Pathology EMQ template.

Name: Rebecca Moss

Candidate number:

Theme: Neoplastic bone disease

OPTION LIST

A	Chondroblastoma	I	Monoplastic synovial sarcoma
B	Chondrosarcoma	J	Osteochondroma
C	Enchondroma	K	Osteosarcoma
D	Ewing’s sarcoma	L
E	Fibrosarcoma	M
F	Fibrous dysplasia	N
G	Giant cell tumour	O
H	Metastatic tumour to bone	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. A 13 year old girl presents with pain of her ribs and right hip. On examination she displays signs of hyperthyroidism and café au lait spots (McCune-Albright syndrome). X-ray demonstrates ‘soap bubble’ osteolysis.

2. A 25 year old woman presents with right shoulder pain. On x-ray a fracture is seen through a lytic lesion involving both the epiphysis and metaphysis of the right humerus.

3. A 15 year old boy, a keen footballer, complains of pain in his right shin. Onion skinning of the periosteum is seen on x-ray and a chromosomal abnormality t(11;22) is detected.

4. A 15 year old boy with a history of retinoblastoma at the age of 2 years presents with painful swelling of his left knee. A metaphyseal lytic lesion is seen on x-ray with a raised periosteum (Codman’s triangle).

5. A 50 year old gentleman complains of urinary frequency. Pelvic x-ray reveals a lytic lesion with fluffy calcification.

ANSWERS

1. F

2. G

3. D

4. K

5. B