Skeletal System Pathology Flashcards
1
Q
MC bone type for osteomyelitis in children
A
Long bones
2
Q
MC bones type for osteomyelitis in adults
A
Vertebrae, pelvis
3
Q
MC organism isolated from osteomyelitis
A
Staph aureus
4
Q
MC route of infx for osteomyelitis in children
A
Hematogenous
5
Q
MC organism isolated from osteomyelitis in infants
A
Group B Strep
6
Q
MC etiology of osteomyelitis in adults
A
Injury exposing bone to local infx
7
Q
MC location for solitary bone cyst
A
Distal ends of long bones
8
Q
MC population for solitary bone cyst
A
Boys
9
Q
MC location for aneurysmal bone cyst
A
Metaphysis of longs bones
10
Q
MC population for aneurysmal bone cyst
A
Young women
11
Q
MC location for osteosarcoma
A
Distal femur/knee
12
Q
MC joint disease
A
Osteoarthritis
13
Q
MC cause of secondary OA
A
DM
14
Q
Nail signs in psoriasis
A
Pitting
Onycholysis
15
Q
MC & 2MC bug in septic arthritis in adults
A
Staph, Strep
16
Q
MC type of muscular dystrophy
A
Duchenne’s
17
Q
MC muscle groups affected in Duchenne’s MD
A
Large, proximal groups
18
Q
MC presentation of rhabdomyoma
A
Round mass in the neck
19
Q
MC soft tissue tumor in kids and location
A
Rhabdomyosarcoma
Orbit, face, scalp, neck
20
Q
Which bug is each of these populations susceptible to in developing septic arthritis?
Sickle cell patients
Young adults
Elderly and IV drug users
A
Sickle cell – Salmonella
Young adults – Neisseria gonorrhea
Elderly, IV drug users – E. coli
21
Q
Osteogenesis imperfecta
- Pathology
- Cause
A
Brittle bones
Type 1 collagen deficiency
22
Q
Rickets
- Pathology
- Cause
- Population
A
- Bone softening
- Vit D deficiency dt severe malnutrition
- Children
23
Q
Paget’s disease of bone
- Pathology
- Population
A
- Increased osteoblast & osteoclast activity –> increased calcification of bone
- Develops in 4th decade, Caucasian, M>F
24
Q
Osteopetrosis
- Pathology
- Etiology
- Population
A
- Bones harden and become more dense (still brittle though)
- Genetic
- Bimodal: early childhood, adults
25
Osteoid osteoma
- Description
- Population
- Small area of neoplastic tissue surrounded by mature bone
| - Children, young adults
26
Multiple myeloma--definition
Malignancy in one clone of plasma cells
27
Rheumatoid arthritis
- Description
- Etiology
- Population
- Progressive deforming polyarthritis with chronic systemic inflammatory dz
- Unknown
- Middle age, F>M
28
Rheumatoid arthritis
- Description
- Etiology
- Population
- Progressive deforming polyarthritis with chronic systemic inflammatory dz
- Unknown
- Middle age, F>M
29
Ankylosing spondylitis
- Definition
- HLA
- Population
- Chronic inflammatory dz of axial skeleton, especially SI joints
- HLA-B27
- M>F, onset in adolescence
30
Reactive arthritis
- Definition
- Population
- Autoimmune reaction following GI/GU infx
| - Males in 20s and 30s
31
Gout
- Definition
- Etiology
- Presentation
- Pathognomonic finding
- Deposition of urate crystals in joint dt hyperuricemia
- Overproduction and/or underexcretion of uric acid
- Exquisitely painful distal monoarthritis (esp 1st MTP)
- Tophus
32
Pseudogout
- Definition
- Population
- Deposition of calcium pyrophosphate crystals in joints
| - Older adults
33
Ganglion cyst vs Synovial cyst
Ganglion: no communication with joint space
Synovial: herniation of synovial fluid through joint capsule
34
Duchenne's MD
- Protein
- Pathology
- Inheritance
- Course
- Dystrophin
- Absence of dystrophin --> excess Ca --> oxidative stress --> necrosis of muscle
- Sex linked
- Onset age 2-5, death by 20s
35
Myasthenia Gravis
- Pathology
- Linked to abnormalities in what organ?
- Populations
- Antagonistic antibodies to acetylcholine receptor, causes fluctuating weakness
- Thymus
- Women under 40, both sexes 50-70
36
Lambert-Eaton
- Description
- Strong association with...?
- Pathology
- Changes in weakness with exertion
- Progressive proximal muscle weakness
- Small cell lung cancer
- Antibodies to presynaptic Ca channel --> impaired acetylcholine release
- Greater strength with initial exertion/mild exercise, but weakness with prolonged exertion
37
What are the three most common idiopathic inflammatory myopathies?
Dermatomyositis, polymyositis, and inclusion body myositis
38
Dermatomyositis
- Systems affected
- Possible etiologies
- Mechanism
- Population
- Skeletal muscle and skin
- Post-viral, often paraneoplastic
- Complement-mediated damage to blood vessels
- Primarily adults, also children 5-14
39
Classic microscopic finding of dermatomyositis
Mixed B and T cell perivascular infiltrate with perifascicular muscle fiber atrophy
40
Clinical manifestations of dermatomyositis
- Periorbital heliotrope rash (summetric, purple-red maculopapular rash on eyelids)
- Gottron's sign (red maculopapular rash over dorsal MCPs and IPs)
41
Polymyositis
- Presentation
- Population
- Mechanism
- Bilateral proximal muscle weakness including neck flexors; never ocular muscles
- Almost exclusively adults
- WBC infiltrate of muscle fibers
42
Histo findings of polymyositis
Muscle fibers pale and enlarged, with lymphocyte/macrophage infiltrate
43
Inclusion body myositis
- Clinical description
- Histo (muscle bx)
- Slowly progressive weakness and wasting of distal and proximal muscles, esp arms and legs
- Focal areas of WBCs, vacuoles, amyloid deposits, and inclusion bodies
44
Rhabdomyoma
| Description and presentation
Benign striated muscle tumor
| Round mass in region of the neck
45
MC soft tissue tumor in children and MC sites
Rhabdomyosarcoma
| Within the orbit or face/scalp/neck/extremities
46
What cell line does rhabdomyosarcoma arise from?
| What are histo findings?
Embryonal mesenchymal cells
| Pleiomorphic cells w/ high variability; interweaving bundles of spindle-shaped cells
47
X-ray findings of osteoarthritis (4)
Joint-space narrowing
Osteophytes
Subchondral bone cysts
Greater density
48
Heberden's nodes are at the _____
| Bouchard's nodes are at the ______
Heberden's -- DIPs
| Bouchard's -- PIPs
49
Histo of osteomyelitis
Lytic center with ring of sclerosis
50
Eye finding in osteogenesis imperfecta
Robin's egg eyes: sclera turn blue
51
With rickets, you see genu ____ in toddlers but genu ____ in older children.
Varum toddlers
| Valgum older children
52
Finding on the chest in rickets
Rachitic rosary: prominent knobs of bone at the costochondral joints
53
Pathognomonic histo finding for Paget's disease
Mosaic pattern of lamellar bone
54
Lab finding for Paget's disease
Markedly elevated serum alk phos
55
X ray finding of Paget's disease
Cotton ball skull with thickening of calvarium
56
X ray finding of solitary bone cyst
Smooth, thin cortex
Close to epiphysis
Symmetrical
57
X ray finding of aneurysmal bone cyst
Distortion of bone, less symmetry
| Honeycomb appearance
58
X ray finding of an osteoid osteoma
Small, round, well-circumscribed lesion near the cortex
59
Characteristic finding of osteosarcoma
Skip lesions
60
Histo finding of fibrosarcoma
Sheets of spindle-shaped cells
61
X ray finding of giant cell tumor
Expanded bone contours with non-sclerotic borders
62
Histo and X ray findings of Ewing sarcoma
Uniform, densely packed cells
| Moth-eaten bone
63
X ray finding of multiple myeloma
| Clinical features
Lytic bone lesions
| Bone pain, fractures
64
X ray finding of mets to bone
Ivory vertebra sign
65
Labs for RA
RF (anti-IgG) -- more sensitive
anti-CCP -- highly specific
HLA-DR4
66
Gene assoc w/ ankylosing spondylitis
HLA-B27
67
Classic clinical picture of reactive arthritis
Conjunctivitis, non-gonococcal urethritis, arthritis
68
Derm manifestation of lyme disease
Erythema chronicum migrans
69
Pathognomonic lesion of gout
Topus
70
Histo finding of myasthenia gravis
Lymphocytic accumulation in muscle, pale and atrophic muscle fibers
71
Gross finding of osteoid osteoma
Gritty, cherry red lesion
