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  3. Mock19 Pathological Fracture

Mock19 Pathological Fracture

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  • A Offline
    A Offline
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    wrote last edited by admin
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    Stem
    A young female was cycling when she suddenly developed pain in her thigh as soon as she put her foot on the ground. X-ray showed fracture shaft femur with hypodense shadow.

    What's the type of this fracture?

    Pathological fracture

    What's a pathological fracture?

    Bone fracture which occurs without adequate trauma and is caused by a pre-existent pathological bone lesion.

    What are the causes of a pathological fractures?

    1. Neoplastic: malignant tumours

    Primary (multiple myeloma)
    Metastatic

    1. Non-neoplastic:

    Osteoporosis
    Osteomyelitis
    Osteomalacia
    Osteogenesis imperfecta
    Paget's disease
    Bone cyst
    Radiotherapy

    What are the most common primary sources for bone metastasis?

    Breast
    Prostate
    Lung
    Thyroid
    Kidney

    What's the name of brain tumour causing sclerotic metastasis?

    Medulloblastoma

    Fracture was treated with internal fixation, how to check for malignancy?

    Bone biopsy

    Pathology results showed a typical bland appearance (follicular cells), what's the probable location of the primary?

    Thyroid gland

    A thyroid nodule was detected and FNA was done; however, it has not been able to rule out or confirm cancer, why?

    In follicular thyroid neoplasm, malignancy is determined by capsular and vascular invasion which need histology rather than a cytology to confirm

    What are the other sites of ectopic thyroid tissue other than head, neck and mediastinum?

    Ovarian and testicular teratoma

    Which investigation can be done to confirm thyroid metastasis?

    Radioactive iodine scan

    Which type of thyroid cancer that will show no response to iodine uptake?

    Medullary thyroid cancer as its origin is from parafollicular C cells so it is not of a follicular origin

    Tumour marker for Medullary thyroid cancer?

    Calcitonin

    The patient needed blood transfusion during surgery, what needs to be tested before a transfusion?

    ABO
    RH group cross matching

    If the patient's blood group is known, would you still need cross matching? Why?

    Yes, to determine if the recipient has pre-formed antibodies against any antigens on the donor's cells.

    What are the complications of incompatible blood transfusion?

    Acute haemolytic reactions
    Febrile non-haemolytic transfusion reaction
    Delayed haemolytic transfusion reactions
    Transfusion related acute lung injury

    Define haemolysis?

    Rupture (lysis) of RBCs and release of their contents (cytoplasm) in the surrounding fluid (blood, plasma)

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