Metastatic Bone Disease Flashcards

1
Q

3 indications for surgical intervention

A
  1. intractable pain
  2. impending pathologic fracture
  3. pathologic fracture
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2
Q

Most common reason for bone mets in females

A

breast cancer

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3
Q

What makes up posterior spinal column

A

spinous process, laminae, facets, ligamentum flavum

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4
Q

3 main characteristics of metastatic disease that increases risk of pathologic fracture

A

Anaplastic, rapidly growing, osteolytic

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5
Q

3 most common cancers that results in metastatic bone disease

A

lung, breast, prostate

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6
Q

which bony mets have increased risk of fracture, lytic or blastic?

A

lytic

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7
Q

Majority of symptomatic lesions to the femur come from what 4 cancers?

A

breast, prostate, renal, multiple myeloma

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8
Q

Common symptoms of bone mets

A

bone pain severe at night

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9
Q

What kind of exercises are done in bone cancer rehab

A

isometric and non-resistive isotonic exercises

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10
Q

MC UE location for bony mets

A

humerus

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11
Q

Skeletal survey reveals diffuse punched out lytic lesions with black sclerotic borders

A

multiple myeloma

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12
Q

What makes up middle spinal column

A

PLL, posterior half of vertebral body, posterior annulus

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13
Q

most common bones that osteosarcomas are found in

A

knee and proximal humers

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14
Q

Most common reason for bone mets in males

A

prostate cancer

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15
Q

most common site of pathologic fractures

A

proximal femur

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16
Q

The most common primary malignant bone tumor in children

A

osteosarcoma

17
Q

median survival rate for breast cancer with metastatic cancer

18
Q

What precaution is taken if bony mets to a limb is suspected?

19
Q

spine is considered stable if…

A

one column is involved

20
Q

Surgical intervention is indicated if greater than how much of medullary cross-sectional diameter is involved

21
Q

Bone scan sensitivity and specificity

A

It is highly sensitive, but low specificity for bony mets

22
Q

What kind of physical modalities are contraindicated in malignancy

A

deep heat modalities such as diathermy, microwave and ultrasound

23
Q

Pharmacologic treatment for multiple myeloma

A

bisphosphonates and high dose steroids

24
Q

specificity and sensitivity of PET scan vs bone scan

A

PET scan is more sensitive and more specific for bone mets

25
Any complaint of bone pain in cancer patient warrants what 2 images?
x-ray and bone scan
26
Majority of symptomatic lesions to the hip come from what 4 cancers?
prostate, breast, lung, lymphoma
27
what would bone scan look like for multiple myeloma
normal
28
what pharmacologic treatment is used for metastatic bone disease
biphosphonates or denosumab
29
where is primary cancer if bony mets is blastic vs lytic
blastic lesions = prostatic cancer | lytic lesions = breast, lung, kidney
30
If there is bone mets in the spine, what is relation of pain and position of patient
pain is worse with lying down and better with sitting
31
In the upper extremity, the majority of symptomatic lesions come from what three cancers?
Breast cancer, multiple myeloma, renal cancer
32
median survival rate for prostate cancer
40 months
33
what would skeletal survey look like for multiple myeloma
diffuse punched out lytic lesions
34
LE indication for surgical intervention (%age of cortex involved)
30-50%
35
UE indication for surgical intervention (%age of cortex involved)
>50%
36
Osteoblastic vs osteolytic lesions in terms of strength and stiffness
osteolytic has decreased strength and stiffness | osteoblastic has decreased stiffness
37
median survival rate for lung and kidney cancer with metastatic disease
6 months
38
spine is considered unstable if...
2 columns are involved, only the middle column is involved, or there is >20 degree angulation
39
what makes up the anterior spinal column
ALL, anterior annulus, anterior half of vertebral body