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othopaedics > soft tissue and tumour > Flashcards

soft tissue and tumour Flashcards

1
Q

definition of a lesion, dysplasia, metaplasia, tumour and neoplasia

A

lesion=any abnormality of a tissue

dysplasia: abnormal ratio of undiff to diff
metaplasia: abnormal change of one diff cell type to another

neoplasia: new abnormal formation of tissue the growth of which exceeds and is uncoordinated to that of the normal tissues and persists even when stimulus is removed

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2
Q

benign versus malignant tumours

A

benign

  • well diff
  • slow growth
  • capsule yes
  • localised and contained

malig

  • poor diff
  • fast
  • no capsule, invades
  • spreading
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3
Q

difference between a sarcoma and a lipoma

A

sarcoma= tissue which includes bone
lipoma=fat tissue

sarcoma
-fixed and non mobile
>5 cm

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4
Q

definition of lytic, blastic, explansile, invasive, well-circumsided, diffuse and multi-loculated

in describing bone tumours

A

lytic: removes bone
blastic: deposits bone
expansile: expands the normal bony contours
invasive:
well circumscribed: defined boundary
diffuse: no obvious boundary
multi-loculated many lobes

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5
Q

what colour is lytic and what colour is blastic

A

lytic=darker black

blastic=white

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6
Q

% of bone tumours that are metastatic

A

90%

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7
Q

carcinomas that commonly spread to bone

A
  • prostate
  • breast
  • kidney
  • thyroid
  • lung
  • lead kettle
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8
Q

bone tumour presentation

A

-pain
-soft tissue lumps and bumps
-hypercalcaemia
-signs of cancer
can be an incidental finding

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9
Q

what is a red herring event

A

something that is attributed to another event but then it doesn’t get better

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10
Q

what LFT marker should be checked in particular

A

ALK phos

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11
Q

treatment of bone tumours

A
  • bisphosphonate for hypercalcaemia
  • radiotherapy for pain
  • chemotherapy
  • operative
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12
Q

when might operative management be requird

A
  • for primary bone tumour
  • for metastasis if
  • uncontrolled pain
  • pathological #
  • palliation (fungating tumour due to artery)
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13
Q

3 options for operative management for metastatic

A

-excision
-stabilise
-replace
implant must last longer than the patient

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14
Q

4 options for primary bone cancer surgery

A
  1. intralesional curettage=scoop it out or marginal excision in benign
  2. wide local excision (include surrounding healthy tissue)
  3. radical excision- includes the muscles of that compartment also
  4. amputation
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15
Q

what is the most common primary sarcoma of the bone

A

osteosarcoma

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16
Q

who does osteosarcoma occur in

A

children and young adults

-rarely in elderly adults with pagets

17
Q

clinical features of osteosarcoma

A
  • progressive pain
  • fever
  • swelling
  • mass
  • around knee often
18
Q

sarcoma definition

A

a malignant tumour of connective or other non-epithelial tissue

19
Q

imaging of an osteosarcoma

A
  • blastic and lytic

- codman’s triange:a periosteal reaction as lesion raises the periosteum away and get new subperiosteal bone underneath

20
Q

diagnosis of osteosarcoma

A
  • x-ray
  • mri show hot
  • ct for pulmonary metastases
21
Q

primary causes of osteosarcoma

A

seen in 10-20 year olds with LiFraumeni syndrome, retinoblastoma and familial

22
Q

secondary cases of osteosarcoma

A

seen in areas of pagetic bone or fibrous dysplasia or sites of previous radioactivity

23
Q

treatment osteosarcoma

A
  • chemo for 8-12 weeks
  • surgical resection with limb salvage where possible
  • maintenance chemotherapy 6-12 months
24
Q

survival osteosarcoma

A

76%

25
Q

poor prognostic factors of osteosarcoma

A
  • tumour size and site

- advanced stage of disease

26
Q

red flags for lumps

A

size >5cm
change or rapid growth
pain
previous sarcoma

27
Q

hypercalcaemia symptoms

A 
stones
bones 
groans
moans
thrones-polyuria
28
Q

treatment for hypercalcaemia

A

hydration

bisphosphonates

29
Q

what is multiple myeloma

A

tumour of myeloma or bone marrow that produces plasma cells

30
Q

what is the most common primary bone malignancy in >40 years

A

multiple myeloma

31
Q

survival with multiple myeloma

A

5 years 30% and 10 years 11%

32
Q

what is multiple myeloma pathophysiology

A

neoplastic proliferation of plasma cells (b cells) that produce immunoglobulin
-they go rogue

33
Q

test for multiple myeloma 3

A

-get bence jones protein=proteinuria
-pepper pot skulls: x-ray
lytic lesions
-low wcc and esr and calcium raised

34
Q

treatment multiple myeloma

A
  • chemotherapy
  • steroids
  • bisphosphonates

othopaedics (21 decks)

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