Question 1

A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA).Which of the following is the expected treatment of choice?

Accepted Answer

Methotrexate remains the first line of treatment for RA.
Methotrexate,not NSAIDs,remains the first line of treatment for RA.
Methotrexate,not gold salts,remains the first line of treatment for RA.
Methotrexate,not hydroxychloroquine,remains the first line of treatment for RA.

Question 2

The incidence of fractures of the pelvis is highest in:

Accepted Answer

The incidence of fractures of the upper femur,upper humerus,vertebrae,and pelvis is highest in older adults and is often associated with osteoporosis.
Fractures of healthy bones,particularly the tibia,clavicle,and lower humerus,tend to occur in young persons.Fracture of the pelvis is highest in older adults.
Fractures of healthy bones,particularly the tibia,clavicle,and lower humerus,tend to occur in young persons.Fracture of the pelvis is highest in older adults.
Fractures of healthy bones,particularly the tibia,clavicle,and lower humerus,tend to occur in young persons.Fracture of the pelvis is highest in older adults.

Question 3

Which of the following clinical findings would be expected in the patient with rhabdomyolysis?

Accepted Answer

A classic triad of muscle pain,weakness,and dark urine is considered typical of rhabdomyolysis.
Dark urine,not sweating,is a classic sign of rhabdomyolysis.
Dark urine,not yellow skin,is a classic sign of rhabdomyolysis.
Dark urine,not lower extremity swelling,is a classic sign of rhabdomyolysis.

Question 4

An 80-year-old male presents with skeletal pain and tenderness,especially in the hips.He is diagnosed with osteomalacia caused by:

Accepted Answer

Osteomalacia is a metabolic disease characterized by inadequate and delayed mineralization of osteoid in mature compact and spongy bone.
Idiopathic osteoarthritis leads to collagen breakdown.
Giant cell tumors promote excessive bone resorption.
Abnormal remodeling causes crowding of bone marrow.

Question 5

A 36-year-old male complains of pain and weakness in the elbow.He reports that he is a warehouse worker and lifts boxes daily.MRI reveals inflammation of the tendon where it attaches to bone.This condition is called:

Accepted Answer

When force is sufficient to cause microscopic tears (microtears)in tissue,the result is known epicondylopathy.
When force is sufficient to cause microscopic tears (microtears)in tissue,the result is known epicondylopathy,not periostitis.
Muscle strain is local muscle damage that occurs when the muscle is stretched beyond capacity.
Bursitis is inflammation of the bursae.

Question 6

The cause of Paget disease is:

Accepted Answer

The cause of Paget disease is unknown.
The cause of Paget disease is unknown; it is not due to fluoride deficiency.
The cause of Paget disease is unknown; it is not due to excess vitamin A.
The cause of Paget disease is unknown; it is not due to osteosarcoma.

Question 7

Transchondral fractures are most prevalent in:

Accepted Answer

Transchondral fractures are most prevalent in adolescents.
Transchondral fractures are most prevalent in adolescent,not older adults.
Transchondral fractures are most prevalent in adolescents,not infants.
Transchondral fractures are most prevalent in adolescents,not premenopausal females.

Question 8

A 12-year-old female hurts her ankle while playing basketball.Tests reveal that she tore a ligament.This condition is known as a:

Accepted Answer

A torn ligament is also called a sprain.
Tearing or stretching of a muscle or tendon is commonly known as a strain.
Disunion occurs when fracture ends fail to heal.
Subluxation occurs when contact between the opposing joint surfaces of a fracture are partially lost.

Question 9

A 70-year-old female presents with a hip fracture.She is diagnosed with osteoporosis.One factor that most likely contributed to her condition is:

Accepted Answer

Osteoporosis can be attributed to decreased estrogen levels.
Osteoporosis can be attributed to decreased estrogen levels,not increased androgen levels.
Osteoporosis can be attributed to decreased estrogen levels,not strenuous exercise.
Osteoporosis can be attributed to decreased estrogen levels,not excessive dietary calcium.

Question 10

A 76-year-old female was diagnosed with osteoporosis by radiologic exam.She is at high risk for:

Accepted Answer

The patient will be at risk for pathologic bone fractures due to bone fragility.
The patient will not be at increased risk for infection.
The patient could be at risk for joint injury,but will be at greatest risk for fracture.
The patient is not at risk for osteomalacia.

Question 11

A disorder similar to osteomalacia that occurs in growing bones of children is termed:

Accepted Answer

Abnormal bone growth in children is termed rickets.
Paget disease is a state of increased metabolic activity in bone characterized by abnormal and excessive bone remodeling,both resorption and formation.
Osteomyelitis is a bone infection.
Osteosarcoma is a form of bone cancer.

Question 12

A 70-year-old female presents with a hip fracture secondary to osteoporosis.This condition is caused by an increase in bone:

Accepted Answer

Osteoporosis is due to an increase in bone resorption.
Osteoporosis is due to an increase in bone resorption; density would be decreased,not increased.
Osteoporosis is due to an increase in bone resorption,not formation.
Osteoporosis is due to an increase in bone resorption,not mineralization.

Question 13

A 65-year-old Hispanic female is admitted to the hospital with a pathologic,compound,transverse fracture of the femur.Which of the following statements best describes this type of fracture?

Accepted Answer

A transverse fracture occurs straight across the bone.
A linear fracture runs parallel to the long axis of the bone.
A transverse fracture runs straight across the bone,not perpendicular.
A transverse fracture runs straight across the bone,not vertically.

Question 14

A 35-year-old female suffers a broken clavicle following a motor vehicle accident.X-ray reveals that the bone surfaces in the joint partially lost contact with each other.This condition is called:

Accepted Answer

Subluxation occurs when contact between the opposing joint surfaces of a fracture are partially lost.
Dislocation is the displacement of one or more bones in a joint in which the opposing joint surfaces lose contact entirely.
Distortion is not a term applicable to fracture healing.
Nonunion is failure of the bone ends to grow together.

Question 15

A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality.She reports that the fracture occurred following a minor fall.Which of the following best describes the fracture?

Accepted Answer

A pathologic fracture is a break at the site of a preexisting abnormality,usually by force that would not fracture a normal bone.
A fatigue fracture is caused by abnormal stress or torque applied to a bone with normal ability to deform and recover.
Stress fractures occur in normal or abnormal bone that is subjected to repeated stress,such as occurs during athletics.
A greenstick fracture perforates one cortex and splinters the spongy bone.

Question 16

A 56-year-old male was admitted to the hospital with a diagnosis of osteomalacia.History reveals that he takes anticonvulsants,underwent small bowel resection 3 years earlier,and suffers from chronic pancreatitis.What is the common link between these three factors and the development of osteomalacia?

Accepted Answer

Disorders of the small bowel,hepatobiliary system,and pancreas are causes of vitamin D deficiency in the United States.Vitamin D deficiency is the most important factor in osteomalacia.
Vitamin D deficiency,not impaired phosphate absorption,is the common cause of osteomalacia.
Vitamin D deficiency,not increased calcium excretion,is the common cause of osteomalacia.
Vitamin D deficiency,not impaired vitamin C metabolism,is the common cause of osteomalacia.

Question 17

A 70-year-old male presents with back pain,fever,and weight loss.He reports that he had a recent respiratory infection from which he thought he recovered.Tests revealed increased white blood cell count,and a diagnosis of endogenous osteomyelitis was made.The primary organism causing this condition is:

Accepted Answer

Staphylococcus aureus remains the primary microorganism responsible for osteomyelitis.
Staphylococcus aureus,not Salmonella,remains the primary microorganism responsible for osteomyelitis.
Staphylococcus aureus,not Mycobacterium,remains the primary microorganism responsible for osteomyelitis.
Staphylococcus aureus,not Haemophilus influenza,remains the primary microorganism responsible for osteomyelitis.

Question 18

A 32-year-old obese male begins a jogging routine.A week after beginning,he fractures his leg.This is referred to as a what type of fracture?

Accepted Answer

A fatigue fracture is caused by abnormal stress or torque applied to a bone that usually occurs in individuals who engage in a new activity that is both strenuous and repetitive.
A comminuted fracture is one in which a bone breaks into two or more fragments.
A greenstick fracture perforates one cortex and splinters the spongy bone.
An open fracture is a complete and incomplete fracture that breaks through the skin.

Question 19

A 54-year-old female was recently diagnosed with degenerative joint disease.This condition is characterized by loss of:

Accepted Answer

Degenerative joint disease is caused by loss of the articular cartilage.
Degenerative joint disease is caused by loss of the articular cartilage,not the epiphyses.
Degenerative joint disease is caused by loss of the articular cartilage,not the synovial fluid.
Degenerative joint disease is caused by loss of the articular cartilage,not the joint capsule.

Question 20

An important and useful clinical measure in the diagnosis of rhabdomyolysis is measurement of which laboratory value?

Accepted Answer

The most important and clinically useful measurement in rhabdomyolysis is serum CK.A level five times the upper limit of normal (about 1000 units/liter)is used to identify rhabdomyolysis.
White blood cell count may be measured,but it is not more important than the CK.
Antinuclear antibodies may be measured,but it is not more important than the CK.
Aspartate aminotransferase may be measured,but it is not more important than the CK.

Quiz 37: Alterations of Musculoskeletal Function

A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA) .Which of the following is the expected treatment of choice?