QUESTIONS 1 of 11 1 2 3 4 5 6 7 8 9 10 11 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ15.273) A 14-year-old boy presents to your clinic for right knee pain and abnormal Xrays obtained by his pediatrician. His mother brought him in for worsening right knee pain without a history of trauma. The pain is severe enough that he now has a noticeable limp. On questioning, he states the pain is diffuse about his knee. Additionally, he endorses night pain and minimal relief with anti-inflammatory medications. You obtain an xray and MRI studies to further evaluate the lesion. These are shown in figures A-D. Additionally, you obtain a biopsy for pathologic review shown in figure E. What is the correct pairing of diagnosis and treatment for this patient? QID: 5958 FIGURES: A B C D E Type & Select Correct Answer 1 Giant cell tumor of bone, observation 3% (46/1707) 2 Osteosarcoma, neoadjuvant chemotherapy with wide resection. 81% (1375/1707) 3 Aneurysmal bone cyst, wide resection with radiation therapy 12% (199/1707) 4 Chondroblastoma, chemotherapy 2% (38/1707) 5 Osteosarcoma, wide resection alone 2% (41/1707) L 3 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ13.109) A 14-year-old immigrant from a developing country had complained of pain playing soccer 4 months prior. Radiographs at that time were read as normal and he was given a prescription for NSAIDs. More recently, his parents noticed he is limping and complaining of pain after playing games. He has had some intermittent fevers and swelling around his thigh. A complete blood workup is performed. Current radiographs and MRI are seen in Figures A and B respectively. What is the next step in treatment QID: 4744 FIGURES: A B Type & Select Correct Answer 1 Biopsy 95% (3743/3955) 2 Genetic screening for EXT1 and EXT2 gene mutations 1% (53/3955) 3 NSAIDS and single-dose radiation therapy 1% (27/3955) 4 Intravenous antibiotics 2% (97/3955) 5 Observation 0% (17/3955) L 1 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic (OBQ13.86) An 11-year-old male presents with left forearm swelling and pain after getting kicked while playing soccer. Figures A through E are the radiographs, bone scan and MRI scan of the forearm and biopsy results. What is the most likely diagnosis? QID: 4721 FIGURES: A B C D E Type & Select Correct Answer 1 Chondroblastoma 5% (168/3683) 2 Intramedullary osteosarcoma 51% (1869/3683) 3 Parosteal osteosarcoma 36% (1337/3683) 4 Giant cell tumor 4% (130/3683) 5 Osteoblastoma 4% (152/3683) L 5 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (OBQ12.228) A 13-year-old presents with persistent leg pain. Representative radiographs are shown in Figures A and B. A biopsy is subsequently obtained and is shown in Figure C. What is the most likely diagnosis? QID: 4588 FIGURES: A B C Type & Select Correct Answer 1 Ewing's Sarcoma 8% (351/4528) 2 Eosinophilic granuloma 14% (612/4528) 3 Lymphoma 1% (59/4528) 4 Osteosarcoma 61% (2770/4528) 5 Osteoblastoma 15% (679/4528) L 1 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (SBQ12SP.76) A 55-year-old patient presents with lower lumbar back pain. A lateral radiograph of the L3 vertebral bone is shown in Figure A. Figure B and C are pre-operative biopsies. From the following options, what is the most likely diagnosis? QID: 3774 FIGURES: A B C Type & Select Correct Answer 1 Osteoblastoma 7% (243/3365) 2 Osteoblastic osteosarcoma 8% (281/3365) 3 Chondrosarcoma 17% (565/3365) 4 Ewing's Sarcoma 2% (57/3365) 5 Giant Cell Tumor 65% (2201/3365) L 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (OBQ11.122) A 21-year-old female presents with 7 years of leg pain and deformity. Radiographs from when she first noticed the lesion at age 14 are shown in Figures A and B. Current radiographs are shown in Figures C and D. Current MRI and histology section are shown in Figures E & F. What is the most likely diagnosis? QID: 3545 FIGURES: A B C D E F Type & Select Correct Answer 1 Osteofibrous dysplasia 25% (443/1759) 2 Adamantinoma 57% (997/1759) 3 Chronic osteomyelitis 1% (22/1759) 4 Periosteal osteosarcoma 3% (46/1759) 5 Fibrous dysplasia 14% (245/1759) L 2 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (OBQ11.88) A 21-year-old male presents with increasing shoulder pain for the past 6 months. Radiograph, CT scan, bone scan, MRI, and histology slide are shown in Figures A through E. What is the most appropriate diagnosis? QID: 3511 FIGURES: A B C D E Type & Select Correct Answer 1 Ewing's sarcoma 2% (45/2162) 2 Periosteal osteosarcoma 26% (564/2162) 3 Parosteal osteosarcoma 59% (1283/2162) 4 Osteochondroma 7% (154/2162) 5 Myositis ossificans 5% (107/2162) L 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic