Diseases

 METASTATIC BONE TUMORS (1)

1. Neuroblastoma aka sympathicoblastoma
   - 2nd mc abdominal neoplasm in childhood w/ Wilms' tumor being mc.
   - sunburst spiculation on skull, virtually pathognomonic of metastatic neuroblastoma
   (skull deposits widen sutures)
   - 75% arise w/in adrenal gland
   - 2/3 show granular calcification radiographically
   - skeletal metastases common (>50%)
   -  diffuse and symmetric, seldom monostotic

PRIMARY MALIGNANT BONE TUMORS (8-9)

1. Multiple Myeloma aka Kahler's dz aka Plasma Cell Cytoma
   MM results from a malignant proliferation of plasma cells which infiltrate bone marrow.  This is the most common primary malignant bone tumor.  90% of pts die within 3 years.  Treatment is usually radiotherapy and chemotherapy.
   - 50-70 yom, 2:1 over female
   -normochromic normocytic anemia (60% of pt's)
   - Elevated ESR
   - Rouleaux's formation (stacks of RBC's)
   - vertebrae, ribs, skull, pelvis aremc sites
   ~1845 (Henry) Bence Jones' proteinuria (40% of pt's)
   - electroimmunophoresis, M spike in IgG accurate >90%
   - A:G reversal common but note ddx for AG reversal includes sarcoidosis, chronic nephritis, chronic cirrhosis and lymphogranuloma venereum.
   - osteolytic defect include punched out lesions or raindrop skull - M&M's, same size lesions
   COLD Bone Scan
   - first Sx is pain which is palliated with bed rest and aggravated by weight bearing
2. Osteosarcoma (osteogenic sarcoma) the second most common primary malignant bone tumor derived from undifferentiated connective tissue which forms a neoplastic osteoid.  There are 5 distinct types; Central, Multicentric, Pareosteal, Secondary and Extraosseous.  The exact cause is unknown.
   - 10-25 yom, 2:1 over females and usually around the knee or shoulder.
   - The metaphysis abutting the physis is the classic location in 75% of cases
   - metastases to the lungs is common (cannonball metastases - sarcomatous bone growths within the lungs) as such, spontaneous pneumothorax is common.
   - Painful swelling of involved limb is a common presenting Sx
   - Elevation of serum alkaline phosphatase is the only consistent laboratory finding.
   Three basic patterns of cases - 50% Sclerotic, 25% lytic, 25% mixed
   - 20% 5 years survival rate, 80% survival rate with intensive chemotherapy
   Amputation is the best treatment
3. Chondrosarcoma is the third most common primary malignant bone tumor.  The Central type (pelvis, proximal femur & humerus) is 5 times more common than the peripheral presentation.  It has a chondrogenic origin that remains essentially cartilaginous throughout its evolution.
   40-60 yom, 2:1 over female
   Chondrosarcoma is the most common primary malignant bone tumor of the hand....
   Tx - Local excisions, segmental resectin or amputation
   Prognosis is good with 90% survival after early surgery
4. Ewing's Sarcoma - fourth most common primary malignant bone tumor with a 7% presentation rate.  Originally descri ed in 1921 by james Ewing as endothelioma of bone or endothelial myeloma.
   10-25 yom 2:1 over female
   Sx mimic infection.
   radiologically presents with diaphyseal permeative lesion with a delicate onion skin or peel periosteal response.
   Tx - amputation around knee, radiation & chemo in early lesions offer a 35% 5-year survival rate.
   - most likely sites are the long tubular bones of the lower extremities (femur, tibia, fibula) the innominate is the mc flat bone affected.
   - lower incidence among blacks in the US and Africa
5. Solitary Plasmacytoma
6. Parosteal Sarcoma
7. Fibrosarcoma - represents 2% of all primary malignant bone tumors.
   - ages range from 4 to 83 but most commonly from 30 to 50 with no sex preference
   - mc found in tubular bones of younger patients & flat bones of older patients
   - The only 1* malignant bone tumor in which sequestration is found.
   Tx - amputation with joint disarticulation, even after this surgery metastasis is >70% and 5-year survival is 30%
8. Chordoma -1% incidence. this 1* malignant bone tumor arises from the bestigial remnants of the notochord.
   - no age is exempt but most often 40-70 yom, 2:1 over females
   - sacrum & skull
   - locally aggressive with a slow growth rate
   Tx - varies according to location
   Prognosis for intracranial & vertebral lesions is poor w/ most pt's dying w/in 3 years
   5-year survival for sacrococcygeal chordomas is 8.7%
9. Non-Hodgkin's Lymphoma of Bone (reticulum cell sarcoma) -
10. Hodgkin's Lymphoma of Bone -
11. Synovial Sarcoma -
12. Adamantinoma -

PRIMARY BENIGN BONE TUMORS (11-20)

1. Solitary Osteochondroma -
2. HME - Hereditary Multiple Exostosis -
3. Hemangioma -
4. Osteoma -
5. Gardner's Syndrome -
6. Bone Island -
7. Osteoid Osteoma -
8. Osteoblastoma -
9. Solitary Enchondroma -
10. Multiple Enchondromatosis (Ollier's dz) -
11. Maffucci's Syndrome -
12. Periosteal Chondroma -
13. Chondroblastoma -
14. Chondromyxoid Fibroma
15. Fibrous Xanthoma of Bone: Non-Ossifying Fibroma
16. Fibrous Xanthoma of Bone: Fibrous Cortical Defects
17. Simple Bone Cyst -
18. Aneurysmal Bone Cyst -
19. Intraosseous Lipoma -

TUMOR LIKE PROCESSES (3-23)

1. Paget's Disease -
2. Fibrous Dysplasia -
3. Neurofibromatosis -

 A R T H R I T I S

DEGENERATIVE ARTHRITIC DISORDERS (6-30)

1. DJD - Degenerative Joint Disease -
2. Erosive Osteoarthritis -
3. DISH - Diffuse Idiopathic Skeletal Hyperostosis aka Forestier's dz and about 10 other aka's....
   >50 yo & male
   ALL - anterior longitudinal ligament calcification -
   ~20% w/ DM
   ~20% w/ dysphagia - also hoarseness of the voice, stridor and dyspnea
   DX (definitive criteria)
   1.  flowing calcification & ossification along anterolateral aspect of at least 4 contiguous vertebrae
   2.  IVD height is preserved
   3.  absence of apophyseal joint ankylosis and sacroiliac joint erosion, sclerosis or intra-articular osseous fusion
   DDX - DJD & AS
4. OPLL - Ossified Posterior Longitudinal Ligament Syndrome -
5. Neorotrophic Arthopathy - probably - check it, you know what i'm thinking.....
   DEF - a destructive articular dz that occurs secondary to a loss or impairment in joint proprioception, the involved joint undergoes premature and excessive traumatic degenerative changes - severe destruction and instability.
6. Synoviochondrometaplasia -

INFLAMMATORY ARTHRITIC DISORDERS (9-39)

1. RA - Rheumatoid Arthritis -
2. Juvenile Rheumatoid Arthritis -
3. AS - Ankylosing Sondylitis -
4. Enteropathic Arthritis -
5. Psoriatic Arthritis -
6. Reiter's Syndrome -
7. SLE - Systemic Lupus Erythematosus -
8. Jaccoud's Arthritis -
9. Idopathic Chondrolysis of the Hip -
10. Scleroderma - silver scales ...pitted nails ...and it is found on extensors..... (sing along...)
11. OCI - Osteitis Condensans Ilii -
12. Osteitus Pubis -
13. Hypertrophic Osteoarthropathy -

 METABOLIC ARTHRITIC DISORDERS (5-44)

1. Gout -
2. CPPD - Calcium Pyrophosphate Dihydrate Crystal Deposition Disease -
3. HPPD - Hydroxyapatite Deposition Disease -
4. Ochronosis - (this was always one of my favorites) :)
5. Tumoral Calcinosis -
6. Sarcoidosis -
7. Pigmented Villonodular Synovitis -

1. contrast above metabolic arthritieds with Pellegrini Striata
2. Heart Failure - CHF (Congestive Heart Failure) // Left sided heart failure
3. Heart Failure - Cor Pulmonale // Right sided heart failure
4. Myocardial Infarction (MI)
5. Strep Story = Strep throat, 2 week sequelae of glomerulonephritis, 2 month sequelae: carditis - subacute endocarditis affecting mitral & aortic valves (ECHO the heart)
6. Staph Story (Au, gold)
7. RA (juxta articular osteoperosis, phase of RA)
8. Bacterial Infections vs...
9. Viral Infections - also know how both affect the lungs and fremitis
10. DeQuervain's Syndrome (or tenosynovitis)
11. TOS - thoracic outlet syndrome
12. CTS - Carpal Tunnel Syndrome, maybe contrast with Tunnel of Guyon, etc
13. Horner's Syndrome - not really a nifty fifty in terms of frequency but, it will be asked about...
14. DM - diabetes mellitus - tail of pancreas - polydipsia, polyuria & polyphagia
15. DI - diabetes Insipidus - posterior pituitary - polydipsia, polyuria
16. Addison's dz (JFK)
17. Cushings (increased adrenocorticoids)
18. Myxedema
19. Grave's
20. Hashimoto
21. rickets, osteomalacia
22. Nephritis (infection) vs...
23. Nephrosis (death) ...HEP me!  HEP me!  (hypertension, edema, protenuria)
24. Prostate - Acute & Chronic Prostatitis - BHP & Cancer
25. Liver - hepatitis / cirrhosis // cancer
26. Gall Bladder - cholecystitis, cholelithiasis
27. Appendicitis
28. Crohn's dz
29. IBS (aka mucous colitis), etc
30. pregnancy ....
31. Heart sounds - stenosis & regurge (A PET Mouse)
32. QRS interpretations
33. Raynaud's
34. Buerger's (TAO)
35. Atherosclerosis / Arteriosclerosis
36. CREST
37. Aneurysm
38. RSDS / CRPS / Sudecks Atrophy .....
39. DVT
40. ANEMIAS! .....omg - tons of these......
    UCRAPE - PEAR..... - HLA-B27, ANA, RA Latex - inc ESR, Syndesmophytes
41. ulcerative colitus
42. Crohn's (duplicate entry)
43. Meniere's
44. COPD
45. Bronchogenic Carcinoma
46. emphysema
47. fibromyalgia
48. neuroblastoma
49. neurofibromatosis (coast of California) and Fibrous dysplasia (coast of main) - cafe au lait
50. pheochromocytoma
51. SCE - slipped capital epiphysis
52. ugh - can't think of the ddx that goes with SCFE .....different age - similar.....LCP!!!
53. stroke - "brain attack" (maybe put by MI)
54. Os Fabella
55. Osteochondromatosis
56. Hodgkin's
57. Myasthenia Gravis - reminds me - neurology chart .....
58. Osteoid Osteoma
59. Syringomyelia
60. Pancoast tumor and / vs - Pancoast Syndrome
61. Nephrolithiasis
62. Scleroderma - one of the lady type S's ...... - contrast w/ the men's HLA-B27's
63. Skin cancers - basic - basal, squamous & Melanoma
64. PAGETS - how did this get so far down on the list......
65. Osteopetrosis
66. 2ndary HPT - renal osteodystrophy
67. 7 types of Spondylolisthesis
68. 8 basic types of fx
69. Muscular Dystrophy
70. ALS - amyotrophic lateral sclerosis
71. MG should go here
72. cerebral palsy
73. parkinsonism (aka paralysis agitans)
74. Guillain Barre
75. Brown Sequards
76. Charcot Marie Tooth (aka Peroneal dz)
77. CVA - (emiplegia
78. PLS - combined systems dz (posterior lateral sclerosis)
79. Multiple Sclerosis
80. subclavian steal
81. Wallenburg syndrome - post trauma (TIA)
82. BPV - and other vertigo's - also relate to HA - (benign paroxysmal positional vertigo)
    Meniere's (aka Endolymphatic hydrops (cnVIII)) can go here along w/ Horner's - syringomyelia should go with this neuro stuff as well.....
83. Cauda Equina syndrome - very important - S2toS4 - bowel & bladder control ...speaking of bladders...
84. Nocturnal Enuresis!  :)
85. UMNL vs LMNL - this is huge - find that spreadsheet
86. tennis elbow -
87. golfers elbow - aka little leaguers elbow
88. plantar fascitis
89. compartment syndrome - cross ref w/ shin splints
90. HA!  HeadAches ...work on knowing the timing and s/s for 14 most common types.....
91. Inversion sprain - m/c - anterior talofibular ligament
92. MFS
93. fibromyalgia - 11/18 tender points
94. terrible triad - knee - mm, acl, mcl
95. Bell's palsy - CN VII
96. Tic Douloureaux (my darling!) CN V - aka trigeminal neuralgia
97. CN II pathology - optic nerve lesions - bitemporal hemianopsia, for example
98. scoliosis - know different xray marking methods
99. upper cross syndrome
100. lower cross syndrome
101. know DR CUMA - Drop wrist due to Radial nerve, Claw hand due to Ulnar nerve, Median nerve lesion Ape hand
102. Morton's neuroma - know m/c location
103. winging scapula - due to long thoracic nerve - SALT on my Wings - serratus anterior, long thoracic

....i guess there are going to be a lot more than 50 ...might have to categorize these......