Bone Tumors MCQs

A 19-year-old male complains of severe, aching thigh pain that is worse at night and dramatically relieved by ibuprofen. Radiographs show a dense cortical sclerosis with a 1 cm radiolucent nidus. The intense pain is mediated by local overproduction of which substance?

A 19-year-old male presents with dull, aching thigh pain that is distinctly worse at night and reliably relieved by ibuprofen. Imaging reveals a 1.2 cm radiolucent nidus with surrounding sclerosis in the proximal femoral diaphysis. What is the primary molecular mechanism responsible for this patient's pain?

A 19-year-old male complains of severe night pain in his proximal tibia that is dramatically relieved by NSAIDs. Radiographs show a small radiolucent nidus surrounded by dense sclerotic bone. What is the primary mechanism by which this lesion causes pain?

A 15-year-old boy presents with progressive distal thigh pain. Imaging shows a sunburst periosteal reaction and Codman's triangle in the distal femur. A biopsy confirms high-grade intramedullary osteosarcoma. What is the standard treatment protocol?

A 20-year-old man complains of severe, aching thigh pain that is notoriously worse at night and dramatically improves with NSAIDs. Radiographs reveal focal cortical thickening in the proximal femur with a central radiolucent nidus. What is the principal molecular mediator responsible for the intense pain in this lesion?

A 55-year-old male presents with a transverse fracture of the tibial shaft after a minor fall. Laboratory results show normal serum calcium, normal phosphorus, and markedly elevated alkaline phosphatase. Which of the following is the most likely underlying condition?

A 65-year-old male presents with severe back pain, fatigue, and recent onset of renal insufficiency. Radiographs show multiple 'punched-out' lytic lesions in the skull and pelvis. Which laboratory test is most diagnostic for his underlying condition?

The 'fallen leaf' (or 'fallen fragment') sign on a plain radiograph is virtually pathognomonic for which of the following benign bone lesions?

A 68-year-old man presents with diffuse bone pain and a pathological fracture of the proximal humerus. Laboratory testing shows anemia, hypercalcemia, and a monoclonal spike on serum protein electrophoresis. Which of the following imaging modalities is notoriously insensitive for detecting the skeletal lesions associated with this condition?

A 7-year-old girl is diagnosed with acute hematogenous osteomyelitis of the proximal tibia. In children, why is the metaphysis the most common initial location for hematogenous bacterial seeding?

A 15-year-old boy presents with severe, nocturnal diaphyseal tibial pain that is dramatically relieved by ibuprofen. Radiographs show a small radiolucent nidus surrounded by dense reactive sclerosis. What is the molecular mechanism responsible for this classic pain pattern?

A 20-year-old man presents with a 6-month history of a dull, aching thigh pain that is significantly worse at night and dramatically relieved by taking ibuprofen. Radiographs demonstrate a diaphyseal cortical thickening with a small radiolucent nidus. The relief of pain by NSAIDs in this condition is due to the inhibition of which molecule highly produced by the nidus?

A 19-year-old male complains of severe, unrelenting right thigh pain that is distinctly worse at night and dramatically relieved by NSAIDs. Radiographs show a small radiolucent nidus surrounded by dense sclerotic bone in the proximal femur. Which of the following substances is produced in high amounts by the cells within the nidus?

Which of the following is the most sensitive whole-body imaging modality for detecting skeletal marrow involvement in a patient newly diagnosed with multiple myeloma?

A 19-year-old male presents with severe nocturnal thigh pain that is rapidly and completely relieved by ibuprofen. Radiographs demonstrate diaphyseal cortical thickening with a 1 cm radiolucent nidus. The dramatic pain relief is due to NSAID inhibition of which specific molecule secreted by the nidus?

A 22-year-old male presents with dull, aching pain in his posterior mid-thoracic spine that is poorly relieved by NSAIDs. CT imaging reveals a 3.0 cm expansile, radiolucent lesion in the right T8 lamina with a thin sclerotic margin and focal internal mineralization. Histologic examination shows interlacing trabeculae of woven bone lined by a single layer of plump, uniform osteoblasts. What is the most likely diagnosis?

A 19-year-old male complains of severe left thigh pain that is worse at night and dramatically relieved by ibuprofen. Radiographs show a small radiolucent nidus surrounded by dense sclerotic bone in the proximal femur. Which of the following enzymes is typically found in high concentrations within the nidus?

A 65-year-old patient undergoes a workup for pathological vertebral compression fractures, anemia, and hypercalcemia. Radiographs show multiple punched-out lytic lesions in the calvarium. Which laboratory test is the most diagnostic for this suspected malignancy?