Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Orthopedic Surgery Ultimate > Tumors COPY > Flashcards

Tumors COPY Flashcards

1
Q

Tumors and tumor-like lesions of bone. Present how? 4

A
  1. Persistent skeletal pain and swelling
  2. Limitation of motion
  3. Spontaneous fracture
  4. Proceed with clinical, radiographic, lab and biopsy exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tumors and tumor-like lesions of bone: What are the three types of tumors?

A
  1. Osteoblastic connected tissue tumors
  2. Cartilage tumors
  3. Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the tumors in the following categories:
1. Osteoblastic connected tissue tumors? 2

  1. Cartilage tumors? 3
  2. Bone? 3
A
  1. Osteoblastic connected tissue tumors
    - Osteoid osteoma
    - Osteosarcoma
  2. Cartilage tumors
    - Enchondromas
    - Chondromyxoid fibromas
    - Chondrosarcomas
    • Giant Cell
    • Chondroblastomas
    • Ewing’s sarcoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you treat the following:

  1. Osteoid osteoma?
  2. Osteosarcoma?
A
  1. Osteoid osteoma
    - Pain usually relieved by aspirin
  2. Osteosarcoma
    - Resection and chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tumors and tumor-like lesions of bone:
1. Giant cell are mostly benign or malignant?

  1. Chondroblastomas: benign or malignant?
  2. Ewing’s sarcoma prognosis?
A
  1. 50% are benign
  2. Almost always benign
  3. 50% mortality rate in spite of chemotherapy, radation and surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

RED FLAGS FOR TUMORS?

5

A
  1. Night pain,
  2. constant pain,
  3. unusual symptoms,
  4. no improvement with conservative management,
  5. or general symptoms such as fever, malaise, weakness
  6. Unexplained mass, especially in the thigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

RED FLAGS on xray findings?

3

A

X-ray findings with

  1. lytic or blastic bone changes,
  2. soft tissue calcification or
  3. periosteal reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Evaluation of tumors?

A
  1. Physical exam and x-rays for most
  2. Possible bone scan, CT scan, MRI, chest x-rays/CT for more high risk lesions
  3. Consider
    - lab tests
  4. consults/referral Oncologist, Path, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Whch labs to evaluate for tumors? 3

A
  1. CBC
  2. calcium, phosphorous
  3. alk phos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If you have a patient that has weakness, anemia and is over 40 what do you have to R/O?

A

MM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are you looking for on CT with evaluaiton of bone tumors?

A

history of calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. If suspecting Malignancy after XRAY you must order a what?
  2. What lab would be elevated in lots of bone breakdown?
  3. Bottom line need to what?
A
  1. CT
  2. ALK phos= lots of bone breakdown
  3. biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Who should the biopsy be performed by?
  2. How should the biopsy be dissected?
  3. Consult for what?
A
  1. Ideal if performed by “ultimate” surgeon
  2. Longitudinal and stay in one compartment
  3. Consult to plan incision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would be the different in trying to decide whether to observe, excise or refer in malignant vs benign tumors of the bone?

A
  1. Clearly benign-observation versus excision/curettage
  2. Possibly malignant- consider referral to Regional Cancer Center having teams of pathologists, radiologists, surgeons, and oncologists and radiation therapists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we classify tumors? 3

A
  1. Bony versus soft tissue
  2. Benign versus malignant
  3. Primary versus metastatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MALIGNANT BONE TUMORS
Prognosis greatly improved in recent years with dedicated referral centers, pre-op chemotherapy, limb-sparing procedures, etc.

4

A
  1. Osteosarcoma
  2. Ewing’s
  3. Soft tissue tumor
  4. Mets
17
Q

Second most common primary bone tumor after myeloma?

A

OSTEOSARCOMA

18
Q

OSTEOSARCOMA

  1. High risk of what?
  2. What percent of all bone sarcomas?
  3. What years?
  4. Gender?
  5. Where?
  6. Xray findings?
  7. Other imaging?
A
  1. high risk mets (poor prognosis!)
  2. 20% of all bone sarcomas
  3. second decade (10-20YO)
  4. male equal female
  5. appendicular (50% knee)
  6. x-rays mixed lytic/sclerotic with cortical destruction (Codman’s triangle, “star burst” periosteal reaction, etc)
  7. MRI
19
Q

EWING’S

  1. Highly what?
  2. Path looks like what?
  3. Xray findings? 5
  4. Prognosis?
A
  1. Highly anaplastic
  2. small round cell tumor in sheets
    • long bone diaphyses,
    • lytic,
    • moth-eaten,
    • indistinct margins,
    • “onion skin”
  4. survival rates now 80 to 90% with pre-op chemotherapy (versus 20%)
20
Q

SOFT TISSUE TUMORS
1. Why is the diagnosis challenging? 2

  1. Will present how?
  2. Where will the tumor be found?
  3. Type of resection? 4
A
  1. Challenging –
    - history rarely helpful,
    - x-rays usually negative
  2. Small (less than five centimeter) superficial cystic lesions usually benign/observed
  3. Large deep solid tumors-studies/biopsy
  4. Type of resection-
    - intralesional,
    - marginal,
    - wide,
    - radical
21
Q

Sot tissue tumors:

Class based on apparent differentiation such as? 7

A
  1. Fibrous
  2. Lipomatous
  3. Smooth muscle
  4. striated muscle
  5. vascular
  6. synovial
  7. neurologic
22
Q

Sot tissue tumors:
Class based on apparent differentiation.
1. What are some fibrous tumors? 2

  1. What are some lipomatous tumors? 2
A
  1. Fibrous
    - Dupuytren’s
    - desmoid
  2. Lipomatous
    - lipoma
    - liposarcoma
23
Q

What is the most common cause of bone distruction in adults?

A

METASTATIC BONE DISEASE

24
Q

Which cancers commonly mets to bone?
4

Initial presentation may be to the orthopedist with what?

A
  1. breast,
  2. lung,
  3. prostate,
  4. kidney

back pain

25
Q

Cancer typically goes to which bones?

4

A
  1. Spine,
  2. ribs,
  3. pelvis,
  4. proximal limb girdles most common
26
Q

Common pitfalls in bone tumors? 4

Tx? 3

A
  1. assume metastatic,
  2. not recognizing that a fracture is pathologic,
  3. inadequate workup/planning/fixation,
  4. not knowing when to refer

Treatment-

  • fracture risk,
  • function,
  • palliation
27
Q

Benign Bone Tumors

4

A
  1. Osteochondroma
  2. Osteoid Osteoma
  3. Bone Cyst
  4. Nonossifying fibroma
28
Q

Most common (35 to 50%) of benign and 20 to 15% of all primary bone tumors?

A

OSTEOCHONDROMA

29
Q

OSTEOCHONDROMA

  1. What is it?
  2. Where?
  3. Gender?
  4. Years?
  5. Causes what kind of problems?
A
  1. Not true neoplasms
  2. Knee/proximal humerus,
  3. 2:1 males
  4. Second and third decades
  5. Mostly mechanical problems/compression, space occupying
30
Q

OSTEOCHONDROMA

  1. Stops growing when?
  2. IMaging? 2
  3. Tx?
A
  1. Stops growing at skeletal maturity (if they dont then think of something else)
  2. CT first. MRI if unclear
  3. Surgery- completely excise cartilage and perichondrium
31
Q

How big are osteochonrdomas?

A

1-2cm

32
Q

OSTEOID OSTEOMA

  1. Characteristics? 3
  2. Years?
  3. Gender?
  4. Where? 3
A

Benign

  1. Nidus-
    - well demarcated,
    - bone forming,
    - up to one centimeter.
  2. Second/Third decade-
  3. male to female 3:1
    • Long bones lower extremity,
    • cortex,
    • posterior elements lumbar spine

Approximately 10% of benign bone tumors and 2-3% of all primary bone tumors

33
Q

OSTEOID OSTEOMA

  1. Characteristics? 3
  2. Imaging? 2
  3. Tx? 2
A
    • Dull/sharp pain,
    • worse at night,
    • better with aspirin/NSAIDs
  2. X-ray/CT
    • En bloc resection (CT, X-rays)-gotta remove everything/lymph drainage etc
    • Percutaneous radiofrequency ablation
34
Q

UNICAMERAL BONE CYST

  1. Ages?
  2. gender?
  3. Where?
  4. what is different about this?
A
  1. Ages 5-15,
  2. boys 3:1 over girls
  3. 50-60% proximal humerus
  4. Not true cyst
35
Q

UNICAMERAL BONE CYST

  1. Where is it? what does it look like?
  2. Imaging?
  3. Tx? 2 Reoccurrence rates?
A
  1. Central radiolucent lesion metaphyseal side of growth plate, long bones
  2. MRI if unclear
  3. -Curettage/graft-
    20% to 45% recurrence
    -Needle aspiration and several steroid injections at two month intervals-
    10% recurrence
36
Q

What is FCD-NOF?

A

Fibrous cortical defect/non ossifying fibroma

37
Q

Fibrous cortical defect/non ossifying fibroma

  1. Common when?
  2. Neoplastic?
  3. Where?
A
  1. Common in childhood
  2. Non-neoplastic
  3. Metaphysis of long bones (knee)

Approximately 5% of benign primary bone tumors

38
Q

FCD-NOF

  1. Which decades?
  2. Shaped? 2
  3. Tx- if weakening bone?
  4. If fractured? 3
A
  1. First two decades
    • Oval elongated radiolucent,
    • well marginated
  3. If weakening bone then curettage/graft
  4. Fracture-
    - immobilize,
    - observe,
    - sometimes lesion heals

Orthopedic Surgery Ultimate (88 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions