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ortho-rheum > Ortho Oncology > Flashcards

Ortho Oncology Flashcards

1
Q

what is the most common reason for destructive bone lesions in adults?

A

metastatic cancer

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2
Q

which carcinomas most commonly spread to bone?

A

Breast
Lung
Thyroid
Kidney
Prostate

“BLT and a Kosher Pickle”

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3
Q

what is the most common site of bony metastasis?

A

thoracic spine

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4
Q

what is the most common site of fracture secondary to metastasis?

A

proximal femur

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5
Q

what are the 3 symptoms of bone metastasis?

A

pain in affected limb with movement/load

pain that awakens pt at night

metastatic hypercalcemia

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6
Q

what is the full workup for a patient who presents without a known primary cancer? (3)

A

plain xray
CT chest/abdomen/pelvis
CT guided core biopsy

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7
Q

what is the tumor marker for bones?

A

alkaline phosphatase

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8
Q

what lab finding is more common in lytic lesions?

A

hypercalcemia

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9
Q

what is the goal of treatment in metastatic bone lesions? (2)

A

pain control
maintain patient independence

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10
Q

what is the non-op treatment for metastatic bone lesions? (2)

A

radiation
bisphosphonates (IV pamidronate)

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11
Q

what do all patients with metastatic bone lesions require?

A

postop radiation to stabilize bone

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12
Q

benign tumor located in the soft tissues

A

lipoma

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13
Q

a patient presents with a mobile, painless, and palpable mass. Dx? Tx?

A

lipoma
non-op (unless symptomatic or rapidly growing)

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14
Q

malignant tumor that arises from transformed cells of mesenchymal origin (connective tissue)

A

sarcoma

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15
Q

what part of the body does sarcoma most commonly metastasize to?

A

lungs

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16
Q

a patient presents with a painless rapidly growing mass. Dx?

A

sarcoma

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17
Q

what imaging must be done for a possible sarcoma?

A

MRI w/ contrast

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18
Q

what is the treatment for a sarcoma? (2)

A

careful wide excision
radiation

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19
Q

neoplastic proliferation of plasma cells that result in osteoclastic stimulation, most common primary bone malignancy in adults

A

multiple myeloma

20
Q

how is multiple myeloma frequently discovered?

A

through fracture

21
Q

labs show pancytopenia, hypercalcemia, renal failure, and Bence-Jones Proteins on UPEP. Dx?

A

multiple myeloma

22
Q

what would an xray show in multiple myeloma?

A

punched out lesions

23
Q

what is the treatment for multiple myeloma?

A

chemo

24
Q

most common malignant bone tumor in kids that typically arises as solitary lesions within the fastest growing areas of the long bones

A

osteosarcoma

25
Q

what are the 2 most common sites of osteosarcoma?

A

distal femur
proximal tibia

26
Q

what is the most common site of metastasis of osteosarcoma?

A

lungs

27
Q

what is the diagnostic for osteosarcoma?

A

core needle biopsy

28
Q

what is the treatment for osteosarcoma? (3)

A

preop + postop chemo
wide resection
limb salvage/amputation

29
Q

second most common malignant bone tumor in children

A

ewing’s sarcoma

30
Q

where does ewing’s sarcoma most commonly occur? (3)

A

pelvis
distal femur
proximal tibia

31
Q

an xray shows a large destructive lesion in the diaphysis or metaphysis with a moth-eaten appearance lesion. Dx?

A

ewing’s sarcoma

32
Q

what must we get to diagnose ewing’s sarcoma?

A

core needle biopsy

33
Q

what is required as a workup of Ewing’s sarcoma?

A

bone marrow biopsy to r/o mets to marrow

34
Q

what is the treatment for ewing’s sarcoma? (3)

A

pre-op and post-op chemo
wide dissection
limb salvage/amputation

35
Q

which one of the kid’s carcinoma DOES respond to radiation?

A

ewing’s sarcoma

36
Q

most common benign bone tumor in childhood

A

non-ossifying fibroma

37
Q

where do most non-ossifying fibromas occur?

A

lower extremity

38
Q

an xray shows a bubbly lytic lesion. Dx?

A

non-ossifying fibroma

39
Q

what is the treatment for non-ossifying fibroma?

A

resolves spontaneously

40
Q

self-limited benign bone lesion that presents with pain unrelated to activity; occurs in the diaphysis or metaphysis

A

osteoid osteoma

41
Q

what is the most common location of osteoid osteomas?

A

proximal femur

42
Q

what is important to note about pain d/t osteoid osteoma?

A

relieved by NSAIDs

43
Q

an xray shows an intensely reactive bone around a radiolucent nidus. Dx?

A

osteoid osteoma

44
Q

what is the study of choice for a osteoid osteoma?

A

CT

45
Q

what is the first line treatment for osteoid osteoma?

A

NSAIDs

46
Q

when does pain from osteoid osteoma usually resolve?
when does the lesion spontaneously resolve?

A

after 3 yrs
5-7 yrs

ortho-rheum (27 decks)

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