Metastatic Bone Cancer + Multiple Myeloma

Question 1

Multiple Myeloma;

Presentation
Bone ? leads to ? fractures, particularly in the ?
leading to ?.
There will also be signs of ? ? infiltration and ? impairment, so the patient can also present with ??? signs, recurrent ?, signs of
?, hyper? etc.

Answer 1

destruction
patho
vert
backache
BM
renal
CKD
infections
anamia
hypercalcaemia

Question 2

Multiple Myeloma

Investigation
 XR shows ? ? ? lesions.
Management of bone pain;
? for local disease control.
Spinal ? and ? if necessary.

Answer 2

punched out lytic
RT
decompression
fusion

Question 3

Bony Mets

Most common cause of ? bone disease in adults, with deposits most commonly found in the ? ?.

Presentation
Unremitting, ? pain, worse in ? and may be sharp upon ? ?.
Features of ?.
? fractures.
? symptoms.

Answer 3

destructive
axial (central) skeleton
dull
night
wt bearing
hypercalcaemia
patho
b

Question 4

Bony Mets

On examination there will be bone ?, reduced ?
of the joints and local ?.
More rarely it can present as spinal cord ?, leading to
? pain and ? dysfunction.
The five most common tumours that metastasize to bone are ?, lung (?), ?, ? and ?

Answer 4

tenderness
ROM
LNopathy
compression
radicular
autonomic
BLT KP
Breast, lung (bronchial) Thyroid Kidney Prostate

Question 5

Bony Mets

Differentials may be ? ?, ? or ?.

Investigation
Skeletal ? scans;
0 Show metastases as ‘?areas’ before radiological changes occur.
Skeletal XR;
0 ? or ? areas once the tumour reaches a certain size.

Answer 5

multiple myeloma
lymphoma
osteomy
radioisotope
hot
lytic
sclerotic

Question 6

Bony Mets
Ix

CT/MRI;
0 To define bone ?, ?involvement and tumour ?.
0 Imaging for the ? tumour.
CT guided ?;
0 If the diagnosis is in doubt.
General bloods+/- ? ?.

Answer 6

loss
marrow
extension
primary
biopsy
tumour markers

Question 7

Management of bone pain;

Establish the ? diagnosis
?/local ? to control the pain.
? to reduce the fracture risk.
May respond to chemo / ?(breast / prostate) therapy.
Prophylactic ? ? may be indicated to prevent pathological fractures.

Answer 7

primary
analgesia
RTx
bispho
hormone
surgical stabilisation