Pathology EMQ template.

Name:

Candidate number:

Theme: Neoplastic Bone Disease

 

OPTION LIST

 

A	Fibrous dysplasia	I	Multiple myeloma
B	Aneurysmal bone cyst	J	Osteoblastoma
C	Bone metastases	K	Osteochondroma
D	Chondrosarcoma	L	Osteosarcoma
E	Ewing’s sarcoma	M
F	Fibrosarcoma	N
G	Giant cell tumour	O
H	Malignant Fibrous Hystiocytoma	P

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. 20 year old male presents with a 2 month history of lower back pain, unresponsive to OTC analgesics. X-ray shows a well-defined lesion in the posterior elements of the spine with expansion of the spinous processes.

 

2. 16 year old female presents with a 2 month history of knee pain that is worse on exercise and at night. X-ray shows an osteoblastic lesion in the distal femur, with disruption and elevation of the periosteum.

 

3. 67 year old male presents with a 2 month history of lower back pain. He also reports weight loss, fatigue and frequent chest infections. Skeletal survey shows lytic, punched-out lesions of the spine.

 

4. 30 year old female presents with a 1 month history of wrist pain, swelling and reduced range of motion. X-ray shows an osteolytic, lucent lesion in the subarticular part of the distal ulna. Resection shows a soft, chocolate brown lesion.

 

5.  14 year old female presents with a 3 month history of worsening pain and swelling in her right thigh and left lower ribs. Further history and examination reveals Café-au-lait spots and hyperthyroidism. X-rays of the lesions show a ground glass appearance.

 

 

ANSWERS

1. J

2. L

3. I

4. G

5. F