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Bone Path II > Bone Path II Quiz 1 > Flashcards

Bone Path II Quiz 1 Flashcards

1
Q

DDX: Young Adult (<40) With Primary Malignant Tumor

A 
Osteosarcoma (10-25)
Ewings Sarcoma (10-25)

Giants Cell Tumor (20-40)
Parosteal Osteosarcoma (30-50)
Non-Hodgkins Lympoma (20-50)

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2
Q

Most Common Primary Bone Malignancies

A

Multiple Myeloma (most)
Osteosarcoma
Chondrosarcoma
Ewings Sarcoma

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3
Q

DDX: >40 Lytic

A 
METS!
Multiple Myeloma (multiple)
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4
Q

Is osteosarcoma lytic or blastic?

A

50% Sclerotic
25% Lytic
25% Mixed

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5
Q

What is the most aggressive form of osteosarcoma?

A

Lytic

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6
Q

Primary Malignant bone tumors that like the Epiphysis

A

Giant Cell (metaphysis/diaphysis)
Clear Cell Chondrosarcoma
Fibrosarcoma

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7
Q

Expansile/ Soap Bubbly Lesions

A

Solitary plasmacytoma
Fibrosarcoma
Giant Cell Tumor

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8
Q

Pt with primary bone maligancy that is 10-25 years old. DDX

A

Osceosarcoma

Ewings Sarcoma

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9
Q

Pt that is 25-35 DDX

A

Giant Cell Carcinoma

Hodgkin’s Lymphoma

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10
Q

What is the most common cause of a missing pedicle?

A

Mets

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11
Q

Where does Mets like to go in bone?

A

Spine (40%)
Axial skeleton
Skull
Proximal extremities

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12
Q

What labs can you run to check for Mets?

A 
ESR
Serum Ca (lytic)
Alk Phos (blastic)
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13
Q

DDX for Ivory Vertebra

A

Osteoblastic Mets
Pagets
Hodgkins

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14
Q

What would you treat with to inhibit osteoclast activity?

A

Biphosphates

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15
Q

What is the most common symptom of MM?

A

Bone pain #1

Systemic Symptoms

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16
Q

What is the age group for MM?

A

50-70

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17
Q

How do you diagnose MM?

A

Elevated Serum Proteins= Reversed A/G Ratio (G>A)

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18
Q

Where does MM like to go?

A

Humerus, Femur, Diaphysis, Spine, Skull (same as mets)

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19
Q

What does MM look like on x-ray?

A

Multiple Punched out lytic lesions.

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20
Q

If its looks like mets, but there is one one lesions, what do you suspect?

A

Solitary Plasmacytoma

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21
Q

What do Solitary Plasmacytomas look like on x-ray?

A

Lytic
Expansile
Soap Bubbly

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22
Q

What age group does Osteosarcoma affect?

A

10-25

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23
Q

Where do you most often see Osteosarcoma in bones?

A

Metaphysis of long bones.

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24
Q

What does osteosarcoma look like on x-ray?

A 
Cortical disruption
Spiculated
ST mass
Cumulus Cloud
Lytic 25% (more aggro) 
Blastic 50%
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25
Q

What ancillary study do you use to plan treatment in Osteosarcomas?

A

MRI

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26
Q

What ancillary study do you use to scan for mets with Osteosarcoma?

A

CT/Bone Scan

27
Q

Can you use bone scan to look for MM?

A

No- doesnt show up

28
Q

Where is mets most common from Osteosarcoma?

A

Lung (Cannonball mets)

29
Q

Dense mass with stalk to cortex and no periosteal response. DDX

A

Parosteal Osteosarcoma

Myositis ossificans (no stalk)

30
Q

What age group do Parosteal Osteosarcomas affect?

A

30-50

31
Q

What is the most common primary malignancy of hand, sternum, scapula?

A

Chondrosarcoma

32
Q

Where do you most commonly find Chondrosarcomas?

A 
Pelvis
Prox femur
Prox humerus
Ribs
Scapula
Knee
Craniofascial bones.
33
Q

What do Chondrosarcomas look like on x-ray?

A

Large
Lytic
Popcorn stippled calcifications
Can have large ST mass

34
Q

What age group are chondrosarcomas found in?

A

40-60

35
Q

Where is long bones do you find Chondrosarcomas?

A

Metaphysis (most)

Diaphysis (some)

36
Q

Where do you find Clear Cell Chondrosarcomas?

A

Epiphysis

37
Q

What age groups do Ewing Sarcomas affect?

A

10-25

38
Q

What are the symptoms Ewing Sarcomas?

A

Pain and swelling

Looks like an INFECTION

39
Q

In what part of bone do you most commonly find Ewing Sarcomas?

A

Diaphysis

40
Q

Are Ewing Sarcomas well defined?

A

No, wide zone of transition

41
Q

Does Ewing Sarcomas have a good prognosis?

A

No, often amputation if found

42
Q

Where do you most commonly find Fibrosarcomas?

A

Knee (50%)

43
Q

Do Fibrosarcomas have a periosteal response?

A

No, but they do have a large ST mass

44
Q

What is the treatment of choice for Fibrosarcomas?

A

Amputation

45
Q

Is the pronosis good for Fibrosarcomas?

A

No

46
Q

What is the msot common ST sarcoma in adjults?

A

Malignant Fibrous Histocytoma (MFH)

47
Q

What do Malignant Fibrous Histocytomas look similar to on x-ray?

A

Fibrosarcomas

48
Q

Where in the body are Chordomas most commonly found?

A

Sacrococcyggeal and Spheno-occipital regions.

49
Q

Is mets common with Chordomas?

A

No

50
Q

What are the symptoms in Chordomas most often from?

A

The mass of the tumor affecting surrounding tissues.

51
Q

Chodomas are lytic/blastic?

A

Lytic

52
Q

What age group does Non-Hodgkins Lympomas affect?

A

20-50

53
Q

Are Non-Hodgkin’s Lympoma pts healthy?

A

Usually, Yes

54
Q

Where is Non-Hodgkins Lympomas usually found?

A

Femur, Tibia, Humerus

55
Q

What does Non-Hodgkins Lymphomas look like on x-ray

A

Permeative (moth eaten)
Lytic
Minimal Periosteal Response

56
Q

What is the most common symptom of Hodgkins Lympoma?

A

Pain

57
Q

Where is Hodgkins Lympomas most common?

A

Verteba

58
Q

What does Hodgkins looks like in vertebra?

A

Ivory Vertebra

Poss exuberant peristeal response

59
Q

What age group does Synovial Sarcomas affect?

A

30-50

60
Q

Are Synovial Sarcomas painful?

A

Yes

61
Q

What do Synovial Sarcomas look like on x-ray?

A

Calcification in 1/3

Speckled

62
Q

How do you treat Synovial Sarcomas?

A

Excitation (mod good prognosis)

63
Q

What ancillary study do you use to check Synovial Sarcomas?

A

MRI

Bone Path II (5 decks)

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