Predisposing Factors:

Non-modifiable: Age 10-30 years (teenage growth spurt), Genetics, Height (too tall for age), Sex (more
common in MALES), Race (more common in African American, Hispanics, and Latins), Paget disease
(heaving and thick bones that are weak), Hereditary multiple osteochondromas (benign tumors formed of bone
and cartilage), Fibrous dysplasia (bone makes too much fibrous (scar-like) tissue, which replaces the normal
bone) (least risk)
Modifiable: Exposure to Radiation in bones, Benign tumors, Lack of exercise, Smoking and drinking, Injury,
Metabolic/ hormonal disturbances

Etiology: Active Rapid deposition Highly

mesenchymal of osteoblasts concentrated DNA mutation
Unknown
cells bone formation

Proliferation of MALIGNANCY Activation of

CDKN2A is inactivated (causes
abnormal of osteoblasts tumor suppressors: p16 and p14) Oncogene
osteoblasts
Biopsy

Formation of MALIGNANT Dilation of vessel

immature bone NEOPLASM
or osteoid Destruction of adjacent bone tissue

Uncontrolled Shiny skin appearance

Overcrowding in
Bone mass formation growth of tumor
the bone
in the bone Tall height for age

MRI, CT scan, Xray

INCREASED
PRESSURE IN THE Surgical bone fixation
Pathological Fracture
AFFECTED AREAS

Increase rest periods,

deep breathing
Pain techniques, NSAIDs, Edema
acetaminophen,
corticosteroids

Limited ROM Stimulation of immune response

Unable to walk without Reduce salt, elevation of Fever (> 37.5 deg. centigrade)
support affected area, NSAIDs

Acetaminophen,
Use of supportive NSAIDs
devices as needed
SUPRESSION OF Decreased RBC Anemia
RED BONE
MARROW
Nutritional rehab, family Anorexia Hgb 8.40 gm/dL
therapy, psychotherapy,
hospitalization,
antidepressants,
antipsychotics

Fatigue Nutritional rehab,

Oxygen therapy (low
conc. 2L/min), deep
breathing techniques,
incentive spirometry,
pursed-lip breathing, Shifting of aerobic to anaerobic
inhaled steroids,
diuretics, continuous
positive airway pressure
mask (CPAP)
exercise, NSAIDs,
antihistamines,
stimulants,
Erythropoietin is secreted in antidepressants,
the kidney anxiolytics
SOB/ Hypoxia
Stimulation of RBC
Increased ESR
respiration Erythropoiesis
65mm in 1 hour
Release of lactic acid
Dizziness Environment
Irritation of receptors modification, place in
sitting position, use
supportive devices, sleep
with HOB elevated with
2 pillows, antihistamines

Increase rest periods, Pain

deep breathing
techniques, NSAIDs,
acetaminophen, Decreased WBC Higher risk for
corticosteroids infection

WBC 14800 cu/mm

Antibiotics, NSAIDs,
decongestants

CBC, Blood chem, HbA1c

Blood transfusion
Decreased Platelets
(PRBC), corticosteroid

METASTASES TO
OTHER BODY Organ infiltration
PARTS
 Kidneys CNS Liver/ Spleen Lungs

Disturbances in renal Leukocyte cells impair Invasion and Overcrowding of

filtration circulation of CSF overcrowding of cancer in lungs
liver/spleen
GFR, BUN, urine Lumbar puncture, biochem
analysis, cytology, biomarkers
albumin, crea, BP,
imaging tests
Leukocyte cell Hepatomegaly/ Bronchial/ tracheal
compress spinal/
Kidney failure splenomegaly obstruction
cranial nerves
Abdominal Xray, CT scan Pulmonary function tests,
Dialysis, kidney laryngoscopy
transplant
Weakness,
Extra cells cause Severe hypoxia
blurred vision,
balance difficulty, liver/spleen to rupture
Little to no urine output vomiting,
lethargy

Increase fluid
intake, MIO, IVF Increased resting Bleeding Cough, Wheeze, SOB,
therapy periods, plan chest pain, hoarseness
activities, of voice, dysphagia
increased fluid
intake, IVF Oxygen therapy (low
therapy, conc. 2L/min), deep
Flank pain antihistamines, Hypovolemic shock
breathing techniques,
antimuscarinics, incentive spirometry,
MIO Oxygen therapy, pursed-lip breathing,
Increase rest
IVF therapy, inhaled steroids,
periods, deep
supine position diuretics, continuous
breathing
with feet at heart positive airway
techniques,
level pressure mask (CPAP)
NSAIDs,
acetaminophen,
corticosteroids Coma

Admission to
ICU, intubation Hypotension,
Edema tachycardia, tachypnea

Reduce salt,
elevation of
affected area,
NSAIDs

LEGEND:
Red: Predisposing factor

Purple: Etiology

Blue: Compensatory mechanisms

Pink: Laboratory tests/ possible results

Yellow: Signs and Symptoms/ manifestations

Orange: Interventions (Non-pharmacological, pharmacological, medical)