Deck 14: Endocrine, Metabolic, and Nutritional Diseases

Question 1

Radiographic features of hyperparathyroidism include all of the following except __________.

A) salt-and-pepper skull
B) acroosteolysis
C) resorption of lamina dura
D) thickened calvarium

Answer 1

thickened calvarium

Question 2

Which of the following is the most common cause of hypercalcemia?

A) Hypervitaminosis D
B) Hypothyroidism
C) Pseudohypoparathyroidism
D) Hyperparathyroidism

Answer 2

Hyperparathyroidism

Question 3

A collection of fibrous tissue and giant cells in bone that is found in primary and secondary hyperparathyroidism is referred to as osteitis fibrosa cystica or __________.

A) brown tumor
B) Cushing syndrome
C) Sudeck's atrophy
D) leontiasis ossea

Answer 3

brown tumor

Question 4

Primary hyperparathyroidism is produced by __________.

A) chronic renal failure
B) a complication of dialysis
C) secretory carcinomas
D) a single adenoma

Question 5

What is the hallmark of giantism?

A) Generalized osteoporosis
B) Proportional, exaggerated skeletal growth
C) Localized sclerosis
D) Metacarpal shortening

Question 6

Heel pad thickness should not exceed ___ mm among females and ___ mm among males.

A) 23, 25
B) 25, 23
C) 30, 32
D) 32, 30

Question 7

Generalized or localized sclerosis is the most common skeletal abnormality in __________.

A) hypothyroidism
B) hypervitaminosis A
C) hypoparathyroidism
D) hypervitaminosis D

Question 8

Hypocalcemia secondary to low or absent parathormone is the hallmark of __________.

A) hypervitaminosis D
B) pseudohypoparathyroidism
C) hypoparathyroidism
D) hypothyroidism

Question 9

Rugger jersey spine is a radiographic finding most likely seen with __________.

A) hypoparathyroidism
B) hyperparathyroidism
C) pseudohypoparathyroidism
D) rickets

Question 10

What condition results from hypersecretion of growth hormone in skeletally immature patients?

A) Acromegaly
B) Cushing syndrome
C) Hypoparathyroidism
D) Giantism

Question 11

Which statement best applies to acromegaly?

A) It typically causes initial joint space widening and thickening of the soft tissues.
B) It leads to an elaboration of endochondrally formed bone.
C) It affects women three times as much as men.
D) It is marked clinically by a rounded moon face.

Question 12

Acromegaly results from excessive secretion of growth hormone from the ___________.

A) posterior lobe of the pituitary gland
B) thyroid gland
C) parathyroid gland
D) anterior lobe of the pituitary gland

Question 13

What is the hallmark radiographic sign in Cushing syndrome?

A) Hook-like osteophytes
B) Generalized osteoporosis
C) Acroosteolysis
D) Subperiosteal resorption

Question 14

The physical appearance of a "moon face" and a "buffalo hump" are typical in patients with __________.

A) Cushing syndrome
B) osteomalacia
C) hypoparathyroidism
D) hypothyroidism

Question 15

Which of the following is the best differential diagnosis for a patient with decreased bone density, renal calculi, and cystic bone defects?

A) Hyperparathyroidism
B) Pseudohypoparathyroidism
C) Hypervitaminosis D
D) Hypoparathyroidism

Question 16

In pseudohypoparathyroidism, hypocalcemia, and hyperphosphatemia occur, despite _____ serum levels of _____.

A) increased, parathormone
B) increased, thyroxin
C) decreased, parathormone
D) decreased, thyroxin

Question 17

An X-linked genetic disorder associated with normal or enlarged parathyroid glands and parathyroid target organ insensitivity best describes __________.

A) hypothyroidism
B) pseudohypoparathyroidism
C) osteomalacia
D) Cushing syndrome

Question 18

Oversecretion of growth hormone in a skeletally mature patient leads to __________.

A) Cushing syndrome
B) hyperparathyroidism
C) acromegaly
D) hypothyroidism

Question 19

Which of the following diagnostic imaging modalities best demonstrates the pituitary gland?

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

Question 20

The familial form of hypoparathyroidism often presents within what age range?

A) Birth to 1 year of age
B) 5-10 years of age
C) 11-25 years of age
D) Greater than 60 years of age

Question 21

Which of the following statements is true regarding osteoporosis?

A) It typically affects more males than females.
B) More than 80% of the patients diagnosed present with increased blood calcium levels.
C) It decreases in incidence with age.
D) It is the most common cause of generalized metabolic osteopenia.

Question 22

In hypervitaminosis A, painful regions that show subperiosteal cortical thickening commonly affect which parts of the body?

A) Humerus and radius
B) Clavicle and scapula
C) Ulna and metacarpals
D) Femur and tibia

Question 23

Osteoporosis is characterized by _____ of bone.

A) decreased quality
B) decreased quantity and quality
C) decreased quantity
D) increased quality

Question 24

Osseous changes due to hypothyroidism that are predominant in children may include all of the following except _________.

A) shepherd's crook deformity
B) persistent sutures with Wormian bones
C) bullet-shaped vertebrae
D) brachycephaly

Question 25

Which of the following radiographic features is present in osteomalacia, but not in osteoporosis?

A) Coarsened trabeculae (accentuation of the primary trabeculae)
B) Osteopenia
C) Bowing deformities
D) Insufficiency fractures

Question 26

Osteoporosis is a common cause of fractures of the _____, which are associated with a 10% to 40% mortality rate, depending on age.

A) spine
B) hip
C) radius
D) clavicle

Question 27

Radiographic findings in a patient with hypervitaminosis A usually include all of the following except __________.

A) generalized osteopenia
B) basilar invagination
C) appositional bone thickening
D) metastatic calcification in viscera

Question 28

What pattern of osteoporosis occurs secondary to the hyperemia of rheumatoid arthritis?

A) Regional
B) Generalized
C) Age-related
D) Localized

Question 29

Which of the following describes a lack of appropriate osteoid mineralization resulting in deficient bone?

A) Rickets
B) Scurvy
C) Osteomalacia
D) Osteoporosis

Question 30

Which of the following would best diagnose osteoporosis in a patient?

A) Dual photon absorptiometry
B) Magnetic resonance imaging
C) Conventional radiography
D) Bone scan

Question 31

Signs and symptoms including lethargy, dry hair and skin, delayed dentition, large tongue, and hypotonia would likely be present in patients with __________.

A) osteoporosis
B) hypervitaminosis A
C) hypothyroidism
D) hypervitaminosis D

Question 32

The radiographic appearance of a thin cortex and accentuated trabecular pattern would be present in patients with __________.

A) hypervitaminosis D
B) hypervitaminosis A
C) osteoporosis
D) hypothyroidism

Question 33

Dietary deficiency of vitamin C for a duration of 4 months or more leads to the typical changes of __________.

A) rickets
B) hypervitaminosis D
C) scurvy
D) hypervitaminosis A

Question 34

Which of the following is not a typical radiographic finding of rickets?

A) Generalized osteopenia
B) Lucent zones of provisional calcification
C) Heel pad sign
D) "Rosary bead" appearance of the costochondral junction

Question 35

Which of the following diseases demonstrates regional osteoporosis associated with severe pain, skin changes, and soft tissue swelling?

A) Reflex sympathetic dystrophy
B) Rickets
C) Scurvy
D) Hyperparathyroidism

Question 36

Signs and symptoms of hypervitaminosis A include all of the following except __________.

A) hepatosplenomegaly
B) bleeding gums
C) perioral fissures
D) blurred vision

Question 37

Hypothyroidism in infants results in __________.

A) cretinism
B) juvenile myxedema
C) Cushing syndrome
D) hepatosplenomegaly

Question 38

What is another term for scurvy?

A) Hypervitaminosis D
B) Hypervitaminosis A
C) Hypovitaminosis C
D) Hypovitaminosis D

Question 39

Hypothyroidism resulting from decreased stimulating hormone secondary to disorders of the pituitary gland defines __________.

A) primary hypothyroidism
B) tertiary hypothyroidism
C) quaternary hypothyroidism
D) secondary hypothyroidism

Question 40

Radiographic findings of growth plate abnormalities, wide metaphyses, sclerotic zones of provisional calcification, and Pelken's spurs are present in patients affected with ___________.

A) rickets
B) hypervitaminosis D
C) hypervitaminosis A
D) scurvy