113 Questions
What is the recommended volume of fixative to be used compared to the specimen volume?
Ten times the volume
Which tissue consistency requires more time for thorough fixation?
Hard tissues
What is the main advantage of using 10% neutral buffered formalin as a fixative?
Little shrinkage
Which component of formalin affects tissue stainability if it stays for a long time?
Formic acid
Why does formalin need to be changed every 3-6 months?
To prevent formic acid formation
Which of the following is NOT an advantage of using 10% neutral buffered formalin as a fixative?
Minimize tissue shrinkage
What is the quickest way to determine if a mass is a malignant tumor?
Conducting a frozen section after biopsy
What is surgical pathology primarily concerned with?
Studying tissues removed during surgery
Which of the following is NOT a method for specimen collection for surgical pathology?
Swabbing the skin surface
What is the purpose of fixation of tissue in surgical pathology?
To preserve tissue structure for microscopic examination
Which of the following is an advantage of using formalin for fixation in surgical pathology?
Preserves tissue structure well
What are the two main contents of the routine work associated with a surgical pathology specimen?
Microscopic examination and gross examination
What is considered the 'gold standard in diagnosis' in pathology?
Microscopic examination
Which type of biopsy is performed specifically for both diagnosis and treatment?
Excisional biopsy
What is the recommended action for ulcerated lesions, including tumors, during biopsy?
Perform peripheral biopsy
Which method is the routine and widely used procedure for paraffin embedding in surgical pathology?
Paraffin embedding method
In surgical pathology, what is the primary purpose of gross examinations of specimens?
To evaluate size and shape of specimens
What is the general recommendation regarding the fixation of specimens meant for paraffin sectioning?
Fix in fixatives ASAP
What might happen when formalin solution is stored for a long period?
Formation of white precipitate
Which step involves dissolving paraffin using xylene in the procedures for paraffin section?
Clearing
What is the standard method used for staining in paraffin sections?
H & E staining
Which step involves cutting tissue into very thin sections in the procedures for paraffin section?
Sectioning
How can para-formaldehyde be removed from tissues?
By using alcohol
What is the first step in the procedures for paraffin section?
Fixation with 10% formalin
What is the purpose of mounting media in the context of H & E staining?
To enhance visibility by staining the nucleus blue and the cytoplasm pink-red
What distinguishes a frozen section from a permanent section?
Frozen sections are immediate but not permanent
What is the main purpose of assessing the presence or absence of ganglion cells in the large intestinal wall of Hirschsprung disease using frozen sections?
To confirm the diagnosis of Hirschsprung disease
Why are specimens like thyroid tissue considered inappropriate for frozen section analysis?
Thyroid follicular lesions are difficult to differentiate between benign and malignant
In the context of frozen sections, why is it recommended to use fresh tissues and small tissue sizes?
To enhance visibility by proper staining techniques
What is a Cryostat primarily used for in frozen section analysis?
To make thin sections of fresh-frozen tissues
Which structure represents the most common accessory ossicle in the foot?
Accessory navicular
What type of ossicle is classified as a true sesamoid because it is located within a tendon?
Small ossicle proximal to navicular tuberosity
Which type of articulation causes an exaggerated prominence at the head of the talus in the foot?
Supination of subtalar joint
Which prominence in the foot remains virtually unaffected by subtalar joint motion?
Navicular prominence
What radiographic feature distinguishes a true accessory scaphoid from other foot prominences?
Fibrous connection to navicular
In foot deformities, which condition is characterized by soft tissue inflammation rather than bone abnormalities?
Neuritis
What is the primary surgical treatment for a Type III talonavicular prominence?
Resection of the tuberosity
How is surgery for Type II different from surgery for Type III?
Excision of the ossicle from the tendon
What is a common initial conservative treatment for navicular prominences?
Non-weight bearing
What adjunctive procedures may be considered in addition to surgical arthrodesis for navicular prominences?
TN fusion
What surgical approach is taken for Type I talonavicular prominences?
Tendon splitting approach
What should be done intraoperatively for Type II talonavicular prominences to locate the mobile piece of bone?
Isolate the location using fluoroscopy
What type of dorsal exostosis is characterized by an angular malalignment at the 1st metatarsal-cuneiform joint?
Type III
What is the possible etiological agent for dorsal bossing of the 1st tarsometatarsal joint?
Charcot arthropathy
In which type of dorsal exostosis is there involvement of the Lisfranc's joint along with the 1st metatarsal-cuneiform joint?
Type IV
Which type of dorsal exostosis is associated with a history of arthritis and an arthritic component at the 1st metatarsal-cuneiform joint?
Type II
What characteristic distinguishes Type V dorsal exostosis from the other types?
Pseudo exostosis formation
Which type of dorsal exostosis is secondary to forefoot valgus and plantarflexed 1st ray?
Type I
What is the recommended treatment for a patient with navicular cuneiform joint prominence?
Fusion of the articular surface
Where is the Os Vesalianum typically located in the foot?
Base of the 5th metatarsal
In children, pain associated with an extremely large tuberosity of the Os Vesalianum is usually related to:
Physical activity
Where is the Os Peroneus accessory bone commonly located?
Inferior to the peroneal groove
What is the primary consideration when approaching accessory bones of the foot with symptomatology?
Pain characteristics
What is a potential surgical intervention for managing an Os Peroneus fragment?
Attachment to the peroneus brevis tendon
What is the most likely reason for irritation of the Os Trigonum?
Friction caused by the flexor hallucis longus muscle
What action is commonly taken in the treatment of symptomatic Os Trigonum?
Excision of accessory sesamoids
What is the best description of the position of the Os Subfibulare?
Situated between the fibula and tibia
Which anatomical structure is most commonly involved in chronic ulcers near the sub IPJ?
Flexor hallucis longus tendon
In what age range does the Os Trigonum typically unite or fuse with the talus?
By age 18
What is a common symptom associated with a painful left ankle in a 32-year-old male?
+edema on lateral ankle
What characteristic distinguishes a Type II talonavicular prominence?
It appears radiographically as an extension of the navicular
In the context of foot prominence, which deformity is associated with ganglionic cysts?
Neuritis
At what age does the accessory navicular typically become radiographically apparent?
9-11 years
What causes an exaggerated prominence at the head of the talus in the foot?
Pronation of the subtalar joint
What is a distinguishing feature of a Type I talonavicular prominence?
It is classified as a true sesamoid within a tendon
Which prominence in the foot remains virtually unaffected by subtalar joint motion?
Navicular prominence
Which surgical procedure involves resection of the tuberosity following the normal contour of the bone for Type III talonavicular prominences?
Fluoroscopy-guided excision
What is the primary procedure of choice for Type III talonavicular prominences, with adjunctive procedures potentially needed?
Arthrodesis of the talonavicular joint
What is the recommended conservative initial treatment for navicular prominences before considering functional orthosis if severe pronation is present?
Immobilization and NSAIDs
Which surgical approach involves reflection of the posterior tibialis from the talonavicular joint capsule for Type I talonavicular prominences?
Fluoroscopy-guided tendon splitting
What is a potential consequence of excision of the fragment in Type II talonavicular prominences?
Weakening of the tendon and capsule
What should be done intraoperatively to visualize the entire tuberosity for Type II talonavicular prominences?
Fluoroscopy-guided location isolation
What is the recommended surgical intervention for navicular cuneiform joint prominence if the articular surface is involved?
Midfoot fusion
In patients with an extremely large tuberosity of the Os Vesalianum in children, what is a characteristic of pain?
Pain related to shoe gear irritation
What is the etiological agent for dorsal bossing of the 1st tarsometatarsal joint?
Plantarflexed 1st ray
What is the primary treatment for symptomatic Os Trigonum before considering surgical intervention?
NSAIDs
What distinguishes Type V dorsal exostosis from other types?
Pes cavus
Where is the Os Peroneus accessory bone commonly located in relation to the cuboid bone?
Inferior to the peroneal groove of the cuboid
In Type IV dorsal exostosis, which joint apart from the 1st metatarsal-cuneiform is involved?
Lisfranc's joint
What differentiates OS VESALIANUM from other common symptomatic ossicles in terms of location?
Lies at the base of the 5th metatarsal
What angular malalignment is present in Type III dorsal exostosis?
Dorsiflexed
What distinguishes OS PERONEUS as an accessory bone in terms of its classification?
Considered a sesamoid bone
What is associated with Type II dorsal exostosis?
History of trauma
What is the etiology of Type I dorsal exostosis?
Forefoot varus malalignment
What surgical intervention was performed on the 32-year-old male patient with a painful left ankle?
Excision of an accessory ossicle
What is the primary cause of irritation usually associated with the Os Trigonum?
Flexor hallucis longus irritation
At what age does the Os Trigonum usually unite or fuse with the talus?
18 years
What is the main treatment for Type III talonavicular prominences?
Excision of ossicle
What was the primary treatment for the 47-year-old male with a chronic ulcer at the sub IPJ?
Conservative care
What is the primary purpose of a biopsy of a bone tumor?
To identify the type of bone tumor
How are 'narrow' margins of a bone tumor defined?
0.1-1.0 mm
What do 'geographic,' 'motheaten,' and 'permeative' refer to in bone tumor evaluation?
Characteristics of pathological findings on diagnostic studies
What do poorly defined margins of a bone tumor indicate?
There is an unclear border between tumor and normal bone
What does periosteal reaction indicate in a bone lesion?
Biologic activity of the bone lesion
When should a referral to an Oncologist be considered for a patient with a suspected bone malignancy?
Upon recognition of pathological findings on diagnostic studies
What is the most common bone tumor found in the foot and ankle according to the text?
Chondrosarcoma
What is the average age of the patients treated for tumors of the foot and ankle according to the text?
22.6 years
What percentage of patients showed good to excellent functional results after treatment of foot and ankle tumors?
82%
What is the most common surgical treatment for foot and ankle tumors based on the text?
BKA (Below-Knee Amputation)
Which type of biopsy involves cutting tissue into thin sections in the context of bone tumors according to the text?
Fine needle biopsy
What is the common follow-up duration range for patients treated for foot and ankle tumors as per the text?
1 to 13 years
What is the radiographic appearance when growth is very rapid and the periosteum cannot lay down bone?
Sun-burst appearance
Which type of lesion requires over treatment with marginal excision that removes the intra articular surface with associated fusion?
Stage 2 benign lesions
What type of lesions show evidence of continued growth and require surgical intervention with methyl methacrylate augmentation?
Aggressive radiographic presentation lesions
Which type of lesion, based on staging, may require a partial or complete amputation at the appropriate level?
Malignant stage 2
What characteristic distinguishes stage 3 malignant lesions from other stages in terms of treatment?
Presence of metastasis
What is the primary surgical intervention for high-grade malignant lesions?
Partial or complete amputation
What is the appropriate treatment for a 35-year-old female with a mass present in the lateral right foot centered over the 5th mpj?
Excision of the lesion with bone curettage
What is the most likely diagnosis for a 14-year-old male with heel pain unresponsive to conservative treatment?
Aneurysmal bone cyst
What procedure would be indicated for a 27-year-old female with an intra-osseous ganglion in the ankle joint?
Excision of the lesion with bone curettage
What differentials would be suitable for a 12-year-old male with an increase in level of activity and no significant past medical history?
Radiographs
What is the likely diagnosis for a 57-year-old female presenting with severe pain in the hallux?
Dorsal exostosis
What surgical intervention is most likely required for a 37-year-old male with pain in the right hallux of 4 months duration?
Excision of the lesion with bone curettage
Test your knowledge on surgical pathology objectives like definition of surgical pathology, biopsy, fixation of tissue, and more. Learn about the routine work associated with a surgical pathology specimen and different methods for specimen examination.
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