Question 1

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?

Accepted Answer

The common link between anticonvulsant use, small bowel resection, chronic pancreatitis, and osteomalacia is vitamin D deficiency. Anticonvulsants can increase liver metabolism of vitamin D, small bowel resection can reduce absorption of vitamin D from the diet, and chronic pancreatitis can impair the pancreatic secretion of enzymes necessary for vitamin D metabolism. Vitamin D is important for calcium and phosphate absorption, so a deficiency can lead to impaired mineralization of bones and the development of osteomalacia.

Question 2

A 54-year-old female was recently diagnosed with degenerative joint disease. This condition causes:

Accepted Answer

Degenerative joint disease, also known as osteoarthritis, causes degeneration and loss of articular cartilage in the joints. This leads to pain, stiffness, and difficulty with movement. It does not typically cause degeneration or loss of the epiphyses, loss of synovial fluid, or degeneration of the joint capsule.

Question 3

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:

Accepted Answer

The symptoms described suggest epicondylitis, which is inflammation of the tendon where it attaches to the bone at the epicondyle of the elbow. This condition is commonly seen in individuals who engage in repetitive activities, such as lifting boxes, and is also known as tennis elbow or golfer's elbow, depending on the location of the inflammation. Periosteitis is inflammation of the periosteum, which is the outermost layer of bone, and is usually caused by injury or infection. Pericondylitis is inflammation of the tissue surrounding the cartilage, and is most commonly seen in the knee joint. Bursitis is inflammation of a bursa, which is a small fluid-filled sac that acts as a cushion between bone and soft tissue, and is most commonly seen in the shoulder, elbow, hip, or knee. While bursitis can occur in the elbow, the symptoms described by the patient are more indicative of epicondylitis.

Question 4

A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This fracture is referred to as a _____ fracture.

Accepted Answer

A fatigue fracture occurs after repeated stress on a bone, such as with overuse or sudden increase in physical activity. In this case, the obese male's sudden jogging routine likely caused repeated stress on his leg, leading to a fatigue fracture. Insufficiency fractures occur in weakened bones, such as in osteoporosis or cancer. Greenstick fractures typically occur in children because their bones are still developing and are more flexible. Compound fractures involve the bone breaking through the skin.

Question 5

Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis)?

Accepted Answer

Patients undergoing surgery, especially with a history of anesthesia problems, are at higher risk for rhabdomyolysis due to potential muscle damage from prolonged immobility or complications related to anesthesia.

Question 6

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?

Accepted Answer

The fracture in this scenario is likely a pathological fracture, which occurs as a result of weakened or diseased bone. Osteoporosis is a common cause of pathological fractures, and the fact that this fracture occurred at a site of preexisting abnormality further supports this diagnosis. An idiopathic fracture would have no clear cause, an iatrogenic fracture would be caused by a medical intervention, and a greenstick fracture typically occurs in children due to the flexibility of their bones.

Question 7

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:

Accepted Answer

A subluxation occurs when the bone surfaces in a joint partially lose contact with each other, often as a result of trauma or injury. This is different from a dislocation, which is a complete displacement of the bone out of the joint, and nonunion, which refers to a failure of bone to heal properly after a fracture. Sublimation is not a medical term used in this context.

Question 8

A 54-year-old male was recently diagnosed with osteoarthritis. Which of the following symptoms is he most likely experiencing?

Accepted Answer

Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and subsequent bone damage, resulting in joint pain. Joint swelling, hypermobility, and contractures are not commonly associated with osteoarthritis.

Question 9

A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?

Accepted Answer

A compound fracture is one in which the bone breaks through the skin, and an oblique fracture is one in which the fracture line is diagonal to the shaft of the bone. Therefore, a pathologic, compound, oblique fracture of the femur refers to a break in the femur in which the bone has broken through the skin, and the fracture line is diagonal to the shaft of the bone, caused by underlying pathology.

Question 10

After the Boston Marathon, seven runners were admitted to local hospitals with suspected myoglobinuria (rhabdomyolysis). What is the most likely cause of myoglobinuria in these athletes?

Accepted Answer

Excessive muscular activity, such as that experienced during a marathon, can cause rhabdomyolysis, a condition in which muscle breakdown releases myoglobin into the bloodstream, leading to myoglobinuria. This can cause kidney damage and other serious health complications. Tendon injury, undiagnosed hypertension, and undetected cardiac abnormalities are not directly linked to myoglobinuria.

Question 11

An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by:

Accepted Answer

Osteomalacia is a condition in which bones become soft and weak due to inadequate mineralization of the bone matrix, specifically calcium and phosphate. This can lead to bone pain, muscle weakness, and fractures. Choice A (collagen breakdown in bone matrix) is more indicative of osteogenesis imperfecta. Choice B (excessive bone resorption) is more indicative of osteoporosis. Choice C (crowding of bone marrow by excessive bone growth) is more indicative of multiple myeloma.

Question 12

Noninflammatory joint disease is differentiated from inflammatory joint disease by all of the following factors except:

Accepted Answer

Noninflammatory joint disease may cause pain, which is also a common symptom associated with inflammatory joint disease. The factors that differentiate noninflammatory joint disease from inflammatory joint disease include the absence of synovial membrane inflammation, the lack of systemic signs and symptoms, and normal synovial fluid.

Question 13

Researchers have now determined that rheumatoid arthritis:

Accepted Answer

Rheumatoid arthritis has been determined to be an autoimmune disease, in which the immune system attacks the body's own tissues. It is not curable with antiviral agents and does not arise from rheumatic fever. It also has different causes than osteoarthritis.

Question 14

Transchondral fractures are most prevalent in:

Accepted Answer

Transchondral fractures are most commonly seen in adolescents due to growth plate injuries.

Question 15

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

Accepted Answer

Osteoporosis is characterized by weakened bones caused by an increase in bone resorption, leading to a reduction in bone density and an increased risk of fractures.

Question 16

The incidence of fractures of the pelvis is highest in:

Accepted Answer

The incidence of fractures of the pelvis is highest in elderly adults, particularly those who have osteoporosis or who have experienced traumatic injury due to falls. Fractures of the pelvis in preadolescent and adolescent boys and girls are relatively rare.

Question 17

A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:

Accepted Answer

Osteoporosis is a condition where the bones become fragile and brittle, increasing the risk of fractures. Therefore, individuals with osteoporosis are at high risk for bone fractures.

Question 18

A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. This condition is known as a:

Accepted Answer

A torn ligament is a sprain, not a strain (which is an injury to a muscle or tendon), disunion (not a medical term), or a fracture (which is a broken bone).

Question 19

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 organisms causing this condition entered the bone through:

Accepted Answer

Endogenous osteomyelitis occurs when microorganisms enter the bone through the bloodstream. It is a more common type of osteomyelitis in adults and usually affects the vertebrae, pelvis, or long bones. The patient's recent respiratory infection may have caused bacteremia, leading to the development of osteomyelitis. Open fractures, animal bites, and infected bedsores can also cause osteomyelitis, but they are classified as exogenous osteomyelitis.

Question 20

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:

Accepted Answer

The decrease in estrogen levels that occurs during menopause is a major risk factor for osteoporosis in women. Estrogen plays a role in maintaining bone density, and its decline leads to increased bone resorption and decreased bone formation. This puts women at higher risk for fractures, particularly of the hip, spine, and wrist.

Quiz 37: Alterations of Musculoskeletal Function