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J MSK > Tumours and soft tissue swellings > Flashcards

Tumours and soft tissue swellings Flashcards

1
Q

bony outgrowth on surface of bone (eg knee)

A

ostechondroma

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2
Q

are osteochondromas benig or malignant

A

benign

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3
Q

where in the bone do ostechondromas occur

in which direction do they grow

A

metaphysis

grows away from epiphysis

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4
Q

where in the bone do enchondromas occur

A

metaphysis

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5
Q

which bones do osteochondromas occur in

A

long bones

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6
Q

which bones do enchondromas occur in

A

short bones

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7
Q

lucent lesion with patchy sclerosis

in small bones of hands and feet

A

enchondroma

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8
Q

fluid filled neoplasm in long bones

A

simple bone cyst

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9
Q

how do most benign bone tumours present to hospital

A

incidental finding on xray after fracture

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10
Q

treatment of benign bone tumours

A

curettage to remove it

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11
Q

what is an aneurysmal bone cyst filled with

A

blood

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12
Q

which type of benign bone tumour causes cortical expansion = destruction

A

aneurysmal bone cyst

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13
Q

are giant cell tumours of the bone benign or malignant

A

benign

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14
Q

bone with ‘soap bubble’ appearance on xray

A

giant cell tumour of bone

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15
Q

shephards crook deformity

A

weakened proximal femur in fibrous dysplasia

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16
Q

intense pain in bone
sclerotic halo on xray
in vertebrae or proximal femur
benign growth

A

osteoid osteoma

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17
Q

sclerotic halo on xray
bone pain on exercise
low grade fever

A

brodies abscess

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18
Q

aetiology of most malignant bone tumours

A

malignancy

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19
Q

treatment of malignant bone tumour

A

surgery with 3-4cm circumference (+/- joint replacement, stabilisation)

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20
Q

osteosarcoma in elderly, what must you check for

A

pagets

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21
Q

is osteosarcoma benign or malignant

A

malignant

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22
Q

which age group does sarcoma usually present in

A

young

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23
Q

most common malignant bone cancer

A

osteosarcoma

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24
Q

treatment of osteosarcoma

A

palliative chemo

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25
Q

what does a chondrsarcoma produce

A

cartilage

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26
Q

which age group gets chondrosarcoma

A

45 year olds

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27
Q

where do chondrosarcomas present

A

pelvis/proximal femur

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28
Q

most common bone cancer in teenagers/kids (genetic problem)

A

ewings sarcoma

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29
Q

xray appearance of ewings sarcoma

A

‘onion skin’

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30
Q

microscopic appearance of ewings sarcoma

A

small round blue cell tumours

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31
Q

overproduction of plasma cells = collection of abnormal plasma cells in bone marrow

A

myeloma

32
Q

in myeloma are the plasma cells normal

A

no

33
Q

what do the abnormal plasma cells produce in multiple myeloma

A

paraprotein (abnormal antibodies)

34
Q

which major organ can the paraproteins get deposited in, in myeloma

which causes

A

kidneys = renal dysfunction

35
Q 
bone pain 
back pain 
weakness
fatigue
weight loss
renal failure
anaemia 
recurrent infections 
proteinuria
A

multiple myeloma

36
Q

investigations for multiple myeloma (4)

A

head xray - for sclerotic lesions
bloods - electrophoresis for abnormal proteins
urine - for bence jones proteins
bone marrow biopsy

37
Q

treatment of multiple myeloma (2)

A

chemo (radiotherapy if 1 lesion but usually multiple)

stem cell transplant

38
Q

cancers that commonly metastases to the bone (6(3Bs+3)

A

Breast
Bronchi (lung)
Bowel

renal
thyroid
prostate

39
Q

generally, how does bone cancer look on xray

A

‘patchy’

40
Q

is pagets disease a neoplastic disease

A

no lol

41
Q

which cell activity is increased in pagets

A

osteoclasts AND osteoblasts (negative feedback, increased osteoclasts results in increased osteoblasts)

42
Q

what is the result of increased osteoclasts AND increased osteoblasts in pagets disease

A

thickened, brittle, mis-shapen bones

easily fractured

43
Q

aetiology of pagets (3)

A

genetics
environmental trigger
viral infection

44
Q

presentation of pagets (4)

A

pain, ‘shin splints’
enlarged bones (bigger head)
increased metabolism
fractures

45
Q

investigation findings in pagets

A

increased alk phos (ALP) from osteoblasts

normal Ca+

46
Q

treatment of pagets

A

bisphosphonates - inhibits osteoclasts = prevent disease progression

47
Q

what is a lipoma

where is it

A

benign tumour in fat

48
Q

what is a leiomyoma

A

benign tumour in smooth muscle

49
Q

what is a chondroma

where is it

A

benign tumour in cartilage (eg enchondroma)

50
Q

what is a rhabdomyoma

where is it

A

benign tumour in skeletal muscle

51
Q

what is a neuroma/schwannoma

where is it

A

benign tumour in nerves

52
Q

what is a haemangioma/angiolipoma

A

benign tumour in blood vessels

53
Q

if a soft tissue tumour is malignant what is in its name

A

sarcoma

54
Q

diagnosis of a soft tissue tumour as being malignant not benign

A

biopsy

55
Q

what is bursitis

A

inflammation of burse (small fluid filled sac around a joint to prevent friction)

56
Q

what is a sebaceous cyst filled with

what does this look like when it pops

A

keratin

‘cheesy’

57
Q

where do you get sebaceous cysts

A

anywhere apart from palms and soles

58
Q

treatment of sebaceous cyst

A

excision

59
Q

what is an abscess

A

collection of neutrophils, infective organisms etc

60
Q

treatment of abscess (1 NOT)

A

incision and drainage

NOT antibiotics (they can only reach edges of abscess so wont remove all of it)

61
Q

ossification in muscle after injury

A

myositis ossificans (heterotopic ossification)

62
Q

is myositic ossifcans painful

A

no

63
Q

how does myositis ossifcans present

A

not painful

soft lump at site of injury that grows hard

64
Q

treatment of myositis ossifcans

A

surgery to remove abnormal bone

65
Q

nodular fasciitis

A

rapid growth of lesion after trauma

66
Q

osteochondirits

A

inflammation of cartilage/bone at joint

67
Q

osteochondritis dissecans

A

inflammation of cartilage/bone at joint with bone fragmentation

(hence the dissecans)

68
Q

risk factor for osteochondiritis

A

exercise - increased bleeding and oedema

69
Q

is osteomalacia a neoplastic disease

A

no lol

70
Q

what is osteomalacia (generally)

A

softening of bone everywhere from hypocalcaemia and low phosphate

71
Q

aetiology of osteomalacia

A 
abnormal vitD deficiency 
malnutrition 
malabsorption 
lack of sunlight 
hypophosphataemia 
chronic kidney disease
72
Q

how does osteomalacia present in kids

A

rickets

73
Q

which kidney condition may present as osteomalacia

A

CKD

74
Q

how does multiple myeloma cause renal failure (2)

A

amyloidosis - deposition of amyloid in kidneys

bone destruction = hypercalcaemia = increased renal stones

75
Q

what is amyloid

A

abnormally folded proteins

76
Q

how does amyloidosis causing renal failure present in investigations (which investigation and result)

A

congo red staining - investigation

‘apple green birefringence’

J MSK (30 decks)

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