DPM Podiatric Pathology 2

Question 1

Which histological finding is most characteristic of a plantar fibroma (Ledderhose disease)?

Accepted Answer

Proliferating myofibroblasts within the plantar fascia

Answer

Plantar fibromas consist of proliferating myofibroblasts embedded in a collagen-rich stroma within the plantar fascia.

Question 2

A biopsy of a subungual lesion shows a vascular proliferation with a central fibrous core and surrounding epithelium. What is the most likely diagnosis?

Accepted Answer

Acquired digital fibrokeratoma

Answer

Acquired digital fibrokeratoma presents as a hyperkeratotic protrusion with a fibrovascular core covered by acanthotic epidermis.

Question 3

Which pathological change defines Charcot neuroarthropathy in its acute phase at the histological level?

Accepted Answer

Osteoclastic bone resorption with periosteal new bone formation

Answer

Acute Charcot arthropathy is characterized by osteoclast-mediated bone resorption driven by an autonomic neuropathy-induced inflammatory cascade.

Question 4

A 55-year-old diabetic patient has a heel ulcer with a biopsy showing fibrin exudate, granulation tissue, and no epithelialization. This corresponds to which wound healing phase?

Accepted Answer

Proliferative phase

Answer

Granulation tissue formation is the hallmark of the proliferative phase, even when epithelialization is delayed as in chronic diabetic wounds.

Question 5

Which type of osteomyelitis is most commonly caused by hematogenous spread in children affecting the long bones of the foot?

Accepted Answer

Type A (metaphyseal)

Answer

Hematogenous osteomyelitis in children preferentially affects the metaphysis due to its sluggish blood flow and lack of phagocytic lining cells.

(DPM) Doctor of Podiatric Medicine Practice Test

(DPM) Doctor of Podiatric Medicine Practice Test

DPM Podiatric Pathology 2