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What's the principle demographic for Ewing Sarcoma?
10-15 y/o white male
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What are the clinical presentation of Ewing Sarcoma?
Pain, mass formation, inflammation symptoms
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What's the metatsatsis profile of Ewing's Sarcoma?
Metastasizes early (lung & bones)
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What's the 5-year survival of Ewing's sarcoma post surgery/chemo/radioation therapy?
40-70%
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What's the most common location of ewing's sarcoma?
Diaphysis of long bones of extremties (femur/tibia)
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What's radiologic finding of ewing's sarcoma?
"Onionskin layering" of new bone around tumor
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What's the cellular pattern of ewing's sarcoma?
- Small round blue cells larger than lymphocytes
- Low mitotic index
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What's the staining characteristics of ewing's sarcoma?
PAS+, light/dark pattern
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What's the genetic expression of Ewing's sarcomas?
- t(11;22) translocation - PNET & Ewings
- Overexpression of MIC2 gene (CD 99)
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What's the difference between Ewing's and PNET?
Homer Wright Rosettes in PNETs
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What's the principal demographic of Giant cell tumors of bone?
20-40 y/o Chinese female
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What's the metastasis profile of Giant cell bone tumors?
Rare
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What's the most common location of involvement for giant cell tumors of bone?
- Deisal femur, proxima tibia, distal radius, sacrum
- Metaphyseo-epipyseal portion of bone extending to subchondral/articular cartilage
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What's the histological characteristics of giant cell tumors of bone?
Hypercellular with numerous multinucleated ginat cells (look like osteoclasts)
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What's the clinical presentation of osteomyelitis?
malaise, chills, fever, leukocutosis, pain
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How is osteomyelitis diagnosed?
- biopsy of infected bone
- treat even when no organism is found
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What are the most common infectious agents of ostomyelitis?
- Staph aureus - most common in kids
- Salmonella - sickle cell anemia
- IV abuse/GU infections - Gram negatives
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What's the treatment for osteomyelitis?
5-25% fail to resolve -_ surgeical removal
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Where is the most common site of pyrogenic osteomyelitis?
Metaphysis --> lifting of periostium --> inschemia & necrosis
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What's sequestrum & involucrum?
- Sequestrum: bone necrosis
- Invlucrum: new bone formation surrounding sequestrum
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What are complications of chronic osteomyelitis?
- Squamous Cell Carcinoma (due to inflammation)
- Amyloidosis (AA)
- Pathologic fractures, endocarditis, sepsis, sarcoma
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What are common paths of bacteria to bone?
Hematogenous or direct contact (trauma)
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What are bone-related clinical signs of Vitamin D deficiency?
- Widened epophyseal plates (writst, kennes, ankels), decreased mineralization of bone
- Bowing of legs, rosary of ribs, flattening of skull/pectus
- Delayed fontanelle closure, delayed teeth erruption
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What are non-bone symptoms of vitamin D deficiency?
Hypocalcemia, heart failure, myelofibrosis, pancytopenia
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What's the differnece between osteomalacia and rickets?
- Osteomalacia: adults; softening of bone (osteopenia), increased fracture risk
- No growth plates --> no rickets symptoms
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What's the difference between ostomalacia nd osteoporosis?
- Osteomalacia: minerlaization defect; pain possible with hydration of matrix
- Osteoporosis: loss of bone mass; no bone pain
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What's the histological difference seen in osteomalacia?
Non-minearlized stains pink vs. violet (darker) in mineralized bone
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What is Ollier disease?
What's it associated with?
- multiple enchondromas
- soft tissue hemangiomas (Maffucci sundrome)
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What is maffucci syndrome? What risk does it carry?
- Soft tissue hemangiomas in multiple enchondromas
- Increased risk of malignancies (ovarian carcinoma and brain gliomas)
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What is fibrous dysplasia of bone?
- benign lesion
- mono/poly-ostotic
- localized developmental arrest of bone growth
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What are the clinical presentation of fibrous displasio of bone?
- Monostotic: asymptomatic
- Polyostotic: deformities
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What's benign/malignant neoplasm of adipose?
lipoma/ liposarcoma
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What's benign/malignant neoplasm of blood vessel?
hemangioma/angiosarcoma
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What's benign/malignant neoplasm of smooth muscle?
leioma/leiomyosarcoma
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What's benign/malignant neoplasm of striated muscle?
Rhabdomyoma/rhabrodmyosarcoma
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What's benign/malignant neoplasm of nerve sheath?
neurilemoma/malignant peripheral nerve sheath tumor
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