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D & T exam 2 > Tumor and Metabolic Diseases > Flashcards

Tumor and Metabolic Diseases Flashcards

1
Q

Musculoskeletal tumors come from what tissue

A

mesodermal

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2
Q

what is mesodermal tissue

A

connective tissue like bone, fat, muscles

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3
Q

what are Musculoskeletal called

A

sarcomas

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4
Q

Sarcomas metastasize where

A

lung

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5
Q

what are 4 types of Musculoskeletal tumors

A

benign bone
malignant bone
benign soft tissue
malignant soft tissue

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6
Q

histories of what other cancers are important for Musculoskeletal tumors

A

prostate, lung, breast, thyroid, renal

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7
Q

chest x-ray: CXR

A

lung

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8
Q

mammogram

A

breast

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9
Q

PSA

A

prostate

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10
Q

UA

A

renal

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11
Q

TSH/Thyroid US

A

thyroid

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12
Q

SPEP/ UPEP

A

myeloma

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13
Q

ESR/CRP

A

infection

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14
Q

CBC diff, CMP

A

anemia, alk phos

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15
Q

CT chest/ abdomen/ pelvis

A

look for primary or mets to lung

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16
Q

MRI

A

asses soft tissue of anatomy

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17
Q

bone scan

A

bony activity, skip lesions

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18
Q

X-ray of limbs

A

bony destruction

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19
Q

above what age are bone tumors most likely metastatic

A

40

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20
Q

growing soft tissue masses are most likely what

A

malignant

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21
Q

how do you treat soft tissue >5cm or deep

A

excision

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22
Q

how do you treat malignant soft tissue

A

resection

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23
Q

how do you treat benign bone

A

excision if aggressive

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24
Q

how do you treat malignant bone

A

chemo
resection
reconstruction
radiation ( not first line)

25
Q

what is the translocation of Ewing

A

11,22,

26
Q

what part of the bone does osteomyelitis occur

A

metaphysis

27
Q

osteomyelitis: most common bacteria involvied

A
  1. staph aureus
  2. hemolytic strep
    others: TB, syphillis, fungus and virus
28
Q

most common spread for osteomyelitis? other avenues

A

hematogenously

- direct inoculation with open fractures

29
Q

someone with osteomyelitis will have a history of what

A

achy, unrelenting night pain

fever

30
Q

what will the exam show for osteomylitis

A

tenderness in bone
ROM of joints ok
swelling, warmth, redness, draining sinus

31
Q

Osteomyelitis: CBC with diff

A

elevated WBC with left shift

32
Q

Osteomyelitis: ESR/CRP

A

elevated inflammatory markers

33
Q

Osteomyelitis: X-ray of limb

A

may show Brodie’s abscess

34
Q

Osteomyelitis: blood culture

A

may grow bug from hematogenous spread

35
Q

Osteomyelitis: bone culture

A

gold standard for diagnsosis

36
Q

Osteomyelitis: MRI/bone scan

A

very helpful to asses abscess and extent

37
Q

Osteomyelitis: treatment

A

empiric: Vanc
clear abscess or no improvement: surgical washout
chronic: multiple treatments

38
Q

what is osteoprosis

A

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

39
Q

Describe the different types of primary osteoprosis

A

type I: postmenopausal, caused by hormone changes

Type II: senile, altered calcium metabolism

40
Q

what is secondary osteoporosis

A

long term steroid use

  • hyperparathyroidsm
  • hyperthyroidsim
  • long term immobilization
41
Q

what are 3 things the physical exam will show for osteoporosis

A

loss of height

  • thoracic kyphosis
  • loss of menstruation
42
Q

what is a common test used for osteoporosis

A

DEXA scan of spine, hip, or femur
T score: compare to 25 yr old
Z score: compare to matched age

43
Q

for DEXA scan how much below SD means they have osteoporosis

A
44
Q

what does NTx measure

A

bone collagen

45
Q

osteoporosis: CBC

A

anemia

46
Q

osteoporosis: TSH/PTH

A

hyperthyroid

hyperPTHism

47
Q

osteoporosis: SPEP/UPEP

A

Multiple myeloma

48
Q

osteoporosis: Ca/P/Alk Phos/Vit D

A

osteomalacia

49
Q

BUN/Cr/ LFT indicates what

A

renal/liver causes

50
Q

how does one prevent osteoporosis

A

maximize Ca/Vit D
weight bearing exercises
minimize smoking, caffeine, meds

51
Q

treatment for osteoporosis

A

bisphosphates
Calcitonin
Pulsed PTH
SERMS ( not recommended)

52
Q

what does the doctor need to pay attention to with Biphophates

A

can only use for about 5 years

- disrupts ruffled border of osteoclasts

53
Q

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

A

prostate, lung, breast, thyroid, renal

54
Q

what is the common bacteria that causes oestomyelitis

A

staph aureus

55
Q

what is the difference between T and Z score in DEXA scan

A

T- compare with 25 yr old

Z- compare with your age

56
Q

what is the most common metastatic site for sarcomas

A

lung

57
Q

why does osteomyelitis most commenly happen in the metaphysis of bone

A

blood vessels

58
Q

name one common medicine that with long term use can cause secondary osteoprorsis

A

Steroid use

D & T exam 2 (27 decks)

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