Deck 45: Alterations of Musculoskeletal Function in Children

Question 1

What diagnosis is given when the infant's hip maintains contact with the acetabulum but is not well seated within the hip joint?

A) Dislocatable hip
B) Subluxated hip
C) Dislocated hip
D) Subluxable hip

Answer 1

Subluxated hip

Question 2

The failure of bones to ossify,resulting in soft bones and skeletal deformity,characterizes which disorder?

A) Osteogenesis imperfecta
B) Rickets
C) Osteochondrosis
D) Legg-Calvé-Perthes disease

Answer 2

Rickets

Question 3

Until the skeleton matures and adult stature is reached,where does growth in the length of bone occur?

A) Epiphyseal line
B) Physeal plate
C) Epiphyseal cartilage
D) Metaphyseal plate

Answer 3

Physeal plate

Question 4

At birth,the diagnosis of cerebral palsy (CP)may be made based on what factor?

A) Brain trauma during birth
B) Prematurity
C) Major brain malformation
D) Genetic defect

Question 5

An insufficient dietary intake of which vitamin can lead to rickets in children?

A) C
B) B12
C) B6
D) D

Question 6

In scoliosis,curves in the thoracic spine greater than how many degrees result in decreased pulmonary function?

A) 40
B) 50
C) 60
D) 80

Question 7

What pulmonary complication in children with Duchenne muscular dystrophy contributes to their death?

A) Infection
B) Kyphoscoliosis
C) Impaired formation of alveoli
D) Cancer

Question 8

Which serum laboratory test is elevated in all forms of osteogenesis imperfecta?

A) Phosphorus
B) Calcium
C) Alkaline phosphatase
D) Total protein

Question 9

Which assessment finding characterizes Osgood-Schlatter disease?

A) Lateral epicondylitis of the elbow
B) Inflammation of the anterior cruciate ligament
C) Bursitis of the subscapular bursa in the glenohumeral joint
D) Tendinitis of the anterior patellar tendon

Question 10

Which bones are affected in Legg-Calvé-Perthes disease?

A) Heads of the femur
B) Distal femurs
C) Heads of the humerus
D) Distal tibias

Question 11

The total mass of muscle in the body can be estimated from which serum laboratory test value?

A) Albumin
B) Blood urea nitrogen
C) Creatinine
D) Creatine

Question 12

How do the clinical manifestations and onset of juvenile rheumatoid arthritis (JRA)differ from those of rheumatoid arthritis (RA)in adults?

A) JRA begins insidiously with systemic signs of inflammation.
B) JRA predominantly affects large joints.
C) JRA has more severe joint pain than adult RA.
D) JRA has a rapid onset of generalized aches as the first symptom.

Question 13

What is the most common congenital skeletal defect of the upper extremity?

A) Vestigial tabs
B) Paget disease
C) Rickets
D) Syndactyly

Question 14

Which muscular dystrophy syndrome develops from an X-linked recessive mode of inheritance?

A) Duchenne
B) Facioscapulohumeral
C) Myotonic
D) Limb girdle

Question 15

Which skeletal deformity is normal at birth but generally disappears by 2_1/2 years of age?

A) Genu varum (bowleg)
B) Genu valgum (knock knee)
C) Equinovarus (clubfoot)
D) Pes planus (flat feet)

Question 16

What is the cause of osteochondrosis?

A) Imbalance between calcitonin and parathyroid hormone
B) Nutritional deficiency of calcium and phosphorus
C) Bacterial infection of the bone
D) Vascular impairment and trauma to bone

Question 17

Which statement is true regarding the pain experienced with Legg-Calvé-Perthes disease?

A) Pain experienced with Legg-Calvé-Perthes disease in the elbows and upper and lower arms is aggravated by activity and relieved by rest.
B) Pain experienced with Legg-Calvé-Perthes disease in the knees, inner thighs, and groin is described as a continuous ache and relieved by antiinflammatory drugs.
C) Pain experienced with Legg-Calvé-Perthes disease in the knees, inner thighs, and groin is aggravated by activity and relieved by rest.
D) Pain experienced with Legg-Calvé-Perthes disease in the elbows and upper and lower arms is described as a continuous ache and relieved by antiinflammatory drugs.

Question 18

Which sign or symptom is a very late indication of developmental dysplasia of the hip?

A) Asymmetry of the gluteal or thigh folds
B) Leg-length discrepancy
C) Waddling gait
D) Pain

Question 19

In osteomyelitis,bacteria gain access to the subperiosteal space in the metaphysis,which is considered the path of least resistance.What factor makes this route for bacteria the path of least resistance?

A) Cortex of the bone in this area is porous or mazelike.
B) Blood supply to the metaphysis is easily compromised.
C) Macrophages and lymphocytes have limited access to the subperiosteal space.
D) Bacteria usually spread down the medullary cavity of the bone.

Question 20

Which protein,absent in muscle cells of Duchenne muscular dystrophy,mediates the anchoring of skeletal muscle fibers to the basement membrane?

A) Syntrophin
B) Laminin
C) Dystrophin
D) Troponin

Question 21

Match the type of muscular dystrophy with its description.Types may be used more than once.
The face is expressionless,and pouting of the lips makes whistling impossible.

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Myotonic dystrophy
D)Becker muscular dystrophy

Question 22

Osteosarcoma usually metastasizes to the:

A) Pancreas
B) Liver
C) Lungs
D) Brain

Question 23

What is the most common malignant bone tumor diagnosed during childhood?

A) Chondrosarcoma
B) Fibrosarcoma
C) Ewing Sarcoma
D) Osteosarcoma

Question 24

Rhabdomyosarcoma can develop in which type of muscle?

A) Cardiac
B) Smooth
C) Involuntary
D) Striated

Question 25

What is the cause of structural scoliosis?

A) Poor posture
B) Vertebral rotation
C) Poor calcium absorption
D) Intrauterine trauma

Question 26

Which statements are true regarding bone growth before adulthood? (Select all that apply.)

A) Growth in the length of bone occurs at the physeal plate.
B) Growth occurs through endochondral ossification.
C) Bone growth takes place under hormonal control.
D) Cartilage cells at the epiphyseal side of the physeal plate multiply and enlarge.
E) Cartilage cells at the metaphyseal side of the plate are replaced by bone.

Question 27

Molecular analysis has demonstrated that osteosarcoma is associated with which gene?

A) TP53
B) src
C) myc
D) TSC2

Question 28

Match the type of muscular dystrophy with its description.Types may be used more than once.
Shares the X-linked inheritance pattern but produces milder symptoms.

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Myotonic dystrophy
D)Becker muscular dystrophy

Question 29

Match the type of muscular dystrophy with its description.Types may be used more than once.
Is an autosomal dominant condition with a slow rate of progression and frequently mental retardation.

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Myotonic dystrophy
D)Becker muscular dystrophy

Question 30

The anatomic makeup of which bone structures make them susceptible locations for osteomyelitis in children? (Select all that apply.)

A) Hip joint
B) Distal femur
C) Proximal humerus
D) Distal radius
E) Lateral ankle

Question 31

Which organism is the primary cause of osteomyelitis in a newborn?

A) Staphylococcus aureus
B) Escherichia coli
C) Group B streptococcus
D) Bacillus anthracis

Question 32

Generally,what is the first symptom of facioscapulohumeral muscular dystrophy?

A) Inability to open the eyes completely
B) Difficulty standing
C) Drooping shoulders
D) Facial pain

Question 33

Match the type of muscular dystrophy with its description.Types may be used more than once.
Onset occurs at approximately 3 years of age with rapid progression and frequently mental retardation.

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Myotonic dystrophy
D)Becker muscular dystrophy

Question 34

A Ewing sarcoma arises from the:

A) Bone marrow
B) Bone-producing mesenchymal cells
C) Metadiaphysis of long bones
D) Embryonal osteocytes