral cysts (synovial fluid accumulation)

Question 2

what can osteophytes irritate?

Answer 2

nerves

Question 3

pathology of RA

Answer 3

cytokine production with pannus formation (granulation tissue) and destroyed cartilage leading to fibrosis and deformity

Question 4

what do seronegative spondyloarthritides affect?

Answer 4

ligamentous attachments

Question 5

examples of seronegative spondyloarthritides

Answer 5

ankylosing spondylitis
reactive arthritis
enteritis arthritis
psoriatic arthritis

Question 6

causes of gout

Answer 6

hyperuricaemia by increased production (enzyme defect)

or reduced excretion by kidney (chronic renal disease or thiazide diuretics side effect)

Question 7

three ways to detect genetic abnormalities

Answer 7

1. karotyping
2. FISH
   immunohistochemitry

Question 8

what is karotyping?

Answer 8

overview of chromosome number and structure

Question 9

what is FISH?

Answer 9

looks for specific abnormalities using immunofluorescence

Question 10

what is immunohistochemistry?

Answer 10

pigmented antibody is used to detect protein being produced

Question 11

benign bone tumours

Answer 11

osteochondroma
enchondroma
simple bone cyst
aneurysmal bone cyst
giant cell tumour
fibrous dysplasia

Question 12

describe aneurysmal bone cyst

Answer 12

lots of chambers filled with blood or serum due to AV malformations

Question 13

giant cell tumour appearance

Answer 13

XR shows soap bubble appearance

Question 14

can giant cell tumour metastasize?

Answer 14

yes to the lung to change benign pulmonary CGT

Question 15

describe fibrous dysplasia

Answer 15

genetic mutation results in lesions of fibrous tissue forming a shepherd’s crook deformity

Question 16

examples of malignant bone tumours

Answer 16

osteosarcoma
chondrosarcoma
fibrosarcoma
Ewing’s sarcoma

Question 17

describe osteosarcoma associations

Answer 17

young
Codman’s triangle
sunray spiculation

Question 18

XR of chondrosarcoma

Answer 18

popcorn calcification

Question 19

describe presentation of Ewing’s sarcoma

Answer 19

small, round, blue tumours with “onion-peel” sign
10-20
fever and swelling

Question 20

genetic abnormality in Ewing’s sarcoma

Answer 20

t(11;22)

Question 21

management of Ewing’s sarcoma

Answer 21

radio and chemo sensitive

Question 22

what is nodular fasciitis?

Answer 22

benign soft tissue lesion that presents rapidly with history of preceding trauma

Question 23

what is myositis ossificans?

Answer 23

bone formation in muscle with history of preceding trauma

Question 24

when do you intervene in myositis ossificans?

Answer 24

must wait until maturity of ossification or risks reoccurrence

Question 25

soft tissue tumour examples

Answer 25

ganglion cyst
bursitis
sebaceous cyst
abscess
superficial and deep fibromatoses

Question 26

what is a ganglion cyst?

Answer 26

peripheral lump near joint capsule or tendon sheath e.g. Baker’s cyst in the knee

Question 27

what is bursitis

Answer 27

inflamed bursa due to repeated pressure resulting in swelling
can become abscess

Question 28

what can an abscess form from?

Answer 28

cellulitis
bursitis
penetrating wound
infection

Question 29

example of superficial fibromatoses

Answer 29

Dupuytrens

Question 30

example of deep fibromatoses

Answer 30

desmoid tumours (Gardner’s syndrome FAP)

Question 31

examples of tumours of unknown origin

Answer 31

Ewing's sarcoma
synovial sarcoma
pleomorphic undifferentiated sarcoma
giant cell tumour
aneurysmal bone cyst

Question 32

which is more common- primary or secondary bone tumours?

Answer 32

secondary (metastasis)