Tumor and Metabolic Diseases

Question 1

Musculoskeletal tumors come from what tissue

Answer 1

mesodermal

Question 2

what is mesodermal tissue

Answer 2

connective tissue like bone, fat, muscles

Question 3

what are Musculoskeletal called

Answer 3

sarcomas

Question 4

Sarcomas metastasize where

Answer 4

lung

Question 5

what are 4 types of Musculoskeletal tumors

Answer 5

benign bone
malignant bone
benign soft tissue
malignant soft tissue

Question 6

histories of what other cancers are important for Musculoskeletal tumors

Answer 6

prostate, lung, breast, thyroid, renal

Question 7

chest x-ray: CXR

Answer 7

lung

Question 8

mammogram

Answer 8

breast

Question 9

PSA

Answer 9

prostate

Question 10

UA

Answer 10

renal

Question 11

TSH/Thyroid US

Answer 11

thyroid

Question 12

SPEP/ UPEP

Answer 12

myeloma

Question 13

ESR/CRP

Answer 13

infection

Question 14

CBC diff, CMP

Answer 14

anemia, alk phos

Question 15

CT chest/ abdomen/ pelvis

Answer 15

look for primary or mets to lung

Question 16

MRI

Answer 16

asses soft tissue of anatomy

Question 17

bone scan

Answer 17

bony activity, skip lesions

Question 18

X-ray of limbs

Answer 18

bony destruction

Question 19

above what age are bone tumors most likely metastatic

Answer 19

40

Question 20

growing soft tissue masses are most likely what

Answer 20

malignant

Question 21

how do you treat soft tissue >5cm or deep

Answer 21

excision

Question 22

how do you treat malignant soft tissue

Answer 22

resection

Question 23

how do you treat benign bone

Answer 23

excision if aggressive

Question 24

how do you treat malignant bone

Answer 24

chemo
resection
reconstruction
radiation ( not first line)

Question 25

what is the translocation of Ewing

Answer 25

11,22,

Question 26

what part of the bone does osteomyelitis occur

Answer 26

metaphysis

Question 27

osteomyelitis: most common bacteria involvied

Answer 27

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

Question 28

most common spread for osteomyelitis? other avenues

Answer 28

hematogenously | - direct inoculation with open fractures

Question 29

someone with osteomyelitis will have a history of what

Answer 29

achy, unrelenting night pain | fever

Question 30

what will the exam show for osteomylitis

Answer 30

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

Question 31

Osteomyelitis: CBC with diff

Answer 31

elevated WBC with left shift

Question 32

Osteomyelitis: ESR/CRP

Answer 32

elevated inflammatory markers

Question 33

Osteomyelitis: X-ray of limb

Answer 33

may show Brodie's abscess

Question 34

Osteomyelitis: blood culture

Answer 34

may grow bug from hematogenous spread

Question 35

Osteomyelitis: bone culture

Answer 35

gold standard for diagnsosis

Question 36

Osteomyelitis: MRI/bone scan

Answer 36

very helpful to asses abscess and extent

Question 37

Osteomyelitis: treatment

Answer 37

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

Question 38

what is osteoprosis

Answer 38

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

Question 39

Describe the different types of primary osteoprosis

Answer 39

type I: postmenopausal, caused by hormone changes | Type II: senile, altered calcium metabolism

Question 40

what is secondary osteoporosis

Answer 40

long term steroid use - hyperparathyroidsm - hyperthyroidsim - long term immobilization

Question 41

what are 3 things the physical exam will show for osteoporosis

Answer 41

loss of height - thoracic kyphosis - loss of menstruation

Question 42

what is a common test used for osteoporosis

Answer 42

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

Question 43

for DEXA scan how much below SD means they have osteoporosis

Question 44

what does NTx measure

Answer 44

bone collagen

Question 45

osteoporosis: CBC

Answer 45

anemia

Question 46

osteoporosis: TSH/PTH

Answer 46

hyperthyroid | hyperPTHism

Question 47

osteoporosis: SPEP/UPEP

Answer 47

Multiple myeloma

Question 48

osteoporosis: Ca/P/Alk Phos/Vit D

Answer 48

osteomalacia

Question 49

BUN/Cr/ LFT indicates what

Answer 49

renal/liver causes

Question 50

how does one prevent osteoporosis

Answer 50

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

Question 51

treatment for osteoporosis

Answer 51

bisphosphates Calcitonin Pulsed PTH SERMS ( not recommended)

Question 52

what does the doctor need to pay attention to with Biphophates

Answer 52

can only use for about 5 years | - disrupts ruffled border of osteoclasts

Question 53

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

Answer 53

prostate, lung, breast, thyroid, renal

Question 54

what is the common bacteria that causes oestomyelitis

Answer 54

staph aureus

Question 55

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

Answer 55

T- compare with 25 yr old | Z- compare with your age

Question 56

what is the most common metastatic site for sarcomas

Answer 56

lung

Question 57

why does osteomyelitis most commenly happen in the metaphysis of bone

Answer 57

blood vessels

Question 58

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

Answer 58

Steroid use