Deck 40: Alterations of Musculoskeletal Function

Question 1

A fracture in which the bone breaks into two or more fragments is termed a comminuted fracture.

Answer 1

True

Question 2

What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon?

A) Lateral epicondylitis
B) Medial epicondylitis
C) Bursitis
D) Lateral tendonitis
E) Medial tendonitis

Answer 2

Lateral epicondylitis

Question 3

Which of the following is a fibrous connective tissue that attaches skeletal muscle to bone?

A) Tendon
B) Ligament
C) Bursa
D) Mesentery

Answer 3

Tendon

Question 4

_____ is the temporary displacement of two bones in which the bone surfaces partially lose contact.

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

Question 5

_____ fractures usually occur in individuals who engage in a new activity that is both strenuous and repetitive.

A) Stress
B) Greenstick
C) Insufficiency
D) Pathologic

Question 6

A(n)_____ fracture is a fracture at a site of a preexisting bone abnormality,usually by a force that would not normally cause a fracture.

A) idiopathic
B) incomplete
C) pathologic
D) greenstick

Question 7

A tear in a ligament is known as a:

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

Question 8

In osteomalacia the remodeling cycle proceeds normally through osteoid formation,but mineral calcification and deposition do not occur.

Question 9

A balance between receptor activator of nuclear factor _kß ligand (RANKL)and osteoprotegerin (OPG)is necessary to prevent osteoporosis.

Question 10

Receptor activator of nuclear factor _kß ligand (RANKL)expression is inversely correlated with serum level of 17 ß-estradiol (i.e. ,with estradiol deficiency,RANKL is increased).

Question 11

Compartment syndromes are a localized form of crush syndromes.

Question 12

Which is an outcome of improper reduction or immobilization of a fractured femur?

A) After the cast is removed,the muscles around the fracture site are weak.
B) The fracture healing requires 6 to 8 weeks to complete.
C) After the cast is removed,the skin under the cast is dry and flaky.
D) After the cast is removed,the bone is not straight.

Question 13

Bone is unique among body tissue because after a fracture that destroys bone,a new bone is formed,but there is no scar tissue.

Question 14

Paget disease can occur in any bone,but it most often affects the appendicular skeleton.

Question 15

How do people usually describe the pain associated with tendon and ligament injuries?

A) Dull and diffuse pain that persists over the distribution of the tendon or ligament
B) Sharp and localized pain that persists over the distribution of the tendon or ligament
C) Pins and needle sensations distal to injury on movement
D) Intermittent aching pain over the distribution of the tendon or ligament

Question 16

Alcohol abuse is the most common cause of toxic myopathy.

Question 17

Osteomyelitis is a bone infection only caused by bacteria.

Question 18

Healthy young women can gain bone mass up to and through the second decade of life.

Question 19

The calcium crystals that appear in the cartilage,synovial membranes,tendons,and soft tissue of people with chronic gout are called tophi.

Question 20

Cutaneous,sinus,ear,and dental infections are primary sources of bacteria in hematogenous bone infections.

Question 21

What pattern of bone destruction is described as not well defined and not easily separated from normal bone?

A) Moth-eaten pattern
B) Permeative pattern
C) Geographic pattern
D) Porous pattern

Question 22

Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone?

A) Osteomalacia
B) Paget disease
C) Osteoporosis
D) Osteosarcoma

Question 23

The World Health Organization has defined normal bone density as greater than 833 mg/cm².A woman with a bone density of 675 mg/cm² would be described as having:

A) osteoplasiA.
B) osteoporosis.
C) osteopenia.
D) osteomalacia.

Question 24

Which statement is false about giant cell tumors?

A) They are an overexpression of genes including osteoprotegerin ligand (OPGL)
B) They are malignant,solitary,irregularly shaped tumors
C) They are typically located in the epiphysis in the femur,tibia,radius,and humerus
D) They are slow-growing tumors,which extend over the articular cartilage

Question 25

Which statement is false about factors that contribute to the difficulty in treating bone infections?

A) Bone contains multiple microscopic channels that are impermeable to the cells and biochemical of the body's natural defenses.
B) Microcirculation of bone is highly vulnerable to damage and destruction by bacterial toxins leading to ischemic necrosis of bone.
C) Bone cells have a limited capacity to replace bone destroyed by infections.
D) Bacteria are walled off by macrophages and T-lymphocytes so that the antibiotics cannot penetrate infected area.

Question 26

Considering the pathophysiology of osteoporosis,what are the effects of extracellular signal regulated kinases (ERKs)and receptor activator of nuclear factor _kß ligand (RANKL)on osteoblasts and osteoclasts?

A) ERKs increase the life span of osteoclasts and RANKL decreases the life span of osteoblasts.
B) ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts.
C) ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts.
D) ERKs increase the life span of osteoblasts and RANKL decreases the life span of osteoclasts.

Question 27

Considering the pathophysiology of osteoporosis,which factors increase osteoprotegrin (OPG)production?

A) Transforming growth factor-beta (TGF-ß)and glucocorticoids
B) Interleukin 1 (IL-1),prostaglandin E₂,and leukotrienes
C) Tumor necrosis factor alpha (TNF-),leptin,and 17 ß-estradiol
D) Interleukin 8 (IL-8)and parathyroid hormone (PTH)

Question 28

What are characteristics of inflammatory joint disease?

A) Unilateral joint involvement
B) Normal joint synovial fluid
C) Absence of synovial membrane inflammation
D) Systemic symptoms are prevalent (e.g. ,fatigue,fever)

Question 29

In considering osteomyelitis,what is sequestrum?

A) An area of devascularized and devitalized bone
B) An enzyme that phagocytizes necrotic bone
C) A subperiosteal abscess
D) A layer of new bone surrounding the infected bone

Question 30

What characterizes rhabdomyolysis?

A) Paralysis of skeletal muscles resulting from impaired nerve supply
B) Smooth muscle degeneration resulting from ischemia
C) Lysis of skeletal muscle cells through the initiation of the complement cascade
D) Release of myoglobin from damaged striated muscle cells

Question 31

What is a primary defect in osteoarthritis?

A) Stromelysin and acid metalloproteinase break down articular cartilage.
B) Immunoglobulin G (IgG)destroys the synovial membrane.
C) Synovial membranes become inflamed.
D) Cartilage-coated osteophytes create bone spurs.

Question 32

What is the most common clinical manifestation of osteoporosis?

A) Bone deformity
B) Bone pain
C) Pathologic fracture
D) Muscle strain

Question 33

What causes the bone to die in osteomyelitis?

A) Formation of immune complexes at the site of infection
B) Localized ischemia
C) Tumor necrosis factor alpha (TNF-)and interleukin 1 (IL-1)
D) Impaired nerve innervation at the site of infection

Question 34

By the time osteoporosis is visible on x-ray,up to ____% of bone has been lost.

A) 30
B) 40
C) 50
D) 60

Question 35

Considering the pathophysiology of osteoporosis,what is the action of the receptor RANK after being activated by receptor activator of nuclear factor _kß ligand (RANKL)?

A) RANK increases osteoclast apoptosis.
B) RANK activates and prolongs osteoblast survival.
C) RANK activates osteoprotegerin (OPG).
D) RANK activates and prolongs osteoclast survival.

Question 36

Which are characteristics of osteosarcoma?

A) Slow growing tumor that begins in the bone marrow and infiltrates the trabeculae.
B) Solitary tumor that most often affects the metaphyseal region of the femur or tibia.
C) An aggressive tumor most often found in the bone marrow of long bones.
D) A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue by seeding.

Question 37

Considering the pathophysiology of osteoporosis,which cytokines and hormones decrease receptor activator of nuclear factor _kß ligand (RANKL)expression?

A) Interleukin 4 (IL-4)and transforming growth factor-beta (TGF-ß)
B) Interleukin 1 (IL-1)and tumor necrosis factor alpha (TNF-)
C) Interleukin 11 (IL-11)and glucocorticoids
D) Interleukin 17 (IL-17)and parathyroid hormone (PTH)

Question 38

Considering the pathophysiology of osteoporosis,which hormone exerts antiapoptotic effects on osteoblasts,but proapoptotic effects on osteoclasts?

A) Parathyroid hormone
B) Glucocorticoid
C) Growth hormone
D) Estrogen

Question 39

Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat a compound displaced fracture of the tibia and fibula?

A) Iatrogenic osteoporosis
B) Regional osteoporosis
C) Idiopathic osteoporosis
D) Osteoblastic osteoporosis

Question 40

After prolonged muscle compression,which pathophysiologic alteration precedes crush syndrome?

A) Muscle ischemia
B) Myoglobinemia
C) Volkmann contracture
D) Neural injury

Question 41

What do acute alcoholic myopathy,McArdle disease,and disorders of lipid metabolism in muscles have in common?

A) They all are autoimmune diseases.
B) They all are deposit immune complexes in muscles.
C) They all are a cause in myoglobinuria.
D) They all cause progressive muscle weakness.

Question 42

Which are clinical manifestations of rheumatoid arthritis?

A) Collection of crystals in subcutaneous tissue of extremities
B) Fatigue,fever,and weakness
C) Pain in one or more weight-bearing joints
D) Edema of the wrists and distal joints of the fingers

Question 43

What are clinical manifestations of fibromyalgia?

A) Hot,tender,and edematous muscle groups bilaterally
B) Fasciculations of the upper and lower extremity muscles
C) Exercise intolerance and painful muscle cramps
D) Burning or gnawing pain at tender points and profound fatigue

Question 44

MATCHING
Match the phrases with the corresponding characteristics.
Rhabdomyolysis

A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease

Question 45

_____ is a chronic,inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints.

A) Ankylosing spondylitis
B) Rheumatoid arthritis
C) Paget disease
D) Fibromyalgia

Question 46

MATCHING
Match the phrases with the corresponding characteristics.
Polymyositis

A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease

Question 47

Recent data from MRI studies show that the primary pathologic alteration in ankylosing spondylitis is:

A) inflammation of the enthesis.
B) inflammation of the synovium.
C) synovitis and bone marrow inflammation.
D) diskitis and nucleus pulposus inflammation.

Question 48

MATCHING
Match the phrases with the corresponding characteristics.
Myositis

A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease

Question 49

What causes the crystallization within the synovial fluid that causes acute,painful inflammation of the joint in gouty arthritis?

A) Reduced excretion of purines
B) Overproduction of uric acid
C) Increase in the glycosaminoglycan levels
D) Overproduction of proteoglycans

Question 50

MATCHING
Match the phrases with the corresponding characteristics.
Myoadenylate deaminase deficiency

A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease

Question 51

People with gout are at high risk for:

A) renal calculi.
B) joint trauma.
C) anemia.
D) hearing loss.

Question 52

What type of infectious arthritis is described as having a sudden onset of symptoms of a painful,hot swollen joint with decreased range of motion?

A) Viral arthritis
B) Lyme arthritis
C) Tuberculosis arthritis
D) Spondylarthritis

Question 53

In ankylosing spondylitis,what is the antigen that is presented to the CD8+ T cells?

A) Synovium
B) Cartilage
C) Tendons
D) Ligaments

Question 54

In osteoarthritis,what is the effect of the disruption of the pumping action of proteoglycans?

A) Pump malfunction stimulates the induction of nitric oxide synthase (iNOS)and nitric oxide (NO),which degrade the cartilage.
B) Cartilage is damaged by proteolytic enzymes because they cannot be pumped out of the joint.
C) Cartilage becomes dry,brittle,and wears away because fluid cannot be pumped into the cartilage.
D) Cartilage takes in too much fluid and is unable to withstand the stresses of weight bearing.

Question 55

MATCHING
Match the phrases with the corresponding characteristics.
McArdle disease

A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease

Question 56

Which joint disease is characterized by joint stiffness on movement that dissipates within 30 minutes and joint pain of weight-bearing joints that usually is relieved by rest?

A) Gouty arthritis
B) Rheumatoid arthritis
C) Osteoarthritis
D) Suppurative arthritis

Question 57

The pathophysiology of gout is closely linked to _____ metabolism.

A) purine
B) pyrimidine
C) vitamin E
D) amino acid