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|MainCategory=Pathology
|MainCategory=Pathology
|SubCategory=Oncology
|SubCategory=Oncology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
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|Prompt=A 12-year-old boy comes to the health center because he has had persistent fever and pain in his right leg for the past 2 months.  He says that he recently added jogging to his weight-lifting workouts, and he started running 5 miles per day 2 weeks ago.  He is 5 ft 7 inches tall and weighs 60kg.  On physical examination, he has moderate tenderness over the diaphysis of the right leg.  Additional tests were done which revealed a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22.  X-ray of the hip will most likely show which of the following?
|Prompt=A 12-year-old boy comes to the health center because he has had persistent fever and pain in his right leg for the past 2 months.  He says that he recently added jogging to his weight-lifting workouts, and he started running 5 miles per day 2 weeks ago.  He is 5 ft 7 inches tall and weighs 60kg.  On physical examination, he has moderate tenderness over the diaphysis of the right leg.  Additional tests were done which revealed a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22.  X-ray of the hip will most likely show which of the following?
|Explanation=Ewing’s sarcoma is a malignant small, round, blue cell tumor in which cancer cells are found in the bone or in soft biological tissue.  It is a rare disease commonly prevalent among boys less than 15 years of age.  The most common locations are: pelvis, femur, humerus, ribs and clavicle (collar bone).  The characteristic appearance on X-ray is the “Onion-skin” appearance.  Treatment is chemotherapy.
|Explanation=Ewing’s sarcoma is a malignant small, round, blue cell tumor in which cancer cells are found in the bone or in soft biological tissue.  It is a rare disease commonly prevalent among boys less than 15 years of age.  The most common locations are: pelvis, femur, humerus, ribs and clavicle (collar bone).  The characteristic appearance on X-ray is the “Onion-skin” appearance.  Treatment is chemotherapy.
Educational Objective: Ewing’s sarcoma is a small, malignant, round, blue cell tumor common among boys less than 15 years, and it is very responsive to chemotherapy.
|AnswerA=“Double bubble” sign
|AnswerA=“Double bubble” sign
|AnswerAExp=Incorrect.  Double bubble sign is a feature of Osteoclastoma.  The age range is between 20-40 years and it is usually located at the epiphysis of long bones.
|AnswerAExp=Incorrect.  Double bubble sign is a feature of Osteoclastoma.  The age range is between 20-40 years and it is usually located at the epiphysis of long bones.
|AnswerB=Codman’s triangle or sunburst appearance pattern
|AnswerB=Codman’s triangle or sunburst appearance pattern
|AnswerBExp=Incorrect.  This is a feature of Osteosarcoma.  It affects men between ages 10-20 years.  It is usually around the metaphysis of long bones.
|AnswerBExp=This is a feature of Osteosarcoma.  It affects men between ages 10-20 years.  It is usually around the metaphysis of long bones.
|AnswerC=“Onion-skin” appearance
|AnswerC=“Onion-skin” appearance
|AnswerCExp=Correct.  The “Onion-skin” appearance is a pathognomonic feature observed in Ewing's sarcoma.
|AnswerCExp=The “Onion-skin” appearance is a pathognomonic feature observed in Ewing's sarcoma.
|AnswerD=Glistering mass within the medullary cavity
|AnswerD=Glistering mass within the medullary cavity
|AnswerDExp=Incorrect.  This is a feature of Chondrosarcoma.  It affects men between the ages 30-60.  It is commonly found in the pelvis, spine, scapula, tibia, and femur.
|AnswerDExp=This is a feature of Chondrosarcoma.  It affects men between the ages 30-60.  It is commonly found in the pelvis, spine, scapula, tibia, and femur.
|AnswerE=Normal findings
|AnswerE=Normal findings
|AnswerEExp=Incorrect.  The presence of a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22 are not normal in any individual.
|AnswerEExp=The presence of a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22 are not normal in any individual.
|EducationalObjectives=Ewing’s sarcoma is a small, malignant, round, blue cell tumor common among boys less than 15 years, and it is very responsive to chemotherapy.
|References=First Aid 2014 page 422
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Ewing’s sarcoma, malignant bone tumors, Osteosarcoma, chondrosarcoma
|WBRKeyword=Ewing’s sarcoma, malignant bone tumors, Osteosarcoma, chondrosarcoma
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 00:59, 11 September 2014

 
Author [[PageAuthor::Ayokunle Olubaniyi, M.B,B.S [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathology
Sub Category SubCategory::Oncology
Prompt [[Prompt::A 12-year-old boy comes to the health center because he has had persistent fever and pain in his right leg for the past 2 months. He says that he recently added jogging to his weight-lifting workouts, and he started running 5 miles per day 2 weeks ago. He is 5 ft 7 inches tall and weighs 60kg. On physical examination, he has moderate tenderness over the diaphysis of the right leg. Additional tests were done which revealed a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22. X-ray of the hip will most likely show which of the following?]]
Answer A AnswerA::“Double bubble” sign
Answer A Explanation AnswerAExp::Incorrect. Double bubble sign is a feature of Osteoclastoma. The age range is between 20-40 years and it is usually located at the epiphysis of long bones.
Answer B AnswerB::Codman’s triangle or sunburst appearance pattern
Answer B Explanation AnswerBExp::This is a feature of Osteosarcoma. It affects men between ages 10-20 years. It is usually around the metaphysis of long bones.
Answer C AnswerC::“Onion-skin” appearance
Answer C Explanation AnswerCExp::The “Onion-skin” appearance is a pathognomonic feature observed in Ewing's sarcoma.
Answer D AnswerD::Glistering mass within the medullary cavity
Answer D Explanation AnswerDExp::This is a feature of Chondrosarcoma. It affects men between the ages 30-60. It is commonly found in the pelvis, spine, scapula, tibia, and femur.
Answer E AnswerE::Normal findings
Answer E Explanation AnswerEExp::The presence of a small, round, blue cell tumor, and a translocation between chromosomes 11 and 22 are not normal in any individual.
Right Answer RightAnswer::C
Explanation [[Explanation::Ewing’s sarcoma is a malignant small, round, blue cell tumor in which cancer cells are found in the bone or in soft biological tissue. It is a rare disease commonly prevalent among boys less than 15 years of age. The most common locations are: pelvis, femur, humerus, ribs and clavicle (collar bone). The characteristic appearance on X-ray is the “Onion-skin” appearance. Treatment is chemotherapy.

Educational Objective: Ewing’s sarcoma is a small, malignant, round, blue cell tumor common among boys less than 15 years, and it is very responsive to chemotherapy.
References: First Aid 2014 page 422]]

Approved Approved::Yes
Keyword WBRKeyword::Ewing’s sarcoma, WBRKeyword::malignant bone tumors, WBRKeyword::Osteosarcoma, WBRKeyword::chondrosarcoma
Linked Question Linked::
Order in Linked Questions LinkedOrder::