Deck 37: Alterations of Musculoskeletal Function

Question 1

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?

A) Impaired phosphate absorption
B) Increased calcium excretion
C) Vitamin D deficiency
D) Impaired vitamin C metabolism

Answer 1

Vitamin D deficiency

Question 2

A 54-year-old female was recently diagnosed with degenerative joint disease. This condition causes:

A) degeneration and loss of the epiphyses.
B) degeneration and loss of articular cartilage.
C) loss of synovial fluid.
D) degeneration of the joint capsule.

Answer 2

degeneration and loss of articular cartilage.

Question 3

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:

A) periosteitis.
B) pericondylitis.
C) bursitis.
D) epicondylitis.

Answer 3

epicondylitis.

Question 4

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

A) insufficiency
B) greenstick
C) fatigue
D) compound

Question 5

Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis)?

A) Admitted to the hospital for hip surgery and has had problems with anesthesia in the past
B) Admitted to the hospital for exacerbation of left heart failure and takes diuretic medications
C) Admitted to the hospital for a bone marrow transplant to treat leukemia
D) Admitted to the hospital to deliver a preterm infant

Question 6

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?

A) Idiopathic fracture
B) Iatrogenic fracture
C) Pathologic fracture
D) Greenstick fracture

Question 7

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:

A) dislocation.
B) subluxation.
C) sublimation.
D) nonunion.

Question 8

A 54-year-old male was recently diagnosed with osteoarthritis. Which of the following symptoms is he most likely experiencing?

A) Joint swelling
B) Hypermobility of joints
C) Contractures
D) Joint pain

Question 9

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

A) The fracture line is parallel to the bone.
B) The fracture line is diagonal to the shaft of the bone.
C) The fracture line is perpendicular to the bone.
D) The fracture line is vertical to the shaft of the bone.

Question 10

After the Boston Marathon, seven runners were admitted to local hospitals with suspected myoglobinuria (rhabdomyolysis). What is the most likely cause of myoglobinuria in these athletes?

A) Tendon injury
B) Undiagnosed hypertension
C) Excessive muscular activity
D) Undetected cardiac abnormalities

Question 11

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

A) collagen breakdown in the bone matrix.
B) excessive bone resorption.
C) crowding of bone marrow by excessive bone growth.
D) inadequate bone mineralization.

Question 12

Noninflammatory joint disease is differentiated from inflammatory joint disease by all of the following factors except:

A) the absence of synovial membrane inflammation.
B) the lack of systemic signs and symptoms.
C) normal synovial fluid.
D) the presence of pain.

Question 13

Researchers have now determined that rheumatoid arthritis:

A) is curable with antiviral agents.
B) is an autoimmune disease.
C) arises from rheumatic fever.
D) has the same causes as osteoarthritis.

Question 14

Transchondral fractures are most prevalent in:

A) adolescents.
B) elderly adults.
C) infants.
D) premenopausal females.

Question 15

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

A) density.
B) formation.
C) resorption.
D) mineralization.

Question 16

The incidence of fractures of the pelvis is highest in:

A) preadolescent boys.
B) adolescent boys.
C) adolescent girls.
D) elderly adults.

Question 17

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

A) bone infections.
B) joint injuries.
C) bone fractures.
D) osteomalacia.

Question 18

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

A) sprain.
B) strain.
C) disunion.
D) fracture.

Question 19

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 organisms causing this condition entered the bone through:

A) blood capillaries.
B) open fractures.
C) animal bites.
D) infected bedsores.

Question 20

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:

A) increased androgen levels.
B) decreased estrogen levels.
C) strenuous exercise.
D) excessive dietary calcium.

Question 21

Myeloma is a cancer that originates in which bone marrow cell?

A) T cell
B) Megakaryocyte
C) Plasma cell
D) Stem cell

Question 22

Fibromyalgia is a chronic musculoskeletal disorder characterized by:

A) pain resulting from joint and muscle inflammation.
B) muscle pain in the back and gastrointestinal symptoms.
C) neurologic pain in the skeletal muscles.
D) diffuse pain, fatigue, and point tenderness.

Question 23

The pattern of bone destruction indicative of an aggressive malignant tumor is known as a:

A) moth-eaten pattern.
B) permeative pattern.
C) geographic pattern.
D) radial pattern.

Question 24

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. The symptoms he experienced are caused by the crystallization of _____ within the synovial fluid.

A) purines
B) pyrimidines
C) uric acid
D) acetic acid

Question 25

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. He is at risk for developing:

A) cholelithiasis.
B) myocarditis.
C) renal disease.
D) liver failure.

Question 26

A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:

A) synovial membrane.
B) articular cartilage.
C) subchondral bone.
D) surrounding ligaments.

Question 27

A 13-year-old female is admitted to the hospital for evaluation and treatment of an osteosarcoma in her left distal femur. Which statement best describes osteosarcoma?

A) Myelogenic, develops in red bone marrow only
B) Benign, develops in spongy bone tissue
C) Collagenic, originates in the periosteum
D) Osteogenic, most often develops in the bone marrow

Question 28

A 29-year-old male was recently diagnosed with ankylosing spondylitis. He is interested in obtaining more information about his disease. Patient teaching would include all of the following statements except:

A) a diagnosis is made from history, physical examination, x-rays, and genetic analysis.
B) inflammation of the fibrocartilage in cartilaginous joints results in the erosion of bone structure, scar tissue formation, and joint fusion.
C) the more common signs and symptoms of early disease include restricted joint movement and increased pain after physical activity.
D) the usual treatment includes antiinflammatory and analgesic medications, exercises, and physical therapy.

Question 29

A malignant tumor of skeletal muscle tissue origin is called:

A) myofibrosarcoma.
B) giant cell tumor.
C) rhabdomyosarcoma.
D) rhabdomyoma.

Question 30

A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as:

A) myodysplasia.
B) ischemic atrophy.
C) disuse atrophy.
D) deconditioning hypoplasia.

Question 31

A 60-year-old male presents with swelling and pain in the knee. CT reveals a cartilage-forming tumor. His diagnosis would be:

A) chondrosarcoma.
B) rhabdosarcoma.
C) hyalinoma.
D) fibrosarcoma.

Question 32

Myotonia is characterized by:

A) prolonged depolarization of muscle cell membranes.
B) absence of ATP for muscle contraction.
C) delayed muscle contraction.
D) hyperactive reflexes.

Question 33

Which of the following people is at highest risk for the development of gout?

A) Men age 40 to 50 years
B) Premenopausal women
C) Male adolescents
D) Female children

Question 34

A 32-year-old female presents to her physician asking for something to ease her pain. She was previously diagnosed with fibromyalgia. Her pain is most likely caused by:

A) inflammation.
B) autoimmune destruction of muscle tissue.
C) alterations in pain tolerance.
D) increased levels of peripheral neurotransmitters.

Question 35

A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?

A) Trauma
B) Anemia
C) High-fat foods
D) Lack of exercise

Question 36

A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?

A) Vertebral and sacroiliac
B) Carpal and pharyngeal
C) Shoulder and hip
D) All hinge joints

Question 37

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:

A) monarticular arthritis.
B) tophaceous gout.
C) asymptomatic hyperuricemia.
D) complicated gout.