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Bone > Cheung Part 1 > Flashcards

Cheung Part 1 Flashcards

1
Q

what are the 5 most common primary bone tumors that metastasize to bone

A 
"BLT with a Kosher Pickle"
Breast
Lung
Thyroid
Kidney
Prostate
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2
Q

what is the difference between the T and Z score

A

Z score is age matched

T score is compared to 25 yo female

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3
Q

musculoskeletal tumors come from what tissue

A

mesodermal (connective tissue like bone, fat, muscles)

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4
Q

musculoskeletal tumors are likely to metastasize to

A

the lung

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5
Q

what shows up radio opaque on an X-ray

A

bones
some soft tissue
hardware

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6
Q

what shows up radio-lucent on X-ray

A

air
sutures
ligaments

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7
Q

oblique X-ray of foot is at what angle

A

15 degrees

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8
Q

what type of break takes the lowest amount of energy to create

A

spiral

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9
Q

what type of break takes the most amount of energy to create

A

comminuted

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10
Q

what type of break goes straight across the bone

A

transverse

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11
Q

what type of break goes across the bone at an angle

A

oblique

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12
Q

over the age of 40 bone tumors are most likely what

A

metastatic

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13
Q

growing soft tissue masses re most likely what

A

malignant

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14
Q

excision is recommended for a benign bone tumor when

A

if it is aggressive

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15
Q

a benign soft tissue tumor grater than 5cm or is deep what is the recommended treatment

A

excision

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16
Q

in osteomyelitis the infection of the bone itself prefers what location

A

metaphysis

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17
Q

what is the most common and second most common causes of osteomyelitis

A 
staph aureus (#1)
hemolytic strep
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18
Q

what are the physical exam results for osteomyelitis

A

tenderness in bone
ROM of joints is OK (unlike septic arthritis)
swelling, warmth, redness, draining sinus

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19
Q

patients with osteomyelitis typically have what history

A

fever

achy, unrelenting night pain

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20
Q

what is seen in a CBS with diff for osteomyelitis

A

elevated WBC with left shift

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21
Q

what is seen on x-raty of the limb with osteomyelitis

A

may show Brodie’s Abscess

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22
Q

Brodie’s Abscess is seen in what

A

osteomyelitis

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23
Q

what is the gold standard of diagnosis for osteomyelitis

A

bone scan

24
Q

how is osteomyelitis treated

A

empire treatment with antibiotic (vanc) while waiting for Cx
surgical washout if no improvement in 2 days or if there is a clear abscess
chronic (eg diabetes) may need multiple treatments

25
Q

what is osteoporosis

A

low bone mass leading to micro architectural deterioration, causing increase fragility of bone

26
Q

what bones are commonly affected by osteoporosis

A

hip, spine, wrist, shoulder fractures

27
Q

what is the mortality rate at 1 year for all hip fractures

A

25%

28
Q

type 1 primary osteoporosis is due to what

A

postmenopausal osteoporosis caused by hormonal changes leading to bone loss

29
Q

type II primary osteoporosis is due to what

A

senile osteoporosis

caused by altered metabolism leading to bone loss

30
Q

secondary osteoporosis is due to what

A 
long term steroid use
hyperparathyoridism
hyperthyroidsm
renal failure
cancers
31
Q

what is seen in physical exam

A

loss of height
thoracic kyphosis
loss of menstruation

32
Q

what test and what score signifies osteoporosis

A

DEXA scan of spine, hip or femur

T or Z score less than -2.5 SD below mean

33
Q

what does NTx measure

A

bone collagen

34
Q

how is osteoporosis treated

A

bisphosphonates
calcitonin
pulsed PTH
SERMS

35
Q

how do bisphosphonates work

A

disrupting ruffled border of osteoclasts

36
Q

how does one prevent osteoporosis

A

maximize Ca/Vit D and WV exercise

minimize smoking, caffeine, meds

37
Q

osteosarcoma presents at what age

A

1st decade

38
Q

osteosarcoma has what clinical signs

A

swelling, night pain

39
Q

osteosarcoma like what bones and what part of the bone

A

metaphysis

knee, hip, pelvis

40
Q

what does osteosarcoma do to the bone

A

both plastic and lytic

41
Q

how is osteosarcoma treated

A 
micromets
neoadjuvent chemo
resection
reconstruction
chemo
NO RADIATION
42
Q

Ewings/PNET presents when

A

2nd decade of life

43
Q

what clinical signs are associated with ewings/pnet

A

swelling, night pain

44
Q

where and in what bones do Ewings/PNET affect

A

diaphyseal to metaphyseal
femur
pelvis

45
Q

what do Ewings/PNED to do to the bone

A

lytic

46
Q

what is the translocation and marker associated with ewings

A

t(11;22)
CD99+
small found blue cells

47
Q

how is Ewings/PNET treated

A

neoadjuvent chemo
resection
chemo
can treat with radiation alone

48
Q

what age is chondrosarcoma seen in

A

50s+

49
Q

what clinical symptoms are seen in chondrosarcoma

A

tooth-achy pain

50
Q

where can one find chondrosarcoma

A

metaphyseal
shoulder
hip
knee

51
Q

what does chondrosarcoma do to the bone

A

lyric among stippled calcification

52
Q

how is chondrosarcoma treated

A

Grade I- currettage
grade other- wide resection and reconstruction
NOT radio or chemo sensitive

53
Q

metastatic disease does what to the bone

A

lytic, blastic, and mixed

54
Q

how is metastatic treated

A

radiation vs currettage and nailing

55
Q

what is the math of metastatic disease

A

cuboidal cells, rosettes, and or an image of the kidney tumor

Bone (19 decks)

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