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Chirurgie > Tumori > Flashcards

Tumori Flashcards

1
Q

Etiopatogenie osteosarcom

A

Retinoplastom 7%
Iradiere
Complicatii boala Paget

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2
Q

Forme histologice de osteosarcom

A 
Osteoblastic 45%
Condroblastic - 27%
Anaplastic - 17%
Fibroblastic - 9%
Teleangiectazic - 1%
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3
Q

Incidenta crescuta metastaze osteosarcom in ce tesuturi

A

Alte structuri osoase
Pulmonar

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4
Q

Predominanta sarcom Ewing

A

Oase membre inferioare
Pelvis

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5
Q

Sarcom Ewing la coloratie PAS se observa

A

Glicogen crescut

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6
Q

Semne prognostic rezervat sarcom Ewing

A

Febra
Leucocitoza
VSH crescut
Anemie

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7
Q

Metastaze sarcom Ewing

A

La distanta
Plamani
Vertebre

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8
Q

Platoul palatoalveolar poate fi afectat de formele de tip

A

Carcinomatos
Sarcomatos

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9
Q

TU maligne de mezostructura invadeaza in peruoada de stare

A

Vestibul
Mucoasa jugala
Mucoasa palatina

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10
Q

TU maligne mezostructura in perioada de stare - aspect ulcerovegetsnt cu tendinta de invazie ptogresiva spre

A

Foze nazale
Orbita
Spatiu pterigomaxilar
Baza craniu

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11
Q

TU suprastructura invadeaza

A

Orbita
Sinus
Fose nazale

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12
Q

Semne oculare TU suprastructura

A

Diplopie
Exoftalmie
Scadere acuitate vizuala/amauroza

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13
Q

TU surpastructura se exteriorizeaza la nivelul

A

Pleoape
Unghi intern orbita

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14
Q

Elemente structurale ganglioni limfatici

A

Capsula conjunctiva
Arie corticala
Arie paracorticala
Aria medulara

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15
Q

DG# adenopatie cervicala metastatica

A 
TU benigne Ce
TU maligne Ce nemetastatice
Infectii regiune Ce
Adenopatii din hemopatii maligne
Adenite inflamatorii si/sau imuno
Afectiuni congenitale
Alte cauze
Structuri normale
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16
Q

Medicamente din limfadenite medicamentoase

A 
Penicile
Strepto
Sulfonamide
Meprobanat
Heparine
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17
Q

Factori de risc recidica keratochisturi

A 
Neindepartare chist monobloc
Keratochist odontogen primordial
Dimensiune mare
Multiloculare
Keratochisturi care au erodat corticalele
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18
Q

Ameloblastomul poate avea origine in

A

Resturile lamei D Serres
Organul adamantin
Epiteliul unui chist odontogen - derivat din tesuturi Malassez
Strat bazal al mucoasei orale

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19
Q

La copii, keratochistul odontogen este parte din

A

Sindromul nevic bazocelular

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20
Q

KO primordial deriva din

A

In locul unui dinte
Resturile Serres
Celulele bazale ale epiteliului oral

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21
Q

KO dentiger deriva din

A

In jurul unui dinte

Epiteliul adamantin redus

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22
Q

Semne clinice indirecte chist periapical

A

Ssb la Pe in axul D
Jena dureroasa la Pa in V bucal, in dreptul D

23
Q

Ameloblastom extraosos periferic - etiopatogenie

A

Resturi lama dentara Serres
Epiteliu bazal mucoasa orala

24
Q

Rata recidive ameloblastoame

A

Intraosos solid multichistic - 15-20%
Intraosos unichistic - 10-20%
Extraosos periferic - relativ scazuta

25
Q

Cele mai frecvente chiste odontogene

A

Radiculare inflamatorii
Periapical
Radicular lateral
Rezidual

26
Q

Al doilea cel mai frecvent chist

A

Folicular dentiger
20% din chisturile de dezvoltare
20% din chisturile odontogene

27
Q

Patogenie chist dermoid

A

Transformare chistica a incluziunilor epiteliale restante de la locul de unire a arcurilor brahiale pe linia mediana

28
Q

Patogenie chist branhial

A

Incluzia epiteliala a unui pliu endodermic al celei de-a 2a fanta labiala
Mecanism etiologic diferit de cel al canalului tireoglos

29
Q

Localizari posibile chist dermoid

A
  1. Tipic - chist dermoid oral, planseu, deasupra milohioidianului, pe linia mediana
  2. Planseu bucal, paramedian
  3. Sub milohioidian - chist dermoid suprahioidian
  4. Extins din planseu in loja submentoniera
  5. Foarte rar - limba, median
  6. Foarte rar - loja SBM
30
Q

Granulom periferic cu celule gigant - forme

A

Sesila

Rar pediculata

31
Q

Tip crestere papilom oral

A

Exofitica, verucoasa, conopidiforma

32
Q

Forme papilom oral

A

Pediculat

Uneori sesil

33
Q

Variante histopatologice papilom sino-nazal

A

Papilom scuamos
Papilom inversat - 15% risc malignizare
Papilom cu celule cilindrice

34
Q

Tipuri de HPV in papiloame orale

A

2
6
11

35
Q

Cele mai frecvente localizari TU carcinomatoase orale

A
  1. limba
  2. planseul bucal
36
Q

TU maligne ale mucoasei gingivale - secundare unor procese TU de vecinatate

A
  1. mucoasa jugala
  2. comisura intermaxilara
  3. planseu bucal
  4. fbm P
  5. TU endosoase in faza de exteriorizare
37
Q

Granulatiile galbui Trelat specifice

A

ulceratiilor tuberculoase - perilezional

38
Q

Evolutie TU maligna buza

A

dupa depasirea etapei locale:
1. adenopatie metastatica loco-regionala
2. afectare osoasa de vecinatate
3. metastaze la distanta

invazie si extindere:
1. parti moi labio-geniene
2. vestibul bucal
3. arc osos mentonier

  • afectarea osoasa madndibulara are loc in special in cazul evolutiei TU pe fata mucozala a buzei
39
Q

TU maligna limba - localizare

A
  • margine laterala
  • fata ventrala
  • sant pelvilingual

mai rar - fata dorsala, varful limbii

40
Q

TU maligna planseu - localizare

A
  • paramedian in portiunea anterioara
  • sant amigdaloglos - in localizarile posterioare
41
Q

TU maligna planseu si limba se extinde spre

A
  1. amigdale
  2. val palatin
  3. mandibula - in formele pelvilinguale
42
Q

Invazie nervoasa TU maligne limba si planseu

A
  1. lingual
  2. glosofaringian - uneori
43
Q

Caracteristici Rx osteosarcom

A
  1. arici
  2. os pieptanat
  3. perna cu ace
  4. raze de soare
  5. triunghiurile lui Codman
44
Q

Etiopatogenie Osteosarcom

A
  1. retinoplastom - 7%
  2. boala Paget
  3. iradiere
45
Q

Histopatologie Osteosarcom

A

asociere de:
- plaje celulare sarcomatoase fuziforme
- neoformare tesut osos
- matrice osteoida

in functie de tipul celular predominant - forme histopatologice:
1. osteoblastic - 45%
2. condroplastic - 27%
3. anaplastic - 17%
4. fibroblastic - 9%
5. teleangiectazic - 1%

46
Q

Aspect Rx carcinoame odontogene in functie de evolutie

A
  1. rapida - Rtransparenta difuza, cu margini zimtate, neregulate
  2. lenta - Rtransparenta relativ bine delimitata
47
Q

TU maligne de mezostructura - au punct de plecare

A
  1. mucoasa sinus maxilar
  2. extindere TU din infrastructura
  3. extindere TU din tegumente etaj mijlociu al fetei
48
Q

Evolutie TU maligne buze - cai afectare osoasa mandibulara

A

directa:
1. invazie os din aproape in aproape
2. cu extensie ulterioara de-a lungul canalului mandibular
3. cu implicare PVN

indirecta:
- adenopatie SBM secundara, fixata
- efractioneaza initial periostul
- invadeaza apoi corticala osoasa

49
Q

Ce ganglioni sunt implicati in TU maligne de limba si planseu

A
  1. retrodigastric - Kuttner - portiune posterioara limba
  2. supraomohioidian - Americani - portiune anterioara limba + planseu bucal anterior
50
Q

Carcinoamele odontogene se pot dezvolta prin:

A
  1. transformare maligna ameloblastom
  2. direct din tesuturile epiteliului odontogen = carcinoame osoase primare
  3. din membrana epiteliala a chisturilor odontogene
51
Q

Sistemul limfatic

A
  1. capilare limfatice
  2. vase limfatice
  3. trunchiuri colectoare
  4. ganglioni limfatici
52
Q

Modificari ale ganglionilor limfatici in context onco

A
  1. Hplazie foliculara
  2. Hplazie corticala
  3. Histiocitoza sinusala - multe histocite
53
Q

Factori care influenteaza diseminarea metastatica a TU primare

A
  1. localizare (ant<post)
  2. dimensiune
  3. proufuinzimea invaziei (corelata cu limfofilia)
  4. forma histopatologica
  5. gradul de diferentiere histo
  6. invazia perinervoasa
54
Q

Evolutia adenopatiilor clinice Ce

A
  1. invazie si ruptura capsula ganglionara
  2. fixare ganglionara
  3. invazie structuri de vecinatate - tegument, vase, structuri osoase

Chirurgie (8 decks)

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