Pathology EMQ

Name: Kinan Muhammed

Theme: Neoplastic disease of bone

OPTION LIST

A	Ankylosing spondylitis	I	Osteoblastoma
B	Chondroblastoma	J	Osteochondroma
C	Chondrosarcoma	K	Osteosarcoma
D	Echondroma	L	Rheumatoid arthritis
E	Ewings sarcoma	M	The Brain
F	Malignant Fibrous Histiocytoma	N	The Bronchus, Breast and Prostate
G	Multiple Myeloma	O	The Kidney and thyroid
H	Osteoarthritis	P	The Liver

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 17 year old male is brought to clinic with pain and swelling in his leg, his x-ray shows a destructive lesion with a moth-eaten appearance in the proximal tibia. The consultant decides to begin chemotherapy and mentions that radiotherapy would not be beneficial in this case.

2. A 48 year old man presents with shoulder pain and swelling, his x-ray show a lesion with a lobular appearance and mottled calcification of the cartilaginous matrix. Surgical resection is the mainstay of therapy.

3. The x-ray of a 16 year old boy shows an onion peel periosteal reaction of the humerus with a generous soft tissue mass. Cell surface markers p30/32 are present as well as translocation of the long arms of chromosome 11 and 22.

4. A 60 year old man presents with widespread bone pain following a recently fractured tibia, bloods show anaemia, hypercalcaemia and a raised ESR. On x-ray a characteristic “pepper pot” skull is seen and Bence Jones proteins found in his urine.

5. The most common metastatic bone tumours arise from…?

ANSWERS

1. K

2. C

3. E

4. G

5. N