Bone tumours: giant cell tumour biology: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone tumours: giant cell tumour biology

Sample item

Which drug targets the RANKL pathway driving osteoclast-like giant cells in unresectable giant cell tumour of bone?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Denosumab

In giant cell tumour the neoplastic stromal cells express RANKL, which recruits osteoclast-like multinucleated giant cells that destroy bone. Denosumab, a monoclonal antibody against RANKL, reduces the tumour and permits less morbid surgery or serves in unresectable disease.

Option by option

  • A. Imatinib

    Imatinib is used in GIST and CML.

  • B. Methotrexate

    Methotrexate is not a treatment for giant cell tumour.

  • C. Denosumab (correct)

    Correct. Denosumab blocks RANKL.

  • D. Zoledronic acid only

    Bisphosphonates inhibit osteoclasts but are not the RANKL-targeted agent.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Denosumab. In giant cell tumour the neoplastic stromal cells express RANKL, which recruits osteoclast-like multinucleated giant cells that destroy bone.

Why is "Imatinib" not the answer?

Imatinib is used in GIST and CML.

Why is "Methotrexate" not the answer?

Methotrexate is not a treatment for giant cell tumour.

Why is "Zoledronic acid only" not the answer?

Bisphosphonates inhibit osteoclasts but are not the RANKL-targeted agent.

What concept does this question test?

It tests Bone tumours: giant cell tumour biology in Orthopaedics. Denosumab, a monoclonal antibody against RANKL, reduces the tumour and permits less morbid surgery or serves in unresectable disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone tumours: giant cell tumour biology?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.