Deck 37: Alterations of Musculoskeletal Function

Question 1

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

A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Gold salts
C) Methotrexate
D) Hydroxychloroquine

Answer 1

Methotrexate

Question 2

The incidence of fractures of the pelvis is highest in:

A) Preadolescent boys
B) Adolescent boys
C) Adolescent girls
D) Older adults

Answer 2

Older adults

Question 3

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

A) Sweating
B) Dark urine
C) Yellow color to the skin
D) Lower extremity swelling

Answer 3

Dark urine

Question 4

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 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:

A) Periostitis
B) Muscle strain
C) Bursitis
D) Epicondylopathy

Question 6

The cause of Paget disease is:

A) Fluoride deficiency
B) Unknown at present
C) Excess vitamin A
D) Osteogenic sarcoma

Question 7

Transchondral fractures are most prevalent in:

A) Adolescents
B) Older adults
C) Infants
D) 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:

A) Sprain
B) Strain
C) Disunion
D) Subluxation

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:

A) Increased androgen levels
B) Decreased estrogen levels
C) Strenuous exercise
D) Excessive dietary calcium

Question 10

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) Pathologic bone fractures
D) Ssteomalacia

Question 11

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

A) Paget disease
B) Rickets
C) Osteomyelitis
D) Osteosarcoma

Question 12

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

A) Density
B) Formation
C) Resorption
D) 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?

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

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:

A) Dislocation
B) Subluxation
C) Distortion
D) Nonunion

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?

A) Fatigue fracture
B) Stress fracture
C) Pathologic fracture
D) Greenstick fracture

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?

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

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:

A) Staphylococcus aureus
B) Salmonella
C) Mycobacterium
D) Haemophilus influenza

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?

A) Comminuted
B) Greenstick
C) Fatigue
D) Compound

Question 19

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

A) The epiphyses
B) Articular cartilage
C) Synovial fluid
D) The joint capsule

Question 20

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

A) White blood cell count
B) Antinuclear antibodies
C) Aspartate aminotransferase
D) Creatine kinase (CK)

Question 21

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 22

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

A) Chondrosarcoma
B) Rhabdomyoma
C) Rhabdomyosarcoma
D) Fibrosarcoma

Question 23

A 35-year-old female presents with impaired motor function and visual disturbances.The diagnosis is Paget disease.What additional symptoms would be expected? (Select all that apply.)

A) Skull thickness
B) Dementia
C) Deafness
D) Headache
E) Hypertension

Question 24

Myotonia is characterized by:

A) Prolonged depolarization of muscle cell membranes
B) Absence of adenosine triphosphate (ATP) for muscle contraction
C) Delayed muscle contraction
D) Hyperactive reflexes

Question 25

A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity.She was diagnosed with ankylosing spondylitis (AS).The first joint to be affected would be the:

A) Sacroiliac
B) Carpal
C) Shoulder
D) Knee

Question 26

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

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

Question 27

Researchers now believe that RA is:

A) Curable with antiviral agents
B) An autoimmune disease
C) A complication of rheumatic fever
D) Related superficial joint injury

Question 28

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 29

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 30

A 29-year-old male was recently diagnosed with AS.He is interested in obtaining more information about his disease.Patient teaching would include which of the following? (Select all that apply.)

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 anti-inflammatory and analgesic medications, exercises, and physical therapy.
E) The spine becomes bent forward as the normal convex curve of the lower spine diminishes.

Question 31

The pattern of bone destruction indicative of an aggressive malignant tumor is known as J_____ pattern.(Select all that apply.)

A) Moth-eaten
B) Permeative
C) Geographic
D) Radial
E) Selective

Question 32

The most common cause of toxic myopathy is:

A) Infection
B) A tumor
C) Alcoholism
D) Osteoporosis

Question 33

To make a diagnosis of fibromyalgia,tenderness must be present in ____ of the 18 points necessary for diagnosis.

Question 34

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 35

Signs and symptoms of subluxation include (select all that apply):

A) Pain
B) Swelling
C) Hemorrhage
D) Limitation of movement
E) Joint deformity

Question 36

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 stones
D) Liver failure

Question 37

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 tender points

Question 38

A malignant tumor of striated muscle tissue origin is called:

A) Myelogenic tumor
B) Giant cell tumor
C) Rhabdomyosarcoma
D) Rhabdomyoma

Question 39

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

A) Synovial membrane
B) Articular cartilage
C) Subchondral bone
D) Surrounding ligaments

Question 40

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