OITE Prep Fredericks > Pathology > Flashcards

Pathology Flashcards

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1
Q

What Cancers is Chemo used for ?

A 
ROPEL
Rhabdomyosacroma
Osteosarcoma
PNET
Ewings
Lymphoma
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2
Q

Most common agents in treatment of sarcomas?

A

Most common agents used in the treatment of sarcomas are ifosfamide and doxorubicin

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3
Q

What is the most locally invasive benign soft tissue tumor?

A

Desmoid tumor

- Wide excision with Glevac (imatinib)

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4
Q

Non_Ossifying Fibroma Appearence?

A

Bubbly, sclerotic borders, eccesntrically based

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5
Q

What study will differentiate synovial chondromatosis from PVNS?

A

Gradient ECHO. Iron will drop out signal in PVNS

- Giant cell tumor of tendon sheath is analogous to PVNS when not intra-articular

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6
Q

Parosteal osteosarcoma typical location?

A

Posterior femur, common in females

- only wide resection if not HIGH grade, 25% invade in intramedullary canal

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7
Q

Sunburst or Hair on end osteosarcoma?

A

Periosteal sarcoma

- multiagent chemo and limb salvage

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8
Q

Treatment for PAgets sarcoma?

A

Chemotherapy, Wide resection, Reconstruction

- Will be hot on bone scan

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9
Q

What are also on differntial for UBC looking lesion?

A

ABC _lakes of blood, fibrous stroma
Telangetatic Osteosarcoma
UBC is never large (more wide) than the physis

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10
Q

Likely to Met to SPINE in rank order:

A

Breast>prostate>lung>kidney>thyroid

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11
Q

CD138 stain?

A

Myeloma

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12
Q

CD1A stain?

A

Eosinophilic granuloma

Langherhan Cell histiocytoma

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13
Q

CD20/CD45

A

Lymphoma

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14
Q

CD 99 Stain?

A

Ewings sarcoma

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15
Q

Herringbone pattern with pleomorphic cells?

A

Fibrosarcoma

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16
Q

Tibial diaphysis lesion?

A
  • Adamantinoma
  • Osteofibrous Dysplasia
    Bowing of tibia and palpable mass is commong
    Adamantinoma soap bubble appearence, sclerosis
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17
Q

What are most soft tissue sarcomas treated with?

A

Wide resection and radiotherapy

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18
Q

Pagets disease of bone lab findings

A

Elevated N-telopeptides, alpha-C-telopeptides, and urinary hydroxyproline l

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19
Q

What are the common primary tumors found in the spine?

A
  • Osteoid osteoma
  • Osteoblastoma
  • EG
  • GCT of bone
  • Hemangiomas
  • ABC
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20
Q

Hand-Shullen-Christian diesase traid
(Langerhanns cell histocytosis)- is specturm 1. EG if one lesion, HSC disease (boney and visceral), 3. Latter-siwe fatal in young

A
  • Exopthalmosis
  • Diabetes insipidus
  • multiple lytic skull lesions
    E
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21
Q

Preopertive versus Post operative radiation theraypy?

A
  • No difference in recurrance
  • Post operative usually high dose, large field therefore increase fibrosis/lymphadema
  • Preoperative- increase rates of wound complications
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22
Q

Osteofibrous Dysplasia Tpical Pattern?

A

Usually anterior COrtex of Tibia

  • Mild anterior bowing
  • Usually in Kids less than 10
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23
Q

Significant change in SSEPs intra op are?

A

> 50% loss in amplitude

>10% increase in latency

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24
Q

What appears in Poland Syndrome?

A

Absence of sternocostal head of Pec Major

- Syndactyly, symbrachydactyly

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25
Langheranns cells Histocutosis
CD1a stain Vertebra plana Young kid Skull findings
26
Polyostotic Tumors
Langerhans cell histiocytosis ``` Fibrous dysplasia (Gnas) (McCabe Albright , Mazzarad) ``` MHE Enchondromatosis (olliers and mafucci)h Vascular tumors (angiosarc cd34)
27
GCT expresses what Ligand
RankL Denosumab- can help treat : RankL inhibitor
28
Denosumab MOA | Uses?
RANKL inhibitor | Unresectable GCT, Hypercalcemia of malignancy, osteoprosis
29
Schwanoma Histo SLide Look ?
Biphasic Antonia A and Antoni B
30
Tumors by Anatomic Location? | Tibia Tumors?
``` Osteofibrious Dysplasia ( young child) Adamantinoma ```
31
Osteofibrious dysplasia versus Fibrious Dysplasia ?
Osteofibrious- Anteiror tibia, Cortical rimming, OSTEOBLASTIC RIMMING Fibrious Dysplasia- in medullary cavity, NO osteoblastic rimming
32
Surface Tumors ?
Osteochondroma Periosteoal Chondroma - No bone formation on Histo and no medullary continuity Parosteal Osteosarc Periosteal Osteosarc
33
Parosteal Osteosarc?
Low grade surface tumors Implied lower grade that Periosteal SURGERY ONLY TUMORS Can differentiate from osteochondroma by LACK of medullary canal continuity
34
Fluid Fluid Levels on Cross Section? Differential
Primary ABC Secondary ABC -- UBC, GCT Telangietatic Osteosarc
35
Differentiate between ABC versus UBC?
ABC the width of the lesion or bone is wider than the phsysis This is not the case in UBC
36
Most Common Sarcomas with ossifications
1. Synovial Sarcoma | 2. Extra-articular Osteosarc
37
Inta-articular Tumors
1. Synovial Chondromatosis 2. Synovial Hemangioma 9 skelatllly imature 3. PVNS: Dark on T1, Dark on T2 ( tenosynovail gian cell tumor
38
Painful Sub-Ungal Mass cuasing nail deformity?
Glomus Tumor
39
Most Common soft tissue sarcoma of hand?
Epitheliod sarcoma | 2nd- synovial
40
Which soft tissue sarcoma require sentinel node biopsy as part of staging?
``` Epitheliod sarcoma ( lung) Rhabdomyosarcoma ( lung) These sarcomas goes to lymph nodes ```
41
ONly couple of things ( tumors) are Dark on T1 and Dark on T2
``` PVNS Desmoid Tumor ( fibromatosis ) ```
42
Schawanoma versus Neurofibroma?
Schanomas on TOP of tumor | Schwanomas- Antoni a and Antoni B
43
MDM2+ ?
Atypical Lipomatous Tumor
44
Myxoid Tumors Appearance on MRI?
t1 hyper intest t2 FS- Hyper intese Myxoma Myxoid Liposarcoma Myxofibrosarcoma
45
Most Commone Soft Tissue Sacroma by Age 5yo? 30yo? 80yo?
5yo- Rhabdomyosarcoma 30- Synovial Sarcoma 80- UPS ( undifferenentied pleomorphic sarcoma
46
12:16
Myxoid Liposarcoma
47
2:13
Alveolar Rhabdoymyosarcoma
48
11:22
Ewings sarcoma | CD 99 +
49
Actin ( SMA) Smooth Muscle
Leiomysosarcoma ( smooth muscle)
50
s-100 ( stans for a lot but on test)
Malignant peripheral nerve sheath tumor
51
Brachyury Stain ?
Chordoma
52
Dose of Pre Op radiation versus Post op in Sarcomas ?
PRE OP- Smaller does that Post op
53
Radiation? For Soft Tissue Sarcomas
Large high grade tumors Decreases LR by 25% Pre Op Dose 50Gy Post Op Dose 66Gy
54
Imatinib ( Gleevac) Targeted therapy for What?
Tyrosine Kinase INhibitor | PVNS
55
What staging portion is unique for ewings versus osteosarcoma?
Bone Marrow Biopsy
56
12:16
Myxoid Liposarcoma
57
12:22
Clear Cell Sarcoma
58
9:22
Myxoid Chondrosarcoma
59
Adamantinoma Location?
Usually Tibia Looks a lot like osteofibrous dysplasia BIPHASIC
60
What malignancy may be cold on bone scan?
Multiple myeloma CD 138 (plasma cells) Associated with hypercalcemia of malignancy
61
CD1A
Langerhanns Cells
62
Mutations in Fibrous Dysplasia?
GNAs mutation | Ground glass
63
Polyostotic Fibrous Dysplasia Association?
McCune Albright - Polyostotic Fibrious Dysplasia - Endocrine abnormalities - Cafe-Au Lait spots Mazabrauds Syndrome - Polyostotic Fibrous Dysplasia - Multiple Myxomas
64
End of Bone Lesions? Epiphyseal?
- Giant Cell Tumor of Bone (adults) - Chondroblastoma ( children) - checken wire calcification, edema in side bone - Clear Cell Chondrosarcoma ALL THREE METS TO LUNGS
65
Lytic Destructive Lesion in Distal Radius?
Giant Cell Tumor
66
Is renal cell carcinoma radiosensitive?
NO
67
Rates of recurrance of patients with chondrosarcoma most directly related to what sample characteristic?
Telomerase activity ( elongates chromosomes leading to cellular growth and porliferation)
68
Osteoid Osteoma in the Spine NEAR neural elements treatment?
Surgical resection is preferred to radiofrequency ablation
69
Typical Adamantinoma location and histo?
``` Anterior Tibia ( Epithelial cells in fibrous stroma ```
70
What tumors are most liley to metastasis to spine?
1. Breast 2. Prostate 3. Lung 4. Kidney 5. Thyroid
71
Fibrodysplasia Ossificans Gene?
ACVR1 | - Minor trauma or surgery results in BAD HO or ankylosing
72
EMA?
Epitheliod Membrane Antigen Epitheliod Sarcoma Stain Common in hands ( amputations for non-healing ulcers)
73
Ossification center of the Hand
1. Capitate 1-3 mo 2. Hamate 2-4month 3. Triquetrum 5. Lunate 6. Scaphoid 7. Trapezium 8. Trapezoid 9. Pisiform 8-12 years
74
Nerves in Tendons
- Golgi, Pacinian Corpusules with proprioceptive ability in myotendinous JXN - Free nerve endings and nociceptic fibers- at Enthesis- bone interface
75
Collagen fibril size ?
Decorin
76
What has been link to growth/development of PVNS?
CSF-1
77
SIRS Criteria: ( 2 or more)
1. Temp >38.0 2. HR >90 bbpm 3. RR >20 3. ABG Co2 <32 5. WBC >12
78
What is the shelf life of Freeze dried bone?
INfinite- only limited by its sterility
79
RCT >80% follow up?
Level 1
80
RCT <60% FU?
Level III
81
Level III studies
Case-control
82
What commonly used metal is most suseptible to pitting corrosion ?
Stainless steel
83
Portals and risk in ankle
1sst: AM portal- TA is at risk. You can trasnillumante to avoid SPN 2nd. AL port- SPN at risk
84
9:22 Translocation?
Mixoid Chondrosarcoma
85
Klippel Feil Manifestations?
Sprengels Deformity Scoliosis Auditory ( deafness) Cardiac Abnormalities
86
What portion of the UCL is isometric throughout
Anterior Band of the Anterior Bundle
87
Peroneal Tendon Tears Type I | : Small Tears in each?
Tubularization and debridement
88
Peroneal Tendon Tears Type II :
One is irreprabably torn and other is fine | TENODESIS to the Good One
89
Peroneal Tendon Tears Type III
Both Irreprabably torn DECISION IS HINGED ON EXCURSION OF proximal muscle belly Exurcsion Good- Allograft tendon No Excursion: FHLl Transfer
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