Orthopaedics - Bone Tumors (Ny!)

Front 1

Which is/are true of the medical history in patients with musculoskeletal tumors:
- medical history usually does not provide any important information
- patients usually complain of pain
- pain is often promoted to the neighboring joint
- pain occurs only during exercise

Back 1

Which is/are true of the medical history in patients with musculoskeletal tumors:
- patients usually complain of pain+
- pain is often promoted to the neighboring joint+

Front 2

Which is/are true of the age of patients with musculoskeletal tumors:
- chondrosarcoma is typical tumor of children and adolescents
- up to 10 years is a frequent occurrence of Ewing's sarcoma of long bones
- between 10–20 years of age is a frequent incidence of osteosarcoma
- primary bone tumors are frequent in elderly

Back 2

Which is/are true of the age of patients with musculoskeletal tumors:
- up to 10 years is a frequent occurrence of Ewing's sarcoma of long bones+
- between 10–20 years of age is a frequent incidence of osteosarcoma+

Front 3

Which is/are true of the clinical symptoms of patients with musculoskeletal tumors:
- general symptoms usually occur at the beginning of disease
- extra-osteal ingredient without pathologic fracture is almost definite sign of malignancy
- a pathological fracture occurs only in malignant tumors
- to limit limb function or joint occurs, especially in malignant tumors and tumors near the joint

Back 3

Which is/are true of the clinical symptoms of patients with musculoskeletal tumors:
- extra-osteal ingredient without pathologic fracture is almost definite sign of malignancy+
- to limit limb function or joint occurs, especially in malignant tumors and tumors near the joint+

Front 4

Which is/are true of radiodiagnostics bone tumors:
- clear radiographs have virtually no significance and is replaced by more modern testing
- intramedullary dissemination of tumor and its extra-osteal folder appears mainly magnetic resonance
- Codman´s triangle we see inside the bones on the MRI and is a response of endosteum to the malignant tumor
- for bone tumors is a typical occurrence of periostosis

Back 4

Which is/are true of radiodiagnostics bone tumors:
- intramedullary dissemination of tumor and its extra-osteal folder appears mainly magnetic resonance+
- for bone tumors is a typical occurrence of periostosis+

Front 5

Which is/are true of the diagnosis of bone tumors:
- alkaline phosphatase and its isoenzymes are usually normal
- for plasmacytoma is often positive Bence Jones protein and the typical finding of immunoelectrophoresis of proteins
- scintigraphy provides information about the localization process and serves to exclude silent bearings in other skeletal
- angiography is nowadays practically omitted because it was replaced by MRI

Back 5

Which is/are true of the diagnosis of bone tumors:
- for plasmacytoma is often positive Bence Jones protein and the typical finding of immunoelectrophoresis of proteins+
- scintigraphy provides information about the localization process and serves to exclude silent bearings in other skeletal+

Front 6

Which is/are true of a biopsy of bone tumors:
- when a clear diagnosis of malignant tumor biopsies usually do not perform
- biopsy is the last link in the diagnostic procedure used for rapid diagnosis
- a biopsy using a standard surgical approaches
- access is chosen along the longitudinal axis of the limb at the point where it is closest to the surface extra-osteal component, calmly through the muscles try not to contaminate the blood vessels and nerves

Back 6

Which is/are true of a biopsy of bone tumors:
- biopsy is the last link in the diagnostic procedure used for rapid diagnosis+
- access is chosen along the longitudinal axis of the limb at the point where it is closest to the surface extra-osteal component, calmly through the muscles try not to contaminate the blood vessels and nerves+

Front 7

Which is/are true of the division and classification of bone tumors:
- according to surgical stage tumors can be divided into benign (G0), low-grade malignancy (G1) and a high degree of malignancy (G2)
- classic osteosarcoma among tumors with low-grade malignancy
- denoted as intra compartmental tumors growing only in the bone
- the boundary between compartments (bone and surrounding soft tissues) is a superficial layer of hard cortical bone

Back 7

Which is/are true of the division and classification of bone tumors:
- according to surgical stage tumors can be divided into benign (G0), low-grade malignancy (G1) and a high degree of malignancy (G2)+
- denoted as intra compartmental tumors growing only in the bone+

Front 8

Which is/are true of the treatment of bone tumors:
- the basis of treatment is surgical treatment
- the radiotherapy is use only as palliative treatment or for benign tumors
- neoadjuvant chemotherapy is used only to reduce the primary site
- adjuvant chemotherapy is used for disposal of micrometastases

Back 8

Which is/are true of the treatment of bone tumors:
- the basis of treatment is surgical treatment+
- adjuvant chemotherapy is used for disposal of micrometastases+

Front 9

Which is/are true of osteoid osteoma:
- is a benign tumor characterized by rest and nocturnal pain
- occurs mainly in the flat bones (e.g. pelvis)
- X-ray is often apparent brightening of the association bearing sizes up to 1 cm with perifocal osteosclerosis
- tumor is an urgent need to remove, as they often turn malignant

Back 9

Which is/are true of osteoid osteoma:
- is a benign tumor characterized by rest and nocturnal pain+
- X-ray is often apparent brightening of the association bearing sizes up to 1 cm with perifocal osteosclerosis+

Front 10

Which is/are true of osteosarcoma:
- is a rare malignant bone tumor
- most often occurs in first and second decade
- most osteosarcomas occur in the shaft of long bones
- occurs mainly in the region of the knee (distal femur and proximal tibia)

Back 10

Which is/are true of osteosarcoma:
- most often occurs in first and second decade+
- occurs mainly in the region of the knee (distal femur and proximal tibia)+

Front 11

Which is/are true of the diagnosis of osteosarcoma:
- the most common cause of poor outcome of treatment of osteosarcoma is the late diagnosis of disease
- X-ray is often periostosis seen as a Codman´s triangle
- for tumor scintigraphy is reflected as a loss of activity of bone metabolism
- early tumor metastasizes to the liver, so it is appropriate to capture the first sonographic examination of the abdomen

Back 11

Which is/are true of the diagnosis of osteosarcoma:
- the most common cause of poor outcome of treatment of osteosarcoma is the late diagnosis of disease+
- X-ray is often periostosis seen as a Codman´s triangle+

Front 12

Which is/are true of the treatment of osteosarcoma:
- the treatment is surgical treatment combined with chemotherapy and radiotherapy because the tumor is highly radiosensitive
- in addition to surgical treatment is used to remove the tumor and neoadjuvant and adjuvant chemotherapy
- the only treatment is amputation of limb
- with a good response to chemotherapy can be indicated to limb saving surgery

Back 12

Which is/are true of the treatment of osteosarcoma:
- in addition to surgical treatment is used to remove the tumor and neoadjuvant and adjuvant chemotherapy+
- with a good response to chemotherapy can be indicated to limb saving surgery+

Front 13

Which is/are true of chondroma:
- tumor mainly occurs in long bones, in the bones of the hand are rare
- is characterized by formation of mature cartilage
- occurs in three forms – chondroma inside the bones (enchondroma), chondroma on the surface of bone and calcifying and ossifying chondroma
- enchondromas of short bones are potentially malignant, enchondromas of long bones and trunk are markedly benign, mostly not turn malignant

Back 13

Which is/are true of chondroma:
- is characterized by formation of mature cartilage+
- occurs in three forms – chondroma inside the bones (enchondroma), chondroma on the surface of bone and calcifying and ossifying chondroma+

Front 14

Which is/are true of chondrosarcoma:
- is a highly malignant tumor of children and adolescents
- occurs most often in the pelvis, where it remains clinically silent for a long time
- on angiography is highly vascularized
- prognosis is relatively poor for the often subtle symptoms, it metastasizes relatively late into the lungs

Back 14

Which is/are true of chondrosarcoma:
- occurs most often in the pelvis, where it remains clinically silent for a long time+
- prognosis is relatively poor for the often subtle symptoms, it metastasizes relatively late into the lungs+

Front 15

Which is/are true of osteoclastoma:
- it is usually benign tumor occurring in the epiphyses of long bones
- typically occurs in old age
- tumor often recurs and often not turn malignant
- during surgery we remove tumor and fill cavity by bone cement, if we reach a recurrence approximately 2 years after we fill it by bone grafting

Back 15

Which is/are true of osteoclastoma:
- typically occurs in old age+
- during surgery we remove tumor and fill cavity by bone cement, if we reach a recurrence approximately 2 years after we fill it by bone grafting+

Front 16

Which is/are true of Ewing's sarcoma:
- a malignant tumor resulting from bone marrow and affects children and adolescents less than 20 years
- occurs mostly on the basis of osteomyelitis
- is the least vascularized tumor, angiography and scintigraphy so that is mostly negative
- the tumor is highly sensitive to chemotherapy and is radiosensitive, so the combined treatment (radiation + surgery + cytostatic) is indicated

Back 16

Which is/are true of Ewing's sarcoma:
- a malignant tumor resulting from bone marrow and affects children and adolescents less than 20 years+
- the tumor is highly sensitive to chemotherapy and is radiosensitive, so the combined treatment (radiation + surgery + cytostatic) is indicated+

Front 17

Which is/are true of myeloma:
- is a rare disease of bone, usually occurs in other locations
- maximum of occurrence is to 30 years of age
- with multiple occurrence of the spine due to pathological fractures may occur up to the loss of height
- surgical treatment of the multiple disability mostly limited to the treatment of pathological fractures

Back 17

Which is/are true of myeloma:
- with multiple occurrence of the spine due to pathological fractures may occur up to the loss of height+
- surgical treatment of the multiple disability mostly limited to the treatment of pathological fractures+

Front 18

Which is/are true of solitary bone cyst following:
- is a benign tumor occurring in the first and second decade of life
- occurs in the metaphyses of long bones with a maximum in the proximal humerus, femur and tibia
- the disease is manifested particularly severe pain by night and responds well to aspirin
- we use primarily in the treatment of decompression of cysts, topical administration of corticosteroids, or curettage and bone grafting

Back 18

Which is/are true of solitary bone cyst following:
- occurs in the metaphyses of long bones with a maximum in the proximal humerus, femur and tibia+
- we use primarily in the treatment of decompression of cysts, topical administration of corticosteroids, or curettage and bone grafting+

Front 19

Which is/are true of bone metastases:
- only tumors occurring in adulthood metastasize to bone
- prostate cancer and some types of breast cancer form osteolytic metastases in bone, most metastases of other organs have osteoplastic character
- pathological fracture can sometimes be the first sign of cancer
- solitary metastasis in an unknown source always treat cancer radically, because we cannot exclude a primary bone tumor

Back 19

Which is/are true of bone metastases:
- pathological fracture can sometimes be the first sign of cancer+
- solitary metastasis in an unknown source always treat cancer radically, because we cannot exclude a primary bone tumor+