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Path IV DJ > Skeletal System Pathology > Flashcards

Skeletal System Pathology Flashcards

1
Q

MC bone type for osteomyelitis in children

A

Long bones

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2
Q

MC bones type for osteomyelitis in adults

A

Vertebrae, pelvis

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3
Q

MC organism isolated from osteomyelitis

A

Staph aureus

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4
Q

MC route of infx for osteomyelitis in children

A

Hematogenous

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5
Q

MC organism isolated from osteomyelitis in infants

A

Group B Strep

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6
Q

MC etiology of osteomyelitis in adults

A

Injury exposing bone to local infx

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7
Q

MC location for solitary bone cyst

A

Distal ends of long bones

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8
Q

MC population for solitary bone cyst

A

Boys

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9
Q

MC location for aneurysmal bone cyst

A

Metaphysis of longs bones

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10
Q

MC population for aneurysmal bone cyst

A

Young women

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11
Q

MC location for osteosarcoma

A

Distal femur/knee

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12
Q

MC joint disease

A

Osteoarthritis

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13
Q

MC cause of secondary OA

A

DM

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14
Q

Nail signs in psoriasis

A

Pitting

Onycholysis

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15
Q

MC & 2MC bug in septic arthritis in adults

A

Staph, Strep

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16
Q

MC type of muscular dystrophy

A

Duchenne’s

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17
Q

MC muscle groups affected in Duchenne’s MD

A

Large, proximal groups

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18
Q

MC presentation of rhabdomyoma

A

Round mass in the neck

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19
Q

MC soft tissue tumor in kids and location

A

Rhabdomyosarcoma

Orbit, face, scalp, neck

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20
Q

Which bug is each of these populations susceptible to in developing septic arthritis?
Sickle cell patients
Young adults
Elderly and IV drug users

A

Sickle cell – Salmonella
Young adults – Neisseria gonorrhea
Elderly, IV drug users – E. coli

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21
Q

Osteogenesis imperfecta

  • Pathology
  • Cause
A

Brittle bones

Type 1 collagen deficiency

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22
Q

Rickets

  • Pathology
  • Cause
  • Population
A
  • Bone softening
  • Vit D deficiency dt severe malnutrition
  • Children
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23
Q

Paget’s disease of bone

  • Pathology
  • Population
A
  • Increased osteoblast & osteoclast activity –> increased calcification of bone
  • Develops in 4th decade, Caucasian, M>F
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24
Q

Osteopetrosis

  • Pathology
  • Etiology
  • Population
A
  • Bones harden and become more dense (still brittle though)
  • Genetic
  • Bimodal: early childhood, adults
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25
Q

Osteoid osteoma

  • Description
  • Population
A
  • Small area of neoplastic tissue surrounded by mature bone

- Children, young adults

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26
Q

Multiple myeloma–definition

A

Malignancy in one clone of plasma cells

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27
Q

Rheumatoid arthritis

  • Description
  • Etiology
  • Population
A
  • Progressive deforming polyarthritis with chronic systemic inflammatory dz
  • Unknown
  • Middle age, F>M
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28
Q

Rheumatoid arthritis

  • Description
  • Etiology
  • Population
A
  • Progressive deforming polyarthritis with chronic systemic inflammatory dz
  • Unknown
  • Middle age, F>M
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29
Q

Ankylosing spondylitis

  • Definition
  • HLA
  • Population
A
  • Chronic inflammatory dz of axial skeleton, especially SI joints
  • HLA-B27
  • M>F, onset in adolescence
30
Q

Reactive arthritis

  • Definition
  • Population
A
  • Autoimmune reaction following GI/GU infx

- Males in 20s and 30s

31
Q

Gout

  • Definition
  • Etiology
  • Presentation
  • Pathognomonic finding
A
  • Deposition of urate crystals in joint dt hyperuricemia
  • Overproduction and/or underexcretion of uric acid
  • Exquisitely painful distal monoarthritis (esp 1st MTP)
  • Tophus
32
Q

Pseudogout

  • Definition
  • Population
A
  • Deposition of calcium pyrophosphate crystals in joints

- Older adults

33
Q

Ganglion cyst vs Synovial cyst

A

Ganglion: no communication with joint space
Synovial: herniation of synovial fluid through joint capsule

34
Q

Duchenne’s MD

  • Protein
  • Pathology
  • Inheritance
  • Course
A
  • Dystrophin
  • Absence of dystrophin –> excess Ca –> oxidative stress –> necrosis of muscle
  • Sex linked
  • Onset age 2-5, death by 20s
35
Q

Myasthenia Gravis

  • Pathology
  • Linked to abnormalities in what organ?
  • Populations
A
  • Antagonistic antibodies to acetylcholine receptor, causes fluctuating weakness
  • Thymus
  • Women under 40, both sexes 50-70
36
Q

Lambert-Eaton

  • Description
  • Strong association with…?
  • Pathology
  • Changes in weakness with exertion
A
  • Progressive proximal muscle weakness
  • Small cell lung cancer
  • Antibodies to presynaptic Ca channel –> impaired acetylcholine release
  • Greater strength with initial exertion/mild exercise, but weakness with prolonged exertion
37
Q

What are the three most common idiopathic inflammatory myopathies?

A

Dermatomyositis, polymyositis, and inclusion body myositis

38
Q

Dermatomyositis

  • Systems affected
  • Possible etiologies
  • Mechanism
  • Population
A
  • Skeletal muscle and skin
  • Post-viral, often paraneoplastic
  • Complement-mediated damage to blood vessels
  • Primarily adults, also children 5-14
39
Q

Classic microscopic finding of dermatomyositis

A

Mixed B and T cell perivascular infiltrate with perifascicular muscle fiber atrophy

40
Q

Clinical manifestations of dermatomyositis

A
  • Periorbital heliotrope rash (summetric, purple-red maculopapular rash on eyelids)
  • Gottron’s sign (red maculopapular rash over dorsal MCPs and IPs)
41
Q

Polymyositis

  • Presentation
  • Population
  • Mechanism
A
  • Bilateral proximal muscle weakness including neck flexors; never ocular muscles
  • Almost exclusively adults
  • WBC infiltrate of muscle fibers
42
Q

Histo findings of polymyositis

A

Muscle fibers pale and enlarged, with lymphocyte/macrophage infiltrate

43
Q

Inclusion body myositis

  • Clinical description
  • Histo (muscle bx)
A
  • Slowly progressive weakness and wasting of distal and proximal muscles, esp arms and legs
  • Focal areas of WBCs, vacuoles, amyloid deposits, and inclusion bodies
44
Q

Rhabdomyoma

Description and presentation

A

Benign striated muscle tumor

Round mass in region of the neck

45
Q

MC soft tissue tumor in children and MC sites

A

Rhabdomyosarcoma

Within the orbit or face/scalp/neck/extremities

46
Q

What cell line does rhabdomyosarcoma arise from?

What are histo findings?

A

Embryonal mesenchymal cells

Pleiomorphic cells w/ high variability; interweaving bundles of spindle-shaped cells

47
Q

X-ray findings of osteoarthritis (4)

A

Joint-space narrowing
Osteophytes
Subchondral bone cysts
Greater density

48
Q

Heberden’s nodes are at the _____

Bouchard’s nodes are at the ______

A

Heberden’s – DIPs

Bouchard’s – PIPs

49
Q

Histo of osteomyelitis

A

Lytic center with ring of sclerosis

50
Q

Eye finding in osteogenesis imperfecta

A

Robin’s egg eyes: sclera turn blue

51
Q

With rickets, you see genu ____ in toddlers but genu ____ in older children.

A

Varum toddlers

Valgum older children

52
Q

Finding on the chest in rickets

A

Rachitic rosary: prominent knobs of bone at the costochondral joints

53
Q

Pathognomonic histo finding for Paget’s disease

A

Mosaic pattern of lamellar bone

54
Q

Lab finding for Paget’s disease

A

Markedly elevated serum alk phos

55
Q

X ray finding of Paget’s disease

A

Cotton ball skull with thickening of calvarium

56
Q

X ray finding of solitary bone cyst

A

Smooth, thin cortex
Close to epiphysis
Symmetrical

57
Q

X ray finding of aneurysmal bone cyst

A

Distortion of bone, less symmetry

Honeycomb appearance

58
Q

X ray finding of an osteoid osteoma

A

Small, round, well-circumscribed lesion near the cortex

59
Q

Characteristic finding of osteosarcoma

A

Skip lesions

60
Q

Histo finding of fibrosarcoma

A

Sheets of spindle-shaped cells

61
Q

X ray finding of giant cell tumor

A

Expanded bone contours with non-sclerotic borders

62
Q

Histo and X ray findings of Ewing sarcoma

A

Uniform, densely packed cells

Moth-eaten bone

63
Q

X ray finding of multiple myeloma

Clinical features

A

Lytic bone lesions

Bone pain, fractures

64
Q

X ray finding of mets to bone

A

Ivory vertebra sign

65
Q

Labs for RA

A

RF (anti-IgG) – more sensitive
anti-CCP – highly specific
HLA-DR4

66
Q

Gene assoc w/ ankylosing spondylitis

A

HLA-B27

67
Q

Classic clinical picture of reactive arthritis

A

Conjunctivitis, non-gonococcal urethritis, arthritis

68
Q

Derm manifestation of lyme disease

A

Erythema chronicum migrans

69
Q

Pathognomonic lesion of gout

A

Topus

70
Q

Histo finding of myasthenia gravis

A

Lymphocytic accumulation in muscle, pale and atrophic muscle fibers

71
Q

Gross finding of osteoid osteoma

A

Gritty, cherry red lesion

Path IV DJ (6 decks)

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