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178 Cards in this Set
- Front
- Back
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1. Tendinosis is:
a. painful because of degradation of collagen fibers caused by repetitive stress on tendons b. painful because of inflammation of tendons c. a torn tendon d. a complete separation of a tendon e. inflammation of a tendon where it attaches to a bone |
a. painful because of degradation of collagen fibers
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2. In an oblique fracture, the energy or force is:
a. twisting with the distal part unable to move b. compressive and at an angle c. directly an already weakened bone d. directly to the distal fragment |
b compressive and at an angle
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3. Which is a definite sign of a fracture?
a. abrasion b. shock c. directly to an already weakened bone d. unnatural alignment e. all of the above are correct |
d unnatural alignment
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4. Compartment syndromes:
a. involve large compartments of hemorrhage b. are caused by wound infection c. lead to muscle ischemia d. may result from myoglobinuria e. both b and c are correct |
c lead to muscle ischemia
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5. The most common cause of osteomyelitis is:
a. hematogenous spread of infection b. rheumatoid disease c. direct contamination of an open wound d. deficiency of calcium e. deficiency of vitamin D |
c direct contamination of an open wound
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6. Osteoporosis is:
a. inadequate mineralization b. impaired synthesis of bone organic matrix c. reduced bone mass or density d. formation of sclerotic bone e. none of the above is correct |
c reduced bone mass or density
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7. Osteomalacia causes:
a. loss of bone matrix b. inadequate mineralization c. radiolucency d. all of the above e. both b and c are correct |
e both b and c are correct
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8. Bone tumors may originate from all except:
a. epithelial tissue b. cartilage c. fibrous tissue d. vascular tissue e. mesoderm |
a epithelial tissue
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9. In benign bone tumors, there is:
a. uniform and well-defined lytic area b. a moth-eaten pattern of bone destruction c. abnormal bone merging with surrounding normal bone tissue d. an area of partially destroyed bone adjacent to completely lytic areas |
a uniform and well-defined lytic area
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10. An osteosarcoma is a(n):
a. collagenic, malignant bone tumor b. myelogenic, benign bone tumor c. myelogenic, malignant bone tumor d. osteogenic, benign bone tumor e. osteogenic, malignant bone tumor |
e osteogenic, malignant bone tumor
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11. The major symptom of bone cancer is a:
a. flattering gait b. persistent pain that worsens at night c. lack of sensation d. general swelling of a bone e. coolness over a bone |
b persistent pain that worsens at night
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12. Giant cell tumors:
a. affect males more frequently than females b. are located in the diaphysis of a long bone c. have extensive osteoblastic activity d. have high recurrence rates e. are multifocal |
d have high recurrence rates
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13. Osteoporosis pathogenesis involves:
a. nonmineralized osteoid tissue b. excessive resorption c. marrow and corticol inflammation d. alteration in the OPG/RANKL/RANK system |
d alteration in the OPG/RANKL/RANK system
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14. Rheumatoid arthritis begins with:
a. inflammatory destruction of the synovial membrane and subsynovial tissue b. inflammation of ligaments c. destruction of the articular cartilage d. softening of the articular cartilage e. destruction of the joint cartilage |
a inflammatory destruction of the synovial membrane
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15. In gout:
a. the pathogenesis is formation of monosodium urate crystals in joints and tissues b. metatarsophalangeal joints are usually involved c. affected individuals likely have an inherited enzyme (HGPRT) defect d. the hyperuricemia can be the result of acquired chronic disease or a drug e. all of the above are correct |
e all of the above
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16. RANKL is:
a. expressed on osteoclasts b. necessary for osteoclast development c. suppressive of apoptosis d. a glycoprotein that activates RANK |
b necessary for osteoclast development
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17. Myotonia is all except:
a. delayed relaxation after voluntary muscle contractions b. prolonged depolarization of the muscle membrane c. mostly inherited d. unresponsiveness to neural stimulation e. progressive atrophy of skeletal muscle |
d unresponsiveness to neural stimulation
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18. Rhabdomyosarcomas have:
a. a poor prognosis b. aggressive invasion c. early, widespread dissemination d. two age peaks, at 6 years and the teens e. all of the above are characteristics of this sarcoma |
e all of the above
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19. Which contributes to osteoarthritis?
a. collagenases b. rheumatoid factor c. circulating immune complexes d. infections |
a collagenases
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20. Which of the following is not true of ankylosing spondylitis?
a. It is a systemic immune inflammatory disease b. It is characterized by stiffening or fusion of the spine c. It causes instability of synovial joints d. It begins with inflammation of fibrocartilage e. It is manifested early by low back pain and stiffness |
c it causes instability of synovial joints
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21. Fibromyalgia:
a. exhibits systemic inflammation b. is characterized by increased sensitivity to touch c. manifests acute pain d. fatigue is most notable in the late evening e. both b and d are correct |
b is characterized by increased sensitivity to touch
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22. Myotonia is:
a. hypertrophy of skeletal muscles b. triggered by exercise c. inherited as an autosomal dominant trait d. due to prolonged depolarization of the muscle membrane |
d due to prolonged depolarization of the muscle membrane
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23. McArdle disease
24. Acid maltase deficiency 25. Polymyositis a. hypothyroidism b. hyperparathyroidism c. accumulation of glycogen in lysosomes d. unable to catabolize glycogen e. immune system abnormality |
23. d - unable to catabolize glycogen
24. c - accumulation of glycogen in lysosomes 25. e - immune system abnormality |
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Begins with the inflammation of fibrocartilage, particularly in the vertebrae and sacroiliac joint
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Ankylosing Spondylitis
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Ankylosing Spondylitis has a strong association with the HLA-B27 __.
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Antigen
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Excessive __ intake, chiefly through sodas and junk foods, interferes with the calcium/phosphorus balance; results in increased risk of brittle bones.
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Phosphorus
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Deficiency of vitamin __ lowers the absorption of __ from the intestines.
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Vitamin D, calcium
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In osteomalacia bone formation progresses to osteoid formation but __ does not occur; the result is soft bones.
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Calcification
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Also called osteitis deformans
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Paget disease
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Excessive resorption of spongy bone and accelerated formation of softened bone
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Paget disease
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Most often affects the axial skeleton
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Paget disease
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Bone density: normal bone is greater than __ mg/cm2
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833 mg/cm2
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The major risks with persons with osteoporosis are what?
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Fractures
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What type of fracture is the most common for osteoporosis? Which gender gets these fractures at a higher rate?
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Vertebral, affects both genders equally
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Is receptor activator of nuclear factor ligand (RANKL) a cytokine or interleukin?
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Cytokine
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What is RANKL's receptor?
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RANK (receptor activator of nuclear factor)
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What's RANKL's decoy receptor?
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Osteoprotegerin (OPG)
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What kind of protein is OPG?
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Glycoprotein
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OPG production is stimulated by what?
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Estrogens and the drug referred to as a selective estrogen receptor modulator (SERM), raloxifene
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Glucocorticoids __ RANKL expression and __ bone formation.
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Increase, decrease
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The most common manifestation of osteoporosis is bone __.
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Deformity
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Vertebral collapse causes ___.
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Kyphosis (hunchback)
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Osteopenia, or decreased bone mass, is __ to __ mg/cm2
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648 to 833 mg/cm2
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Fatal complications of fractures include what type of embolus, among what other complications?
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Fat or pulmonary embolism, hemorrhage, and shock.
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Osteoporosis is detected radio graphically as increased radio__ of bone.
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Radiolucency
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Is single or dual absorptiometry or computed tomography the examination of choice for diagnosis of osteoporosis?
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Dual-photon absorptiometry
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Osteoporosis is less than __ mg/cm2.
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648 mg/cm2
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How many types of osteoporosis are there? Describe...
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2, primary and secondary
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Primary osteoporosis is subdivided into what? When does senile osteoporosis occur?
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Postmenopausal and senile types; after age 70
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What causes secondary osteoporosis?
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Disease or drugs
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If osteoporosis is generalized, what skeleton is affected?
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Axial skeleton
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If osteoporosis is regional, what skeleton is affected?
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Appendicular
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Bone formation continues at a faster pace than resorption until peak bone mass, or max bone density or strength, is reached, around what age?oateo
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30
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A disease in which bone tissue is normally mineralized but the mass-density of bone-is decreased and the structural integrity of __ bone is impaired.
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Osteoporosis, trabecular
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RANKL is expressed by osteo__, and is necessary for osteo__ development.
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Osteoblasts, osteoclast
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RANKL is expressed by osteo__, and is necessary for osteo__ development.
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Osteoblasts, osteoclast
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RANK is expressed on osteo__ and activates apop__, which leads to activation and prolongation of osteo__ survival.
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Osteoclasts, apoptosis, osteoclast
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The balance between RANKL and OPG is regulated by cyto__ and hormones, and alterations of the RANKL/rank/OPG system can lead to dysregulation and pathological conditions including osteo__.
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Cytokines, osteoporosis
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The increase in bone resorption results from__ development of osteo__ and decreased osteo__ apop__.
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Increased,osteoclasts, osteoclast, apoptosis
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In normal bone remodeling, osteo__ development is stimulated by factors released from bone marrow stro__ cells during osteo__ resorption.
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Osteoblast, stromal, osteoclast
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RANKL expression is __ correlated with serum level of B-estradiol, that is, with estradiol deficiency, RANKL is __.
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Inversely, increased
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WNT signaling increases osteo__ and bone formation.
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Osteoblast
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Para__ hormone and biphos__ alter the rate o birth of new osteo__ or osteo__ or osteoclast _apop__
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Parathyroid, biphosphonates, osteoblasts, osteoclasts, apoptosis
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Gluco__ __ RANKL expression and inhibit OPG production by osteo__.
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Glucocorticoids increase, osteoblasts
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RANKL is expressed by osteo__, and is necessary for osteo__ development.
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Osteoblasts, osteoclast
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Androgens promote osteo__ production, thus __ the osteoclast effect of RANKL.
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Osteoblast, inhibiting
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In osteoporosis, fractures tend to occur because the tra__ of sp__ bone become thin and sparse and compact bone becomes po__.
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Trabeculae of spongy, porous
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In osteoporosis, fractures of the __ bones (femur and humerus), distal radius, ribs, and vertebrae are most common.
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Long
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RANK is expressed on osteo__ and activates apop__, which leads to activation and prolongation of osteo__ survival.
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Osteoclasts, apoptosis, osteoclast
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The balance between RANKL and OPG is regulated by cyto__ and hormones, and alterations of the RANKL/rank/OPG system can lead to dysregulation and pathological conditions including osteo__.
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Cytokines, osteoporosis
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The increase in bone resorption results from__ development of osteo__ and decreased osteo__ apop__.
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Increased,osteoclasts, osteoclast, apoptosis
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In normal bone remodeling, osteo__ development is stimulated by factors released from bone marrow stro__ cells during osteo__ resorption.
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Osteoblast, stromal, osteoclast
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RANKL expression is __ correlated with serum level of B-estradiol, that is, with estradiol deficiency, RANKL is __.
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Inversely, increased
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WNT signaling increases osteo__ and bone formation.
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Osteoblast
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Para__ hormone and biphos__ alter the rate o birth of new osteo__ or osteo__ or osteoclast _apop__
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Parathyroid, biphosphonates, osteoblasts, osteoclasts, apoptosis
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Gluco__ __ RANKL expression and inhibit OPG production by osteo__.
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Glucocorticoids increase, osteoblasts
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Age related bone loss begins in the __ decade
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Fourth
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Mg++ is important to bone quality because it controls hydro__ crystal growth and thereby prevents the formation of br__ bones.
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Hydroxyapatite, brittle
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Lateral epicondylopathy is commonly called what?
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Tennis elbow
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Tennis elbow is the result of tissue degeneration or irritation of the extensor carpi rad__ bre__ tendon at its origin.
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Radialis brevis
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Medial epicondylopathy is also known as what?
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Golfer's elbow
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These are small sacs lined with synovial membrane and filled with synovial fluid.
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Bursae
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In bursitis, the inflammation is due to overuse or excessive pre__. Can the inflammation spread to adjacent tissues?
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Pressure; yes
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Bursitis in the knee causes pain when climbing __.
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Stairs
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The location of the olecranon
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Elbow
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Location of the subacromial
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Shoulder
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Location of the greater trochanter
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Hip
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Location of a calcaneal
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Heel
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Severe mg++ deficiency results in hypo__.
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Calcemia
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A late complication of localized muscle injury is myositis oss__
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Myositis ossificans
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Elevation of mg++ or ca++ concentration inhibits Mg++ and Ca++ re__.
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Resorption
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The biphosphonates alen__ and risedr__ have been effective in reducing hip and vertebral fractures on glucocorticoid induced osteoporosis.
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Alendronate and risedronate
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Are muscles ruptured more often than tendons in young people?
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Yes
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Painful degradation of collagen fibers is __.
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Tendinosis
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Inflammation of tendons
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Tendinitis
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Inflammation of bursal sacs
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Bursitis
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Tendinopathy includes what?
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Tendinitis, tendinosis, and paratendinitis
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Inflammation of a tendon where it attached to a bone (at its origin).
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Epicondylitis
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Mg++ is important to bone quality because it controls hydro__ crystal growth and thereby prevents the formation of br__ bones.
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Hydroxyapatite, brittle
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Lateral epicondylopathy is commonly called what?
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Tennis elbow
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Tennis elbow is the result of tissue degeneration or irritation of the extensor carpi rad__ bre__ tendon at its origin.
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Radialis brevis
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Medial epicondylopathy is also known as what?
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Golfer's elbow
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These are small sacs lined with synovial membrane and filled with synovial fluid.
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Bursae
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In bursitis, the inflammation is due to overuse or excessive pre__. Can the inflammation spread to adjacent tissues?
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Pressure; yes
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Bursitis in the knee causes pain when climbing __.
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Stairs
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The location of the olecranon
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Elbow
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Location of the subacromial
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Shoulder
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Location of the greater trochanter
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Hip
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Location of a calcaneal
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Heel
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Severe mg++ deficiency results in hypo__.
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Calcemia
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A late complication of localized muscle injury is myositis oss__
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Myositis ossificans
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Rhabdomyolysis or myoglobin__, is named for the excess of myoglobin in the __.
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Myoglobinurea, urine
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Muscle cell damage releases myo__.
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Globin
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Most severe form of Rhabdomyolysis...
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Crush syndrome
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Elevation of mg++ or ca++ concentration inhibits Mg++ and Ca++ re__.
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Resorption
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The biphosphonates alen__ and risedr__ have been effective in reducing hip and vertebral fractures on glucocorticoid induced osteoporosis.
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Alendronate and risedronate
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Are muscles ruptured more often than tendons in young people?
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Yes
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Painful degradation of collagen fibers is __.
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Tendinosis
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Inflammation of tendons
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Tendinitis
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Inflammation of bursal sacs
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Bursitis
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Tendinopathy includes what?
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Tendinitis, tendinosis, and paratendinitis
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Inflammation of a tendon where it attached to a bone (at its origin).
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Epicondylitis
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Osteoporosis is a disease in which bone tissue is normally __ but the mass-__ of bone-is decreased and the structural integrity of __ bone is impaired.
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Mineralized, density, trabecular
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__ rumors are classified as being of osteo__, chondro__, colla__, and myelo__.
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Bone, genic
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The four types of bone rumors ultimately arise from the primitive meso__.
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Mesoderm
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Osteoporosis is a disease in which bone tissue is normally __ but the mass-__ of bone-is decreased and the structural integrity of __ bone is impaired.
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Mineralized, density, trabecular
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A complete separation of a tendon or ligament from its bony attachment site is known as a what?
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Avulsion
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The four types of bone tumors ultimately arise from the primitive meso__.
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Mesoderm
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Fracture in which a bone breaks into more than two fragments is called a what?
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Comminuted fracture
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Fracture that occurs straight across the bone
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Transverse
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This fracture perforates one cortex and splinters the spongy bone
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Greenstick
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In this fracture the cortex buckles but does not break
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Torus
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These fractures usually occur when longitudinal force is applied to the bone
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Bowing
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Healing of a bone in a nonanatomic position
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Malunion
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Less severe and more localized form of Rhabdomyolysis.
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Compartment syndrome
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Compartment syndrome can lead to vo__ ischemic contracture in the forearm or leg.
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Volkmann
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__ tumors are classified as being osteo__, chondro__, colla__, or myelo__.
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Bone, genic
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The four types of bone rumors ultimately arise from the primitive meso__.
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Mesoderm
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Dislocation is the temporary displacement of a bone from its normal position in a joint. If contact between the two surfaces is only partially lost, the injury is called a what?
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Subluxation
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A __ dislocation can be anterior, posterior, lateral, medial, or rotary.
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Knee
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Damage to the axillary nerve causes paralysis of the __ muscle.
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Deltoid
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A fibrous connective tissue that attaches skeletal muscle to bone.
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Tendon
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A band of fibrous connective tissue that connects bones where they meet a joint.
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Ligament
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A tear in a tendon
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Sprain
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Ligament tears are known as what?
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Sprains
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The point at which ligaments, tendons, and the joint capsule are inserted into a bone
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Enthesis
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98% of extracellular uric acid
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Monosodium urate
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Decreasing temperature cause both urate and uric acid's solubility to do what?
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Decrease
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Uric acid is a breakdown product of __.
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Purine nucleotides
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Primary gout has an unknown __ defect
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Metabolic
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Eliminates most uric acid from the body
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Kidneys
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Why do Monosodium urate precipitate at the periphery of the body?
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Lower temperatures
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Crystals which stimulate and perpetuate the inflammatory response
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Monosodium urate
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Activates cytokines and produces chemo attractants
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Complement system
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Renal stones are __ times more prevalent in individuals with primary gout than in the general population
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1000
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Primary site of rheumatoid arthritis
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Synovial membrane
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Proposed primary site of Ankylosing spondylitis
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Enthesis
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Ankylosing spondylitis is more prevalent in which gender?
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Male
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Gout is prevalent before age 30.
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False.
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Genetic predisposition to gout is x-linked alteration of enzyme __.
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HGPRT (hypoxanthine-guanine phosphoribosyltransferase)
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Crystallization in synovial fluid
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Gouty arthritis
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Small, white nodules that are visible through the skin
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Tophi
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Caused by the formation of calcium pyrophosphate dihydrate (CPPD) crystals.
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Pseudogout
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Uric acid is a byproduct of protein metabolism that normally assists in the removal of __ from the body
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Nitrogen
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Common misdiagnosis is chronic fatigue syndrome.
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Fibromyalgia
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Primitive cartilage or cartilage-like substance
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Chondroid
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Second most prevalent primary malignant bone tumor
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Chondrosarcoma
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Solitary tumor that most often affects the metaphyseal region of the femur or tibia
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Fibrosarcoma
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Bone spurs
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Osteophytes
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Peak age is 30 to 50 years
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Fibromyalgia
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Includes diffuse soft tissue pain of at least 3 months duration and pain on palpation of at least 11 of 18 tender points.
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Fibromyalgia
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Characterized by the formation of bone or osteoid tissue with a sarcomatous tissue.
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Osteogenic tumors
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Account for 38% of bone tumors
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Osteosarcomas
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60% occur in persons younger than 20 years.
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Osteosarcoma
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Area of devitalized bone
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Sequestrum
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Layer of new bone which osteoblasts lay down surrounding the infected bone
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Involucrum
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In children, osteomyelitis separates what?
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Periosteum from underlying bone
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These are elevated in bone lytic tumors.
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Serum alkaline phosphatase levels
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