MLA Domain 5 · Presentation
Bone pain
13 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.
classic presentation · 4
Neutropenic sepsis, bleeding from thrombocytopenia/DIC, or tumour lysis syndrome → emergencies
Progressive neurodegeneration (Tay-Sachs/Niemann-Pick) — supportive; Fabry → renal/cardiac/stroke surveillance
Hypocalcaemic seizures/tetany (severe) → calcium
Symptomatic hypocalcaemia (tetany, seizures, prolonged QT) → calcium replacement
recognised feature · 8
Metastatic spinal cord compression (back pain + neurology) → emergency MRI + dexamethasone + oncology (cross-ref acute_c
Any white pupillary reflex (leukocoria) → urgent ophthalmology; persistent unexplained bruising/pallor/bone pain; a chil
Open fracture (wound communicating with bone) → IV antibiotics, tetanus, photograph + cover, urgent orthoplastics
Severe (>3.5 mmol/L) or symptomatic (confusion, dehydration, arrhythmia) → emergency IV fluids + bisphosphonate
Severe (>3.5) / symptomatic hypercalcaemia → emergency IV fluids + bisphosphonate
Vertebral osteomyelitis with neurology (epidural abscess) → emergency MRI + surgical decompression
New severe pain/soft-tissue mass in Pagetic bone → exclude osteosarcoma
Metastatic spinal cord compression (back pain + neurology) → emergency MRI + dexamethasone + oncology
differential of the above · 1