WorksheetsKB_IRAT_ Bone Tumours _ TBL_ Dr. Kishore
Total questions: 6
Worksheet time: 18mins
1. A 38-year old healthy man notes occasional pain in his right index finger when using a hammer. On palpation of the right proximal phalanx there is point tenderness. A radiograph shows a 1-cm oval lucency in this phalanx, with a surrounding rim of bright, radiodense bone. The microscopic appearance of the excised lesion is shown in the figure.
Which of the following cells is most likely to have given rise to this lesion?
Chondrocyte
Macrophage
Osteoblast
Giant cell
A 30-year-old woman has experienced pain in the area of the left knee for 1 month. On physical examination, there is tenderness to palpation of the distal left thigh and knee. The area is firm, but there is no erythema or warmth. A radiograph of the left leg shows a 7-cm mass in the distal femoral epiphyseal area, with a “soap bubble” appearance. Microscopic examination of a curettage specimen of the lesion shows the findings in the figure. The lesion recurs in the next year; it is excised and does not recur again. What is the most likely diagnosis?
Osteitis fibrosa cystica
Chondroblastoma
Osteoid osteoma
Giant cell Tumour Of bone
A 12-year-old girl has had sudden onset of severe pain in her left knee that has awakened her from sleep on several occasions during the past 6 weeks. For each episode, her mother has given her acetylsalicylic acid (aspirin), and the pain has been relieved. On physical examination, there are no remarkable findings. A radiograph of the left knee shows a well-defined, 1-cm lucent area surrounded by a thin rim of bony sclerosis located in the proximal tibial cortex. The patient undergoes radioablation of the lesion, and the pain does not recur. What is the most likely diagnosis of this lesion?
Osteoblastoma
Chondroblastoma
Osteoid osteoma
Exostosis
A 16-year-old boy has had pain around the right knee for the past 3 months. There are no physical findings except for local pain over the area of the proximal right tibia. A radiograph of the right leg shows an ill-defined mass involving the metaphyseal area of the proximal right tibia, and there is elevation of the adjacent periosteum. A bone biopsy specimen is obtained and on microscopic examination shows large, hyperchromatic, pleomorphic spindle cells forming an osteoid matrix. Which of the following tumor suppressor genes is most likely to be mutated in this boy?
APC
Rb
NF2
NF1
A 9-year-old boy presented with bone pain and swelling at his left leg for the past 3 months was brought to the Hospital Shah Alam. After investigations, he was diagnosed with osteosarcoma at left lower third of femur. The oncologist started chemotherapy along with colony stimulating factors: filgrastim.
Which of the following is the most likely reason of using filgrastim in this patient?
To make new white blood cell quickly.
To reduce the chance of bleeding.
To reduce the fatigue.
To maintain growth.
A 13-year-old girl with osteosarcoma was treated with chemo therapeutic agents. The patient experienced with untoward effects of these drug and need to reduce dosage amount of a particular drug.
Which of the following is the most likely drug that has dose related unwanted effect?
Cisplatin
Doxorubicin
Ifosfamide
Methotrexate
