Oncology

Question 1

Most common site of pathological fracture secondary to boney mets

Answer 1

proximal femur

Question 2

What cell signalling molecule is defective in fibrous dysplasia

Answer 2

G-protein

Question 3

Recurrence of chondrosarcoma is directly related to activity of what

Answer 3

telomerase

Question 4

RB gene

Answer 4

retinobalstoma

osteosarcoma

Question 5

sarcoma, breast cancer oncogene

Answer 5

p53

Question 6

chondrosarcoma, melanoma, osteosarcoma oncogene

Answer 6

p16ink41

Question 7

Colon adenomas, desmoid tumors

Answer 7

APC (familial adenomatous polyposis)

Question 8

NF1

Answer 8

neurofibromas

Question 9

EXT1/EXT2

Answer 9

hereditary exostosis

chondrosarcomas

Question 10

t(11, 22)

Answer 10

Ewing, PNET

EWS, FLI

Question 11

t(X, 18)(p11;p11)

Answer 11

synovial cell

SYT, SSX

Question 12

x(12;22)(p13;a12)

Answer 12

clear cell sarcoma

EWS, AFT1

Question 13

t(2;13)(p35;q14)

Answer 13

rhabdomyosarcoma
PAX3
FKHR

Question 14

t(12;16)(q13;p11)

Answer 14

myxoid liposarcoma

Question 15

Benefit of pre-op rads

Answer 15

higher risk of wound complications
lower risk of fibrosis
lower dose of radiation

Question 16

most common site of oteoid osteoma

Answer 16

proximal femur

increased prostaglandins

Question 17

most common benign tumor of the hand

Answer 17

enchondroma

Question 18

pain associated with enchondroma

Answer 18

chondrosarcoma

Question 19

ollier’s disease

Answer 19

multiple enchondromas; no genetic inheritance
dysplastic bones with bowing
high risk of metastatic conversion (30%)

Question 20

maffucci’s syndrome

Answer 20

multiple enchonromas
associated with angiomas
calcified phleboliths, visceral malignancy
malignant conversion 100%

Question 21

encondroma conversion to chondrosarcoma

Answer 21

50% endosteal scalloping

> 5cm (larger size)

Question 22

chondroblastoma characteristics

Answer 22

like GCT, physeal
occur with ABC, consider clear cell chondrosarcoma
need to CT chest (treat mets with surgery)
intralesional curettage with bone graft
phenol as an adjunct, 10% recurrence

Question 23

Risk of using liquid nitrogen as an adjunct

Answer 23

stress fracture

Question 24

FGF-R3

Answer 24

fibrous dysplasia

may be present with mcune-albright or oncogenic osteomalacia

Question 25

mcCune-Albright

Answer 25

polyostotic fibrous dysplasia (unilateral)
coast of maine - cafe au lait
precocious puberty

Question 26

Mazabraud syndrome

Answer 26

fibrous dysplasia

intramuscular myxomas

Question 27

Jaffe-capanccini syndrome

Answer 27

NOF
metal retardation
cafe au lati
heart, eyes, gonads

Question 28

vertebral planae

Answer 28

eosinophilic granuloma

Question 29

treatment of EG

Answer 29

isolated - injection methylprednisolone acetate
Curettage if biopsy necessary
vertebral planae - treat with brace
disseminated disease - chemo (bad prognosis with visceral invovlement)

Question 30

Fluid-fluid levels on MRI

Answer 30

ABC

DDx
GCT
telangectatic osteosarcoma

Question 31

ABC treatment

Answer 31

intralesional curettage and bone graft
phenol
embolization of spinal or pelvic lesions

Question 32

UBC treatment

Answer 32

allow fracture to heal
methylprednisolone injection
intralesional curettage with bone graft/fixation

Question 33

when can you use embolization for GCT

Answer 33

pelvic, spinal lesions

pre-operatively

Question 34

What do you need to consider in work-up for GCT

Answer 34

mets to lungs

Question 35

most important prognostic indicator of osteosarc

Answer 35

tumor stage

Question 36

risk of recurrence following osteosarc resection

Answer 36

5%

Question 37

5 year survival of osteosarc

Answer 37

70%

mets or pelvis - 20%

Question 38

treatment of parosteal osteosarcoma

Answer 38

wide resection

most common location behind the knee

Question 39

pariosteal osteosarcoma treatment

Answer 39

chemo with wide resection

usually on the diphysis - sunburst

Question 40

CD99

Answer 40

Ewing sarcoma

Question 41

posterior elements spine tumors

Answer 41

osteoid osteoma
osteoblastoma
ABC

Question 42

Factors associated with risk of post-radiation fracture

Answer 42

female
>50
higher dose (>60)
periosteal reaction

Question 43

How to assess maturity of HO

Answer 43

radiographs

bone scan will still be positive
may take longer than 12 months

Question 44

Common radiation doses

Answer 44

HO - 6G
Mets - 30G
Soft tissue sarcoma - 60G

Question 45

Most common tumour found in the foot

Answer 45

synovial cell

Question 46

clinical appearance of angiosarcoma

Answer 46

often occurs in the hand
destructive lytic lesions with vascular invasion
CD31 is a sensitive marker

Question 47

CD31

Answer 47

angiosarcoma

Question 48

what are the urinary markers of pagets

Answer 48

Increased urinary N-telopeptide and alpha-C-telopeptide

Question 49

S100

Answer 49

nerve cell tumor
melanoma
clear cell sarcoma

Question 50

where does HO develop after amputation

Answer 50

when amputation occurs at the level of amputation

increased with blast

Question 51

prefered fixation for osteotomy in pagentoid bone

Answer 51

metaphyseal

plate fixation

Question 52

Fibrodysplasia Ossificans Progressive

Answer 52

Rare, stone man disease

ACVR1 gene

Question 53

ACVRI gene

Answer 53

fibrodysplasia ossficians progressiva

Progressive HO (muscles, fascia, tendons, joints)
Great toe dysplasia
BMP4 is abnormal in this disease

Question 54

chemo

Answer 54

Osteosarcoma
Ewings
synovial sarcoma
dediff chondro
mesenchymal chondro

Question 55

CD31

Answer 55

angiosarcoma

aggressive, lytic lesions
associated with polyvinyl chloride

Question 56

CD20 and CD45

Answer 56

lymphoma

Question 57

development of HO following knee dislocation is correlated to

Answer 57

ISS

Question 58

intramuscular myxoma treatment

Answer 58

wide resection