Chapter 27 WS Flashcards

1
Q

What is the most common primary bone tumor in children?

A

osteosarcoma

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2
Q

What is the most common primary bone tumor in adults?

A

chondrosarcoma

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3
Q

What is the 2nd most common primary bone tumor in adults?

A

osteosarcoma

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4
Q

what is multiple myeloma

A

A malignant disease of the plasma cells which causes as abnormal absorption of bone resulting in painful osseous lesions

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5
Q

In general, do most primary bone tumors occurs more often in males or females?

A

males

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6
Q

are giant cell tumors (GCT) most often benign or malignant?

A

benign

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7
Q

which is more common, primary bone disease or metastatic bone disease?

A

mets

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8
Q

what is the most common primary cancer to spread to bone?

A

lung cancer

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9
Q

translocation of what chromosomes are most often associated with Ewing Sarcoma?

A

11 and 22

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10
Q

define diaphysis

A

main shaft of the bone

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11
Q

define epiphyses

A

the knoblike portion at either end of a long bone

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12
Q

define periosteum

A

the hard dense covering of the bone

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13
Q

where is the most common sites of occurrence of osteosarcomas?

A

Distal femur followed by the proximal tibia and the proximal humerus.

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14
Q

Where do Ewing sarcomas most often develop?

A

In the appendicular skeleton (pelvis, femur) seen more often in the diaphysis.

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15
Q

what three primary cancers most often mets to the bone

A

lung, breast, and prostate

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16
Q

in early stage breast cancer patients, are ER+ or ER- tumors most likely to metastasize to bone.

A

ER+

17
Q

what is the most common presenting symptom of a bone tumor

A

pain

18
Q

Chronic symptoms from a bone lesion is most likely to indicate a ___________ (benign or malignant) tumor whereas symptoms that rapidly progress over weeks or a few months is most likely ___________ (benign or malignant)

A

benign; malignant

19
Q

what is skip metastases

A

When a second, smaller focus of osteosarcoma in the same bone or a second bone lesion on the opposing side of a joint space appears. This is attributed to the extensive spread by the lesion into the marrow cavity of the bone.

20
Q

are most bone tumors radiosensitive or radioresistant?

A

radioresistant

21
Q

when is radiaiton used for treatment of osteosarcomas and chondrosarcomas?

A

Osteosarcomas-before surgery, with adjuvant chemotherapy, and when the tumor is unresectable. Radiation is advised for patients with positive surgical margins and partial resections and for nonsurgical candidates.

Chondrosarcomas-When the tumor cannot be completely removed as a result of proximity of critical structures.

22
Q

are chondrosarcomas chemosensitive?

A

no

23
Q

what is the standard treatment for muliple myeloma?

A

A combination of chemo and radiation. Chemo is given with curative intent, whereas radiation is effective in controlling the pain from a bony lesion (palliation)

24
Q

What is the purpose of radiation in the treatment of multiple myeloma?

A

Palliation, used to help manage a symptomatic lesion. The lesion is usually painful and can result in a fracture if not treated

25
Q

What dose of radiation is typically given to multiple myeloma patients?

A

30 Gy in 10-15 fractions

26
Q

What modalities are used in the treatment of Ewing’s sarcoma?

A

Surgery, chemo and radiation. Surgery is considered the primary treatment option

27
Q

When treating bone tumors and soft tissue sarcomas, why is it important to leave a strip of unirradiated tissue when planning the treatment portal?

A

To preserve lymphatic drainage to avoid fluid buildup

28
Q

List three radiopharmaceutical agents used for palliation of metastatic bone disease

A

Strontium-89, Samarium-153, and radium-223

29
Q

What is the most common soft tissue sarcoma that affects children?

A

rhabdomyosarcoma

30
Q

What is the common sites of metastasis of soft tissue sarcomas and which is the most common?

A

Lung, bones, liver, skin. Lung is most common

31
Q

When treating an upper extremity, how must the arm be positioned in relation to the body?

List two reasons why?

A

The arm must be extended away from the body.

To minimize scatter radiation to the body and to allow for any possible beam angle.