1. 1. A 49 year old man has a pathological vertebral fracture. X ray shows metastasis. What 5 carcinomas metastasize to bone and which of these can be osteoblastic?
    Breast, bronchus, kidney, thyroid, prostate - Prostate can be osteoblastic
  2. 2. A 56 year old woman presents with osteoporosis. What are the 7 secondary causes of osteoporosis?
    Metabolic (low calcium, protein, scruvy), Assocrted endocrine (thyrotoxicosis), Steroid, Cigarette, Alchohol, Reduced excersize, Aluminium antacids - think MASCARA
  3. 3. A 28 year old male with ankylosing spondylitis presents in heart failure. you hear a murmur on examination but you can't characterise it. What heart complication may have occurred?
    Aortic valve incompetence (as a result of rheumatoid aortitis)
  4. 4. A 43 year old man presents with a pathological hip fracture. Phosphate and calcium are normal, ALP is raised. What is this and what malignancy is associated?
    Paget's disease - osteosarcoma
  5. 5. You are the FY1 on a a rheumatological ward. You note someone has written 'tensilon test abnormal' by the most recent conundrum patient. What is this diagnostic for?
    Myasthenia gravis.
  6. 6. A 56 year old male smoker presents with fatigability. Chest x ray shows a central lung lesion. What is this most likely to be and what is causing the fatigability?
    Small cell lung cancer - Lambert Eaton syndrome
  7. 7. A 30 year old man with a history of Gardner's syndrome presents with a bone lump on his femur. What is this most likely to be?
  8. 8. A 24 year old man presents with severe bone pain of his femur, improved by aspirin. X ray shows a central dense area surrounded by translucency. What is this most likely to be?
    Osteoid osteoma
  9. 9. A 41 year old female presents with a humeral lump. X ray shows it is cartilage capped. what is this?
  10. 10. A 7 year old child presents with a limp. X ray shows an onion skin appearance of a femoral lump. what is this?
    Ewing sarcoma
  11. 11. A 15 year old male is referred to orthopaedic clinic for scoliosis. On X ray there is dense bones extending into the medulla. There is a rib fracture. What is this?
    Osteopetrosis (marble bone disease)
  12. 12. A 17 year old male presents with knee pain. What neoplasm might this be and which 2 syndrome as associated?
    Osteosarcoma - Li-Fraumeni and retinoblastoma
  13. 13. A 54 year old woman with a history of rheumatoid arthiritis presents with splenomegaly, lymphadenopathy, anaemia and leucopenia. What syndrome does she have?
    Felty's syndrome
  14. 14. A 31 year old man comes to see you in his clinic. He has true dwarfism. Which gene is likely to be mutated?
    Fibroblast growth factor receptor
  15. 15. A neonate is born with 2 broken bones. You note blue sclera and hearing loss. Which protein is likely to be mutated?
    Osteogenesis imperfecta - type I collagen
  16. 16. A 1-5 year old child presents with a limp. Which 2 diseases should you think of? ?
    Septic arthiritis, developmental dysplasia of the hip
  17. 17. A 5-10 year old child presents with a limp. Which 2 diseases should you think of? ?
    Perthes disease (avascular femoral head necrosis) and septic arthiritis
  18. 18. A 10-15 year old male presents with a limp. Which 2 diseases should you think of? ?
    SUFE, septic arthiritis
  19. 19. Where is osteosarcoma likely to metastasize to? ?
  20. 20. What is the commonest tumour of bone? ?
  21. 21. Where are chondrosarcomas most commonly located? ?
    Hip and pelvis
  22. 22. What heart complication most commonly occurs as a result of rheumatoid arthiritis? ?
    Asymptomatic pericarditis
  23. 23. What triad of symptoms characterises Reiter's syndrome and what disease would you associate with it? ?
    Arthritis, urethritis and conjunctivits - associated with non-specific urethritis
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