Deck 11: Hematologic Bone Diseases

Question 1

Which of the following terms refers to a focal segment of epiphyseal necrosis?

A) Sickle cell anemia
B) Osteochondritis dissecans
C) Hereditary spherocytosis
D) Hemochromatosis

Answer 1

Osteochondritis dissecans

Question 2

What may plain films demonstrate in the inflammatory phase of epiphyseal necrosis?

A) Periarticular osteopenia
B) Sclerosis at the margin of the necrotic segment
C) Chondrocalcinosis
D) Epiphyseal squaring

Answer 2

Periarticular osteopenia

Question 3

Differentiating a medullary bone infarction from a benign ___________ is generally not possible on plain film images.

A) osteochondroma
B) enchondroma
C) osteosarcoma
D) Ewing's sarcoma

Answer 3

enchondroma

Question 4

Early Legg-Calvé-Perthes would present as which of the following?

A) Asymptomatic
B) Swelling in the involved joint
C) Hepatosplenomegaly
D) Ambulation with a limp that worsens with activity

Question 5

Which disease affects the epiphysis of the proximal femur in a child?

A) Kummel
B) Kohler
C) Panner
D) Legg-Calvé-Perthes

Question 6

A radiolucent defect of bone appearing at the lateral margin of the involved epiphysis in patients with Legg-Calvé-Perthes defines __________.

A) protrusio acetabulum
B) Gage's sign
C) snowcap sign
D) mushroom deformity

Question 7

Bone death secondary to an inadequate blood supply is known as __________.

A) hemochromatosis
B) avascular necrosis
C) hereditary spherocytosis
D) hemophilia

Question 8

The process of bone necrosis to deposition and remodeling of new bone may take __________.

A) 1 to 8 years
B) 1 to 8 months
C) 1 to 3 months
D) 1 to 3 weeks

Question 9

Which of the following statements best characterizes osteochondritis dissecans?

A) Osteochondral defect.
B) It only occurs in children.
C) It most commonly affects the distal tibia.
D) It more frequently affects non-weight-bearing bones.

Question 10

Excessive iron deposits within tissues are found in patients with __________.

A) hemochromatosis
B) hemophilia
C) thalassemia
D) sickle cell anemia

Question 11

Which of the following is the most sensitive imaging modality for the detection of early bone infarction?

A) Plain film
B) CT
C) DEXA
D) MRI

Question 12

What is the term for an infarction in the epiphysis of the capitellum of the humerus in a child?

A) Panner disease
B) Hass disease
C) Chandler disease
D) Freiberg disease

Question 13

Radiographic findings of osteochondritis dissecans often include all of the following except __________.

A) subarticular defect
B) free-floating fragment
C) serpiginous calcific opacities
D) marginal sclerosis

Question 14

Avascular necrosis in the femur head of an adult is known as __________ disease.

A) Chandler
B) Pott
C) Panner
D) Perthe

Question 15

Which of the following is the most reliable early plain film sign of epiphyseal infarction?

A) Crescent sign
B) H-shaped vertebrae
C) Madelung's deformity
D) Flattened femoral head

Question 16

The order of events in bone necrosis is __________.

A) osteoarthritis, ischemia, revascularization, repair, deformity
B) ischemia, revascularization, repair, deformity, osteoarthritis
C) ischemia, revascularization, deformity, repair, osteoarthritis
D) osteoarthritis, ischemia, repair, revascularization, deformity

Question 17

What kind of gait does a child with bilateral Legg-Calvé-Perthes disease have because of the abduction and external rotation of the hips?

A) Steppage
B) Ataxic
C) Waddling
D) Scissor

Question 18

What is the most common location of osteochondritis dissecans?

A) The medial aspect of the olecranon process
B) The lateral aspect of the medial femoral condyle
C) The anterior aspect of the medial humeral epicondyle
D) The sustentaculum tali of the calcaneus

Question 19

Articular manifestations in hemochromatosis include both osteoarthritis and __________.

A) epiphyseal squaring
B) generalized osteopenia
C) chondrocalcinosis
D) H-shaped vertebrae

Question 20

What is the most common location for an infarction in the epiphysis of a skeletally immature long bone?

A) Distal femur
B) Proximal humerus
C) Proximal femur
D) Distal humerus

Question 21

A doctor must differentiate leukemia from _____ due to the fact that they both cause periostitis and separations of the sutures.

A) hemochromatosis
B) hemophilia
C) neuroblastoma metastasis
D) thalassemia

Question 22

Which of the following is a condition marked by morphological alterations of red blood cells that reduce their ability to carry oxygen?

A) Hemochromatosis
B) Hemophilia
C) Hereditary spherocytosis
D) Thalassemia

Question 23

Which of the following best characterizes hemochromatosis?

A) It occurs most frequently in Asian and African ethnicities.
B) It generally causes patients to have liver disease.
C) It is always an autosomal dominant inherited disease.
D) It most commonly affects the knee.

Question 24

Which of the following is not a radiographic finding of leukemia?

A) Transmetaphyseal lucent bands
B) Marrow hyperplasia
C) Moth-eaten pattern of osteolytic destruction
D) Generalized osteopenia

Question 25

The green-colored leukemic cells that are sometimes found in patients with acute myelogenous leukemia are called __________.

A) chloromas
B) rodent facies
C) pseudotumors
D) chancres

Question 26

Which of the following is a class of recessive X-linked disorders that results in insufficient clotting factors?

A) Hemochromatosis
B) Hemophilia
C) Thalassemia
D) Sickle cell anemia

Question 27

Avascular necrosis of the lunate is also known as __________ disease.

A) Preiser
B) Kummel
C) Freiberg
D) Kienböck

Question 28

What is the earliest plain film finding of hemophilia?

A) H-shaped vertebrae
B) Intraarticular soft tissue swelling
C) Chondrocalcinosis
D) Pseudotumors

Question 29

What is the most common radiological manifestation of leukemia?

A) Generalized osteopenia
B) Periostitis
C) Spotty sclerosis
D) Marrow hyperplasia

Question 30

Which of the following is not a typical clinical finding in patients with thalassemia?

A) Hepatosplenomegaly
B) Jaundice
C) Hand-foot syndrome
D) Early epiphyseal closure

Question 31

Which of the following statements regarding hereditary spherocytosis is false?

A) The red blood cells are spherical.
B) Patients may develop anemia of varying severity.
C) The most common radiographic finding is periostitis.
D) The spleen may be enlarged in these patients.

Question 32

Which of the following statements best characterizes hemophilia?

A) It is only clinically manifested in males.
B) It is classically carried by males.
C) It is a disorder of excessive iron deposition within tissues.
D) It is a disorder of excessive calcium deposition within tissues.

Question 33

Avascular necrosis of the tarsal navicular is also known as __________ disease.

A) Mauclaire
B) Kohler
C) Hass
D) Freiberg

Question 34

In thalassemia patients, coarse trabeculation, osteopenia and undertubulation of long bones, maxillary overgrowth, and a "hair-on-end" appearance of the skull results from __________.

A) anemia
B) marrow hyperplasia
C) avascular necrosis
D) hemophilia

Question 35

Which of the following statements is characteristic of sickle cell anemia?

A) It causes an increase in lifespan of red blood cells.
B) It causes red blood cells to become spherical in shape.
C) It shows more pronounced radiographic findings in patients who are older and heterozygous for the disease.
D) It affects African Americans more than any other race in North America.

Question 36

Homozygous thalassemia is also known as __________.

A) Cooley's anemia
B) sickle cell anemia
C) iron deficiency anemia
D) pernicious anemia

Question 37

Radiographic findings in a patient with sickle cell anemia may include all of the following characteristics except __________.

A) hair-on-end appearance in the skull
B) H-shaped vertebrae
C) epiphyseal squaring
D) osteopenia

Question 38

Maxillary overgrowth and protrusion of the maxillary incisors describes __________.

A) rodent facies
B) Gaucher's disease
C) Diaz's disease
D) Hass's disease

Question 39

Which of the following evaluations is diagnostic for leukemia?

A) MRI
B) Plain film
C) Urinary analysis
D) Bone marrow biopsy

Question 40

Serial radiographs of the knee of a young child show a rapidly expanding lytic lesion in the distal femur in addition to static findings of squaring of the femoral condyles, epiphyseal overgrowth, and generalized osteopenia. Which of the following is the most likely diagnosis for the expansile femoral lesion?

A) Brodie abscess
B) Giant cell tumor
C) Myositis ossificans
D) Pseudotumor