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INTERP -1 > BRETT LONG MIDTERM #2 BONUS EDITION > Flashcards

BRETT LONG MIDTERM #2 BONUS EDITION Flashcards

1
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Long zone of transition???

A

A

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2
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Short zone of transition???

A

B

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3
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Well-defined borders???

A

B

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4
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Ill-defined borders??

A

A

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5
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Corticalthinning, expansion without destruction??

A

B

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6
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Sclerotic rim or peripheral sclerosis??

A

B

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7
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Solid periosteal reaction???

A

B

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8
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Permeative/ Moth-eaten???

A

A

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9
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Cortical destruction???

A

A

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10
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Asymptomatic or post-traumatic pain???

A

B

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11
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Lesion size stable???

A

B

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12
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Codman’s triangle????

A

A

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13
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Painful & growing???

A

A

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14
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Solid, laminated or spiculatedperiostealreaction???

A

A

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15
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Soft tissue involvement or mass???

A

A

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16
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Leukemia Childhood Osteosarcoma(conventional)
Ewing’s sarcoma Hodgkin lymphoma
Non-Hodgkin lymphoma

A

A

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17
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Enstoma
Fibrous cortical defect
Simple bone cyst
Osteoid osteoma

A

B

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18
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Fibrosarcoma
Chondrosarcoma(conventional) Chordoma
Leukemia Adult

A

A

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19
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Ollier’s disease
Maffucci syndrome
Non ossifying fibroma
Chondroblastoma

A

B

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20
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Solitary plasmacytoma(single multiple myeloma)   Metasisis
Multiple myeloma
A

A

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21
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Aneurysmal Bone Cyst (ABC)
Osteoblastoma
Osteochondroma (solitary)
Hereditary multiple exostoses

A

B

22
Q

General Concepts of Bone Tumors

IS THIS AGGRESSIVE OR BENIGN??

Chondromyxoid fibroma
Enchondroma (solitary)               
Giant cell tumor 
Hemangioma (solitary)               
Intraosseous lipoma
A

B

23
Q

Secondary Tumors of bone - Metastasis x3

1-____________:

  • Single spots
  • sticks to bone through blood/lymph
  • Often in pelvis
  • If congenitally missing since birth, other pedicle would be sclerotic
  • DDX – infection (esp spine) cause don’t respect borde
A

Lytic

24
Q

Secondary Tumors of bone - Metastasis x3

2-__________:

Multiple
•Osteoblast turned on – blastic metastasis

A

Blastic

25
Q

Secondary Tumors of bone - Metastasis x3

3-____________:

Blastic
&
Lytic
Ex. Fracture

Ex. Blow Out
Acralmet – below elbow/knee

A

Mixed

26
Q

BONY TUMOR X 5

1._______________

  • Solid periosteum
  • Central “NIDUS” (focal dense area)*****KEY!!!!
  • Surround by sclerotic bone
  • Asprin takes pain away (unlike Ostesarcoma
A

Osteoid Osteoma

27
Q

BONY TUMOR X 5

2._____________

Takes time (MISSING PEDICLE!!!) ****KEY
•Expansive
•Soap bubbly
•Benign
---USUALLY  POSTERIOR ON SPINE!!! ****KEY!!!
A

Osteoblastoma OR Aneurysmal Bone Cysts (ABC)

28
Q

BONY TUMOR X 5

3._______________

Osseous
Opaque
ONLY IN SKULL ***KEY!!!
ONLY ADULTS **KEY!!

A

Osteoma

29
Q

BONY TUMOR X 5

4.__________________

  • Osseous in pelvis
  • Lesion tails off into medullary bone
  • “BONE ISLAND” *****KEY!!!!
A

Enostoma

30
Q

BONY TUMOR X 5

5.________________

•Mixed periosteal reaction 
•Spiculated
---highly aggressive
---DISTAL FEMUR VERY COMMON
---CORTICAL DESTRUCTION
---OFTEN A LARGE SOFT TISSUE MASS ****KEY!!
•Hair on end
•Long zone of transition 
•In kid

———-Three patterns
•Sclerotic (50%)
•Mixed (25%)
•Lytic (25%)

A

Osteosarcoma

31
Q

Cartilaginous Tumor X 4

1.______________________

•Lucent lesion
•Endosteal scalloping
•Punctate calcification (cart calc) 
---OFTEN IN THE FINGERS ****KEY!!
•May have serpiginous calcification---CALCIFICATION IS USUALLY FOUND WITHIN THE MATRIX OF THE LESION!! ***KEY!!!
A

Enchondroma

32
Q

Cartilaginous Tumor X 4

1-A._____________________

  • EXPANSILE!!
  • Multiple focus
  • Joint left alone
  • Lucent
  • SMALL BONES OF HAND **KEY!
  • Kid <10YOA
A

Multiple Enchondroma (Ollier’s)

33
Q

Cartilaginous Tumor X 4

1-B.__________________

  • Multi lucent, bony expansile
  • Calcification of VEIN in HAND **KEY!!!
  • Soft tissue expanded
  • Small discrete calcific soft tissue
  • Focus calcification
A

Maffucci

(Ollier’s w/ hemangioma [phleboliths])

34
Q

Cartilaginous Tumor X 4

2.____________

•Only in EPIPHYSIS in kid ***KEY!!
•Not much calcification
•Open growth plates
•May cause pain
--BENIGN TUMOR
A

Chondroblastoma

35
Q

Cartilaginous Tumor X 4

3–A._______________

•Around joint near physical plate
-----W/stalk ******KEY!!!!
•Calcify due to cartilage @ edge
•Well defined
--GROW OUT AND AWAY FROM THE NEAREST JOINT.
A

“Pedunculated” Osteochondroma

36
Q

Cartilaginous Tumor X 4

3–B._____________________

  • Bony broad base
  • Cartilaginous cap w/o stalk **KEY!!!
A

Sessile Osteochondroma

37
Q

Cartilaginous Tumor X 4

3–C.____________________

  • Multi-lesion
  • Pedunculated AND!!! Sessile
  • Hereditary
A

Hereditary Multiple Exostosis (genetic) or

Osteochondromatosis (non-genetic)

38
Q

Cartilaginous Tumor X 4

4.______________

•Expansion
•Cartilaginous matrix
•OSSEOUS DESTRUCTION W/STIPPLED CALCIFICATION
•Border ill defined w/ soft tissue
–ARC AND RING CALCIFICATION **KEY
–ESSENTRIC TYPE WITH A SOFT TISSUE MASS
–PRIMARY OR SECONDARY TYPES EXIST **KEY!!
(SECONDARY = MORE “DISTANT METASTASIS AND MORE AGGRESSIVE)

A

ChondroSARComa

“SARC…THROW ME THE RING!!”

39
Q

Soft Tissue Tumor X 4

1._______________

•Well defined, SMALL (UNDER 3 CM) **KEY!!!
•Hazy, frosted, groundglass
•Eccentric
•Kid
–FOUND AT THE CORTEX OF BONE
–LOWER EXTREMITIES OF CHILDREN
–WELL DEFINED WITH A THIN RIM OF SCLEROSIS.

A

Fibrous Cortical Defect

40
Q

Soft Tissue Tumor X 4

2-A.____________________

•Soap bubble,  Hazy
•No calcification
•Lucent, Well defined
•Thin cortex
•Septated (walls w healed fx)
•Kid
---LOWER EXTREMITIES
---LARGER THAN 3 CM
---ECCENTRIC AND MULTI-LOCULATED ***KEY!!!
A

Non Ossifying Fibroma

41
Q

Soft Tissue Tumor X 4

3.___________

•HAZY, SMOKY SCLEROSIS OF INNER MATRIX ***KEY!!
•Well defined
•Long lesion in long bone
—CAN HAVE ONE BONE = MONOSTATIC - COMMON
–CAN HAVE TWO BONES = POLYSTOTIC
—CAN BE SOAP BUBBLY

A

Fibrous Dysplasia

Slut of all tumors

42
Q

Soft Tissue Tumor X 4

4._________

•Hazy lesion
•Path/fracture
•Aggressive periosteal reaction **KEY!!!
—AND SOFT TISSUE MASS
—MOTH EATEN OR PERMEATIVE OSTEOLYTIC REACTION
—UNCOMMON MALIGNANT TUMOR
•Quick, but Rare

A

Fibrosarcoma

43
Q

Other Tumors—set #1

1._____________

•Multi punch lesion in multi bone
•No periosteal reaction
•Osteoblastic activity inhibitied due to osteoclast activity
increased
—LOOKS LIKE “OLD AGE SPOTS” **KEY!!!
—MOST COMMON “PRIMARY” TUMOR OF BONE
–ARISES FROM MONOCLONAL RED MARROW PLASMA CELLS.

A

Multiple Myeloma

**AS A SINGLE LESION THIS IS CALLED A:

PLASMACYTOMA

44
Q

Other Tumors—set #1

2._________________

  • –PELVIS AND LOWER EXTREMITIES
  • –LAMINATED **KEY!!!!
  • –OR HAIR ON END PERIOSTEAL REACTION IS VERY COMMON……….KEY!!!!
  • –LARGE SOFT TISSUE MASS IS OFTEN PRESENT
  • –OFTEN CLINICALLY DIFFERENTIATED WITH INFECTION AND OSTEOSARCOMA
A

EWING SARCOMA

45
Q

Other Tumors—set #1

3.___________

—METADIAPHYSIS HIT HARD THAT FRACTURE OCCURS THERE….KEY!!!
—-PERMEATIVE DESTRUCTION
—PERIOSTEAL REACTION IS MINIMAL
—MALIGNANT TUMOR ARISING FROM LYMPHOCYTES
UMMM…KEY!!!

A

LYMPHOMA W/PATHOLOGICAL FRACTURE

46
Q

Other Tumors—set #1

4.__________

YOU SEE A VERY BRIGHT WHITE VERTEBRAL BODY, IT IS MOST LIKELY???

A

HODGKIN’S IVORY VERTEBRA

47
Q

Other Tumors—set #1

5.___________

YOU SEE RADIOLUCENT BANDS ***KEY!!!
= NO GROWTH
AND MAYBE CIRCULAR PUNCHED OUT LESIONS
WHAT IS IT??

A

LEUKEMIA

48
Q

Other Tumors—set #1

6._________________

YOU SEE CORDUROY CLOTH **KEY!!!
–VERTICAL TRABECULA

A

HEMANGIOMA

49
Q

Other Tumors—set #2

A

SEE SLIDE 6

50
Q

Other Tumors—set #2

A

SLIDE 6

INTERP -1 (12 decks)

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