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Radiology Tumors > Tutoring Session > Flashcards

Tutoring Session Flashcards

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1
Q

what are characteristics of benign vs malignant lesions

A

benign - single, geographic, short zone, respecting borders, well defined, no pain**

malignant - mutliple, long zone, moth eaten, permeative, periosteal reaction, destroying borders, ill defined, pain**

** pain is subjective but most commonly benign are not painful and malignant are painful

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2
Q

what tumor causes cachexia and pain

A

multiple myeloma

cachexia - wasting of the body

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3
Q

what tumor occurs in and affects the red marrow of bone causing osteopenia

A

multiple myeloma

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4
Q

what is needed to confirm diagnosis of multiple myeloma

A

aspiration and biopsy of bone marrow

sternum and ilium

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5
Q

what are rare sclerotic lesions of multiple myeloma called

A

POEMS

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6
Q

what malignant tumor spares the pedicles

A

multiple myeloma

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7
Q

what are risk factors for multiple myeloma

A

farmers, exposure to wood dust, nuclear exposure

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8
Q

what is the mnemonic for lytic lesions

A

fog machines
feg nomashic

fibrous dysplasia
enchondroma
giant cell tumor

non ossifying fibroma 
osteoblastoma 
myeloma 
ABC 
simple bone cyst 
hyperPTH 
infection 
chondroblastoma
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9
Q

what is the most common sclerotic lesion tumor

A

central osteosarcoma

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10
Q

central osteosarcoma typically results in what issues in the limbs

A

asymmetry or taller limb

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11
Q

what part of the bones does central osteosarcoma affect

A

metaphysis

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12
Q

where will central osteosarcoma not spread to

A

physis - limits spread of tumor

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13
Q

what tumor will metastasize to the lungs via the blood

A

central osteosarcoma

“cannonball mets”

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14
Q

what tumor can cause a pneumothorax

A

central osteosarcoma - mets to lungs via blood “cannonball mets”

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15
Q

what tumor can cause skip lesions in the spine via mets

A

central osteosarcoma

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16
Q

condmans triangle and spiculated cortex describes what type of tumor

A

central osteosarcoma

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17
Q

what does central osteosarcoma look like on MRI sequences T1, T2, STIR

A

t1 - low
t2 - high
stir - high

high due to edema

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18
Q

secondary osteosarcoma arises from what

what is the most common

A

benign bone tumor

pagets bone 44%

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19
Q

what lab value can help monitor if pagets bone has gone malignant

A

alkaline phosphatase

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20
Q

what is the process of thinking to know what a tumor is

A

benign or malignant

matrix - bone, fibrous, cartilage

location

unique features

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21
Q

what is advantage of conventional radiography

A

non invasive

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22
Q

what percent of bone needs to be diminished in order to observe it on xray

A

30-50%

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23
Q

how long may it take to visualize osteomyelitis in peripheral bone in xray

Study These Flashcards
A

10-14 days

occult fracture - 7-10 days
spinal osteomyelitis - 21 days
aggressive tumors - 4-6 weeks

24
Q

what agent is used for radionucleotide bone scan

Study These Flashcards
A

technetium methylene disphosphate

25
what is the difference between enchondral, intramembranous, and appositional bone formation
enchondral - develops from cartilage, requires cartilaginous template, forms the physis or growth plate, forms most of skeleton, controls bone lengthening intramembranous - develops from mesenchyme/connective tissue, no cartilage stage, forms the flat bones, mandible. skull, clavicle appositional - controls width of the bone via periosteal activity
26
what are characteristics of different layers of bone
periosteum - surrounds bone except at ends, not seen on imaging unless inflamed or pathology present epiphysis - located at ends of long bones, preformed cartilage slowly ossifies, supports joints apophysis - sites of muscle attachment physis - growth plate, area of maturing cartilage that develops into bone, trauma alters growth zone of provisional calcification - radiopaque band on either side of physis, calcification to mature bone, disease may alter and arrest growth forming harris growth arrest lines metaphysis - most metabolic active portion of bone, most common area for tumors and infection, contains trabeculae that bears stress and weight diaphysis - shaft of bone, thick cortex with decreased medullary cavity
27
what diseases affect the metaphysis
``` mutiple myeloma ewings sarcoma NHL adamantinoma infection ```
28
most common location for tumor inside a bone
metaphysis metabolically active
29
diaphyseal tumors indicates what kind of disease
bone marrow disease
30
what is difference between wide and narrow zone of transition what does each indicate
wide - little or no sclerosis around it - indicates malignancy narrow - sharp sclerotic rings around it - indicates benign
31
what is difference between moth eaten and permeative
moth eaten is larger multiple irregular holes in bone - 2-5 cm permeative is tiny multiple pinholes in bone - very aggressiv and rapidlly forming
32
describe geographic lesions
circumscribed solitary and uniform sharp margin - narrow zone of transition soap bubbly or septated
33
what tumors contain permeative lesions what tumors contain moth eaten lesions
ewings sarcoma NHL MM MM mets
34
what tumors contain osteoblastic lesions
blastic mets - MC - have history of cancer (prostate) osteosarcoma pagets disease
35
how long does it take before a periosteal reaction will show up in imaging after stimulus
10-21 days
36
what are examples of periosteal reactions
solid - benign laminated - called onion skin appearance, alternating lucent and opaque areas, slow and aggressive tumors spiculated - aka sunburst reaction, perpendicular brushed whiskers, highly aggressive tumor
37
laminated periosteal reaction is seen in what tumor
ewings sarcoma | onion skin
38
how is codmans triangle formed
subperisoteal extension of the lesion
39
what are the following lab tests for ``` CBC ESR CRP serum calcium serum phosphorus alkaline phosphatase acid phosphatase total protein ```
CBC - infection ESR - inflammation CRP - inflammation - better serum calcium - indicates lytic bone destruction or PTH dysfunction serum phosphorus - indicates lytic bone destruction alkaline phosphatase - indicates osteoblast activity acid phosphatase - prostate - increased with gauchers and mets total protein - mets or MM - IgG spike and BJ proteins in urine
40
alkaline phosphatase helps indicate what 3 diseases
pagets mets lymphoma
41
what is endosteal scalloping
thinning of cortex along endosteal surface of bone slow growing medullary lesions
42
what are the radiographic densities to dark to light
``` dark- lucent - air fat water bone metal - light - opaque ```
43
what imaging should always be performed first what views
xray 2 perpendicular views
44
how big does the lesion have to be before it is seen on xray
1-5 cm
45
when is special imaging indicated
when patient isnt 50% better after 2 weeks
46
what imaging uses iodinated contrast
discography inject into IVD to recreate pain to determine level causing pain
47
bone scan is good for detecting what what cant it detect
``` mets tumors infection arthritis fractures AVN ``` cant detect MM - no osteoblast activity
48
bone scans are __ but not __
sensitive but not specific
49
bone scans can detect __ % of bone destruction how many times more sensitive than xray
3-5% 10x
50
what are the advantages and disadvantages of ultrasound
advantages - good for msk, abdomen, vascular, cyst, guided biopsy disadvantage - operator dependent and long learning curve
51
what imaging uses mutiplanar reconstruction of images
CT
52
what are advantages and disadvantages of CT
advantages - bone detail and very quick disadvantage - high radiation
53
what are advantages and disadvantages of MRI
advantages - soft tissue, no radiation, sensitive to marrow, good for spinal disease and discs disadvantage - claustrophobia, noisy, metallic clips or implants, expensive
54
what is high intensity and what is low intensity on t1 and t2 MRI
t1 - high - bone marrow/fat - low - csf, edema, infection t2 - high - csf, edema, infection - low - bone marrow/fat
55
what tumors occur in the epiphysis what tumors occur in the diaphysis
epiphysis - chondroblastoma, giant cell, CMF diaphysis - ewings sarcoma, EG, lymphoma

Radiology Tumors (11 decks)

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