Mehlman HY bone tumors Surg + metastases 11-04 (1)

Question 1

M. what is most common primary bone tumor?

Answer 1

Osteosarcoma

Question 2

M. Osteosarcoma. Age?

Answer 2

10-30 y.o

Question 3

M. Osteosarcoma. what mutation is related to this cancer?

Answer 3

Rb - congenital retinoblastoma.
ie. 1yo boy has enucleation of eye for retinoblastoma. what is he at risk of developing later in life? A - osteosarcoma.

Question 4

M. Osteosarcoma. in what other disease can occur apart retinoblastoma?

Answer 4

in paget disease of bone (older patients)

Question 5

M. Osteosarcoma. what are 2 buzzy appearances?

Answer 5

Codman triangle and sunburn appearance

Question 6

M. Osteosarcoma. what is codman triangle?

Answer 6

periosteal reaction with lifting of periosteum off the bone

Question 7

M. Osteosarcoma. what is sunburst appearance?

Answer 7

Periosteal reaction described on NBME as ,,spiculated new bone formation”

Question 8

periosteal reaction with lifting of periosteum off the bone?

Answer 8

codman triangle; in osteosarcoma

Question 9

Periosteal reaction described on NBME as ,,spiculated new bone formation”?

Answer 9

sunburst appearance; in osteosarcoma

Question 10

M. NBME description of osteosarcoma is ,,pleomorphic neoplastic cells producing new woven bone”

Answer 10

.

Question 11

,pleomorphic neoplastic cells producing new woven bone”?

Answer 11

osteosarcoma

Question 12

M. Unicameral bone cyst. underrated diagnosis. Asked in 2CK

Answer 12

.

Question 13

M. Unicameral bone cyst. definition?

Answer 13

benign bone tumor that looks similar to osteosarcoma, but age of onset is usually birth to 20 yo., rather tan 20-40.

Question 14

M. Unicameral bone cyst. age?

Answer 14

birth to 20.

Question 15

M. Unicameral bone cyst. how looks like?

Answer 15

,,one chamber”, it is fluid-filled.

Question 16

M. Unicameral bone cyst. usmle wants to know photo of this.

Answer 16

.

Question 17

M. mestastases. usmle loves it in what site?

Answer 17

vertebra

Question 18

M. mestastases. what origins love usmle? 3

Answer 18

breast, prostaste, lung

Question 19

M. mestastases. usmle wont show photo is vertebral photo. they will give vignette where patient has/had cancer + lytic lesions in vertebra or neurologic syndrome (eg of cauda equina).

Answer 19

.

Question 20

M. mestastases. what 2 components in case will be said?

Answer 20

diffuse bone pain + patient with background of cancer = mets

Question 21

M. mestastases. if photo will show up, it will be Technetium-99 bone scan of mets.

Answer 21

.

Question 22

M. Back pain in elderly patient with hypercalcemia –> Dx?

Answer 22

multiple myeloma or metastases.

Question 23

M. Back in pain in patient with history of other type of cancer –> Dx?

Answer 23

metastases

Question 24

M. Suspected spinal mets –> Dx imaging?

Answer 24

MRI

Question 25

M. Metastases to long bones in prostate cancer –> Dx what imaging?

Answer 25

osteoblastic (Dx with bone scan);
spine do MRI.