Theme 10 L2: Soft tissue tumours Flashcards
The following benign tumours arise from?:
- Lipoma
- Fibroma
- Leiomyoma
- Hemangioma
- Lymphangioma
- Neuroma
- Chondroma
- Fat tissue
- Fibrous tissue
- Smooth muscle
- Blood vessel
- Lymphatics
- Chondroma
Name 4 tumours associated with sarcomas
- Neurofibromatosis type 1 - neurofibroma
- Gardner syndrome - fibromatosis
- Carney syndrome - myxoma, melanotic schwannoma
- Turner syndrome
What is a benign mixed bone tumour?
osteochondroma
What is an osteosarcoma, who gets it and what is the commonest site?
- osteosarcoma
- young age
- commonest site is around the knee
Which malignant tumours commonly metastasise to bone?
thyroid, prostate, kidney, breast and GI tract
What is CREST syndrome?
- calcinosis (calcium deposits in any soft tissue)
- Raynaud’s phenomenon
- oesophageal dysfunction
- sclerodactyly (fingers turning inwards)
- telangiectasia
What is polymyalgia rheumaica?
stiffness, weakness, aching and pain in the muscles of the neck, limb girdles and upper limbs
-associated with giant cell arteritis
What is the difference between myopathy and myositis?
Myopathy - muscle disease unrelated to any disorder of innervation or neuromuscular junction
Myositis - muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness
What is muscular dystrophy?
- heterogenous group
- inherited disorders
- progressively severe muscle weakness and wasting
- begins in childhood
What is malignant hyperthermia?
inherited disease -
fast rise in body temperature and severe muscle contraction when the affected person gets GA
What are the signs and symptoms of malignant hyperthermia?
- Bleeding
- Dark brown urine
- Muscle rigidity
- Quick rise in body temperature to 105 degree F or higher
- Discovered during anaesthesia
- May have family history
What is rhabdomyolysis?
- destruction of skeletal muscle
- release of muscle fibre content in the blood (myoglobin)
- get myoglobinuria (brown urine)
What are the causes of rhabdomyolysis?
- Trauma, crush injuries
- Drugs – cocaine, amphetamine
- Extreme temperature
- Severe exertion – marathon running
- Lengthy surgery
- Severe dehydration
What is arthritides?
- pain and stiffness of a joint
- inflammation of the joint
What is the commonest type of skin disease?
osteoarthritis
What are the clinical features of osteoarthritis?
- progressive erosion of articular cartilage
- results in the formation of bony spurs and cysts at the margins of joints
- results in pain and limitation of movements
What is the cellular basis of OA?
Chondrocytes
What are the features of primary OA?
- abnormal stresses in weight bearing joints
- affecting fingers, knees and cervical/ lumbar spines
- involvement of fingers - herberdens or bouchards nodes
What are the features of RA?
- Chronic systemic disorder – principally affecting the joints
- Producing a non suppurative proliferative synovitis – destruction of articular cartilage and ankylosis of joints
- Also affects skin, muscle, heart, lungs and blood vessels
- Women 3-5x more than men
What are the clinical features of RA?
- malaise, fatigue and generalised MS pain to start of
- involved joints are swollen, warm, painful and stiff in the morning
- slow or rapid disease course
- small joints of the hands and feet are frequently affected
Which genes are involved in susceptibility to RA?
DR4 and DR1
What is the criteria for diagnosis of RA?
- Morning stiffness
- Arthritis in 3 or more joint areas
- Arthritis of hand joints
- Symmetric arthritis
- Rheumatoid nodules
- Serum rheumatoid factor
4 of the above criteria
What are the typical radiographic changes in RA?
Narrowing of joint space, loss of articular cartilage
How do we diagnose RA?
- Rheumatoid factor - present in most patients but not all patients, less specific
- Analysis of synovial fluid - confirms presence of neutrophils - inflammatory picture
What other systems are involved in RA?
Skin - rheumatoid nodules - commonest cutaneous manifestation
-lung, spleen, heart, other viscera
What is sero-negative arthritides?
lack rheumatoid factor
Which arthritis are sero-negative?
- Ankylosing spondylitis
- Reiter’s syndrome
- Psoriatic arthritis
- Enteropathic arthritis
What is gout?
- end point of a group of disorders producing hyperuricemia
- deficiency of enzymes involved
What are the clinical features of gout?
- acute/chronic arthritis
- tophi
- gouty nephropathy
- transient attacks of acute arthritis
What is pyogenic osteomyelitis?
- systemic illness - fever, malaise, chills and marked pain over affected region
- caused by bacteria
- haematogenous spread
What is infective arthritis?
- acutely painful and swollen joints with restricted movements
- fever, leucocytosis and elevated ESR
- bacterial
What is osteoporosis?
- increased porosity of the skeleton
- reduction in bone mass
- localised or entire skeleton
What are the clinical features of osteoporosis?
- vertebral fractures
- kyphosis
- scoliosis
Which disease results from osteoclast dysfunction?
Paget’s disease
What are the features of Pagets disease?
- M>F
- begins in 5th decade
- pain most common symptom
- tumours are benign and malignant
What is osteopenia?
too little bone / decreased bone density
What is osteomalacia a result of?
lack of vitD
What is the net effect of hyperparathyroidism?
increased bone resorption and calcium mobilisation from the skeleton –> hypercalcaemia
