Question 1

If an X-ray of the leg shows a mass in the distal femur that extends into the soft tissue and the biopsy shows translocation of chromosomes 11 and 22, what is this patient's diagnosis?

Accepted Answer

If an X-ray of the leg shows a mass in the distal femur that extends into the soft tissue and the biopsy shows translocation of chromosomes 11 and 22, the patient's diagnosis is Ewing sarcoma. It is a malignant neoplasm of the bone that originates in the medullary canal and is composed of small uniform round cells and often occurs in teenage males.

Question 2

In a patient presenting with chills, fever, and a painful swollen knee, what test would be most appropriate in order to help make the diagnosis?

Accepted Answer

In a patient presenting with chills, fever, and a painful swollen knee, the test that would be most appropriate in order to help in making the diagnosis is a culture of joint fluid from the affected knee. Because of suspected suppurative arthritis in this patient, the test is to ascertain which organism is involved and, with further identification and sensitivity, to determine which would be the antibiotic of choice.

Question 3

All of the following conditions are considered risk factors for postmenopausal osteoporosis except:

Accepted Answer

All of the listed conditions are considered risk factors for postmenopausal osteoporosis except multiparity. Risk factors for postmenopausal osteoporosis include cigarette smoking, thinness, early menopause (natural or surgical), nulliparity, northern European heritage, some medications (e.g., glucocorticoids), high alcohol or caffeine intake, low dietary calcium consumption, and a family history of osteoporosis.

Question 4

Which of the following tests is best to detect and monitor osteoporosis?

Accepted Answer

The test that is best to detect and monitor osteoporosis is dual-energy X-ray absorptiometry (or DEXA scan). It is the newest, least expensive, and quickest method of assessing bone mineral density (BMD). The specificity of DEXA scan is approximately 98-99%. Standard radiography is inadequate for accurate bone mass assessment.

Question 5

Of the following choices, which is a risk factor most likely contributing to the osteoporosis?

Accepted Answer

Of the listed choices, the risk factor that is most likely contributing to osteoporosis is cigarette smoking. The major risk factors for osteoporosis are family history, slender body build, fair skin, early menopause, sedentary lifestyle, cigarette smoking, medications (corticosteroids or L-thyroxine), more than two drinks of alcohol or caffeine per day, and low calcium intake.

Question 6

Which of the following treatments is most appropriate for a patient with osteoporosis?

Accepted Answer

The treatment that is most appropriate for a patient with osteoporosis is alendronate. Alendronate is a bisphosphonate that is approved for the prevention and treatment of postmenopausal osteoporosis and can be administered on a weekly basis to increase compliance.

Question 7

Which of the following drugs produces the greatest increase in bone mineral density (BMD) in patients with osteoporosis?

Accepted Answer

The drug that produces the greatest increase in bone mineral density (BMD) in patients with osteoporosis is Teriparatide. It is a recently approved recombinant form of parathyroid hormone that stimulates bone formation, rather than inhibiting resabsorption.

Question 8

Which of the following is a self healing disorder affecting the growing epiphysis where the bony centre of growth becomes avascular and dies?

Accepted Answer

Osteochondrosis is a self healing disorder affecting the growing epiphysis where the bony centre of growth becomes avascular and dies. The bone is subsequently revascularised and reforms. Sometimes, there is a permanent residual deformity. The whole cycle can take up to two years.

Question 9

Which of the following radiological findings is not consistent with Rickets (osteomalacia)?

Accepted Answer

The radiological finding that is not consistent with rickets (osteomalacia) is the growing metaphysis becomes drum shaped. In Rickets (osteomalacia), the growing metaphysis becomes trumpet shaped.

Question 10

Which of the following statements is not true about osteomyelitis?

Accepted Answer

The statement that is not true about osteomyelitis is it starts with a septic abscess outside the bone. The acute haematogenous osteomyelitis starts with a septic abscess within the bone, which enlarges, pushes up, and spreads under the periosteum, eventually breaking through.

Question 11

Which of the following age groups is most susceptible to osteoid osteoma?

Accepted Answer

The age group that is most susceptible to osteoid osteoma is 10 to 25-year-old males. Osteoid osteoma appears as a spherical mass of osteoid tissue surrounded by a large region of sclerotic bone.

Question 12

Which of the following age groups is most susceptible to non-osteogenic fibroma?

Accepted Answer

The age group that is most susceptible to non-osteogenic fibroma is adolescents. It appears as a spherical mass of osteoid tissue, surrounded by a large region of sclerotic bone. In radiograph, it appears as a growth of cells forming a radio lucent cyst in a metaphysis with a hard bony rim with irregular septa within.

Question 13

Regarding the radiological findings of osteosarcoma, which of the following findings is not present?

Accepted Answer

Regarding the radiological findings of osteosarcoma, the finding that is not present is the periosteum is depressed along the shaft. In fact, the periosteum is elevated along the shaft.

Question 14

Codman's triangle is a characteristic radiographic finding of which of the following disorders?

Accepted Answer

Codman's triangle is a characteristic radiographic finding of osteosarcoma. At the edge of the area of periosteal elevation, the new bone forms a dense triangle called Codman's triangle.

Question 15

Which of the following features is not true of osteochondrosis?

Accepted Answer

The feature that is not true of osteochondrosis is that the disease is usually acute. This is a self healing disorder affecting the growing epiphysis where the bony centre of growth becomes avascular and dies. The bone is subsequently revascularised and reforms. Sometimes, there is a permanent residual deformity. The whole cycle can take up to two years.

Question 16

Regarding the named osteochondrosis of the lower limbs, Perthe's osteochondrosis refers to the osteochondrosis of:

Accepted Answer

Regarding the named osteochondrosis of the lower limbs, Perthe's osteochondrosis refers to the osteochondrosis of head of femur. It is a self healing disorder affecting the growing epiphysis where the bony centre of growth becomes avascular and dies.

Question 17

Regarding the named osteochondrosis of the lower limbs, Kohler's osteochondrosis refers to the osteochondrosis of:

Accepted Answer

Regarding the named osteochondrosis of the lower limbs, Kohler's osteochondrosis refers to the osteochondrosis of the navicular. The disease is self resolving and affects both upper and lower extremities.

Question 18

Which of the following radiographic findings is evident in the radiograph?

Accepted Answer

The radiographic finding that is evident in the radiograph is extensive calcification of the posterior tibial artery. It is a common diagnostic finding in diabetic foot.

Question 19

A podiatrist can find all of the following findings in the shown radiograph except :

Accepted Answer

A podiatrist can find all of the following findings in the shown radiograph except calcification of anterior tibial artery. It is a plain radiograph showing progress of neuro-osteoarthropathy. There is extensive resorption of the talus, subchondral osteosclerosis of the tibia and calcaneus, and extensive ligament ossification. Bone fragments can be seen to protrude laterally.

Question 20

The initial anterior-posterior radiograph shows a fine bony avulsion of which of the following ligaments?

Accepted Answer

The initial anterior-posterior radiograph shows a fine bony avulsion of the talofibular ligaments. The x-ray is indicative of rotational ankle trauma. The initial radiograph shows a fine bony avulsion of the tibiofibular ligaments, with a barely visible bowl-shaped flake.

Quiz 2: Orthopedic and Podiatric Conditions and Diseases