Bone tumors

Question 1

Ends in -oma

Answer 1

benign

except melanoma, lymphoma (hodgkin’s), and gliomas

Question 2

Ends in -sarcoma

Answer 2

Malignant

glandular

Question 3

Where are the malignancies usually taken place in sarcomas

Answer 3

bone
cartilage 
fat
muscle 
glands 
blood vessels

Question 4

What is important about primary bone tumors

Answer 4

They are less common than tumors that metastasize to the bones
e.g. to the spine from prostate adenocarcinoma

Question 5

Osteoma

Answer 5

benign
lesions in bone
non invasive

Question 6

location of osteoma

Answer 6

head and neck

Question 7

Osteomas lesions are unique in that they….

Answer 7

ATTACH TO THE BONE

NOT part of the BONE

Question 8

2 types of osteomas

Answer 8

osteoid osteoma

osteoblastoma

Question 9

Differentiate osteoid osteoma and osteoblastoma

Answer 9

Osteoid osteoma is in tibia and femur - will see bump on the bone with X-ray
PAIN

Osteoblastomas - large and located in the spine
PAIN

Question 10

Which one of the osteomas cause pain but NSAIDs don’t relieve the pain?

Answer 10

osteoblastoma

Question 11

osteosarcomas

Answer 11

Primary ones are usually found above and below the knee
DONT develop from osteomas
if found in the rib area, may want to look elsewhere (the knees) because it may be a secondary nodules

Question 12

Secondary Osteosarcomas

Answer 12

result of paget’s
aggressive ! comes back quickly as opposed to primary osteosarcomas
patients will secondary osteosarcomas must be monitored
Hx is very important!!!

Question 13

What is the most common BENIGN bone tumor?

Answer 13

osteochondroma

Question 14

Male patient in 2nd decade with nodules above and below the knee

Answer 14

primary osteosarcoma

Question 15

A 50 y/o patient presents with multiple lesions in the hands and feet. The patient had a fx in one of the fingers. It was found that mature hyaline cartilage were found in the small bones of the hands and feet.

Answer 15

Oller’s chondroma

Question 16

What is the cartilage in chondroma

Answer 16

hyaline

Question 17

Where does chondroma usually take place?

Answer 17

hands and feet

Question 18

Differentiate between Ollier’s and Maffucci chondroma

Answer 18

Angioma (vessels) is formed at the hands in maffucci chondroma

Question 19

A major problem with ollier’s chondroma is that it develops

Answer 19

into chondrosarcoma

Question 20

Differentiate between chondromas and chondrosarcomas

Answer 20

Chondromas affect people in their 30-50s
Chondrosarcomas affect people in their 60s
Chondromas are located at the hands and feet
Chondrosarcomas are located at the pelvis and shoulder girdle

Question 21

A patient presents with a X-ray that shows growth in the epiphyseal plate of the tibia.

Answer 21

idiopathic tumor
called giant cell tumor of bone
always at the epiphyseal plate
aggressive BENIGN tumor

Question 22

What type of tumor is giant cell tumor of the bone

Answer 22

benign but aggressive

growth on the epiphyseal plate of the tibia

Question 23

Ewing sarcoma family of tumors

Answer 23

Think of the kid with giant tumor on the femur

Question 24

A boy dies of a tumor of the femur (which can also grow at the pelvis)

Answer 24

Ewing sarcoma
has family component to it - gene translocation
undifferentiated is BAD

Question 25

differentiated vs undifferentiated ewing sarcoma

Answer 25

undifferentiated is BAD | -usually death

Question 26

which cells make hyaline cartilage at the articular tissue of the joints?

Answer 26

chondrocytes

Question 27

a 10 year with large joints presents to the doctor | No psoriasis or ankylosing arthritis (NO HLA-B27)

Answer 27

This is juvenile RA, which is differentiated from RA in adults because of the large joints instead of hands and feet also adult RA has ankylosing in the hands

Question 28

Juvenile RA is similar to pseudogout

Answer 28

because it affect large joints but they are different by the nature of disease also the AGE

Question 29

Psuedogout vs gout

Answer 29

affect large joints instead of big TOE calcium deposits instead of monosodium urate seen in normal gout affect people in their 50s

Question 30

Pseudogout

Answer 30

THINK ACUTE INFLAMMATION | in large joints because calcium deposits in the intraarticular areas in the cartilage

Question 31

juvenile RA

Answer 31

before age 16

Question 32

Gout

Answer 32

big toe acute inflammation - there will be neutrophils IL-8 overproduction of uric acid and normal excretion (common) or abnormal excretion with normal production of uric acid HUMANS don't have uricase to break it down so it accumulates in the joints

Question 33

What is the role of monosodium uracate in gout

Answer 33

it accumulates and is a chemotactic factor that recruits neutrophils to the site

Question 34

Adult RA

Answer 34

RA factor CHRONIC inflammation angiogenesis and fibroblasts at the site ankylosis happens = bones anchored together (not due to HLA -B27) RA is autoimmune disease with HLA association of DR4

Question 35

What is found in the synovium of joints in RA

Answer 35

CD4+ cells

Question 36

Osteoarthritis

Answer 36

breaking down type II collagen (cartilage) hyaline cartilage bone ends rub together secondary arthritis from other diseases

Question 37

Osteoarthritis and inflammation

Answer 37

NOT AN INFLAMMATORY DISEASE | can progress to RA

Question 38

Osteoarthritis

Answer 38

strictly a geriatric disease

Question 39

What cells are affected in OA

Answer 39

chondrocytes

Question 40

What are the risks of developing OA?

Answer 40

``` low estrogen (IL-1) low bone density!!!!! (osteoporosis?) ```