All right, welcome to episode 541 of the Divine Intervention Podcasts.

In today's podcast, we're going to be addressing a pretty high-year topic.

I'm going to title this, familial cancer syndromes and the USMLEs.

Familiar Cancer Syndromes and the USMETs.

This is one of those things that you know you're going to see on step one, step two, step three.

So I would not ignore it.

It's something I would know and know well if I were you.

We're going to hit up about seven things.

And there's a worksheet attached to this.

So you can either listen to the workshop, listen to the podcast first and fill out the

worksheet at the end or try to

follow along and then fill out the worksheet as we go one by one. And the worksheet goes in order

with the way I'm going to discuss the pathologies in this question. All right. Now, what if they give

you a question about like a 17 year old boy? And they tell you that, you know, for the last like four weeks, he's been having pretty significant pain in his right lower extremity, just around his knee. And then they tell you that you get an x-ray. And then they tell you that you see destructive processes around the cortex of the bone. And you're told that the boy has lost some weight and whatnot. So what should you be, what should you be thinking about there? I hope you're saying divine, this person probably has an osteosarcoma. This person probably has some kind of osteosarcoma. Remember, for osteosarcomas, you're going to see the Codman's triangle, you're going to see the somers pattern.

That's a very classic x-ray.

You want to make sure you can identify. And typically for those folks, you know, after you get the x-ray, you're going to get some kind of MRI to see the lesion, and then you're going to do a tissue biopsy. You're going to do a bone biopsy. but osteosarcoma is not the big crux of all of this.

I guess maybe I can use that as a leading to what I want to discuss. So what are the classic

things we see with osteosarcoma in terms of risk factors? Well, we know that you can get

osteosarcoma from having an RB mutation, from having an RB mutation. If you have a retinoblastoma mutation,

you can get osteosarcoma. Remember, typically those kids will have a white reflex at birth instead

of a red reflex. So they have a retinoblastoma, which will raise their risk of osteosurcomas.

Another risk factor for osteosurcoma is going to be Padgett's disease of the bone. It's probably

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