Question 1

A student studying osteomyelitis and asks for an explanation of the term "sequestrum." What response by the professor is best?

Accepted Answer

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 
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 A

Question 2

The health care professional teaches a group of seniors that the most common clinical manifestation of osteoporosis is which of these?

Accepted Answer

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

Question 3

The pathophysiologic presentation of gout is closely linked to the metabolism of which chemical?

Accepted Answer

A) Purine 
B) Pyrimidine 
C) Vitamin E 
D) Amino acid 
A) Purine 
B) Pyrimidine 
C) Vitamin E 
D) Amino acid A

Question 4

By the time osteoporosis is visible on an x-ray examination, up to what percent of bone has been lost?

Accepted Answer

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

Question 5

What is the primary pathologic alteration resulting from ankylosing spondylitis (AS)?

Accepted Answer

A) Inflammation of the bursa 
B) Inflammation of the long bones 
C) Inflammation of fibrocartilaginous joints of the vertebrae 
D) Inflammation of the small hand and feet bones 
A) Inflammation of the bursa 
B) Inflammation of the long bones 
C) Inflammation of fibrocartilaginous joints of the vertebrae 
D) Inflammation of the small hand and feet bones

Question 6

A patient in the clinic is worried about having fibromyalgia. For which symptoms should the health care professional assess the patient for?

Accepted Answer

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) Sensitivity at tender points and profound fatigue 
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) Sensitivity at tender points and profound fatigue

Question 7

A patient has been diagnosed with Paget disease. What explanation of the disease does the health care professional provide the patient?

Accepted Answer

A) "It is a severe infection in your bones." 
B) "It is a problem with bone resorption and formation." 
C) "It is a condition in which your bones become soft." 
D) "It's a disorder of altered energy production in muscle." 
A) "It is a severe infection in your bones." 
B) "It is a problem with bone resorption and formation." 
C) "It is a condition in which your bones become soft." 
D) "It's a disorder of altered energy production in muscle."

Question 8

What is the tear in a ligament referred to as?

Accepted Answer

A) Fracture 
B) Strain 
C) Disunion 
D) Sprain 
A) Fracture 
B) Strain 
C) Disunion 
D) Sprain

Question 9

What event is associated with the beginning of bone loss in women?

Accepted Answer

A) Puberty 
B) Sexual activity 
C) Childbirth 
D) Menopause 
A) Puberty 
B) Sexual activity 
C) Childbirth 
D) Menopause

Question 10

In osteoporosis, the receptor activator of nuclear factor kB (RANK) activates what?

Accepted Answer

A) Osteoclast apoptosis 
B) Osteoblast survival 
C) Osteoprotegerin 
D) Osteoclast survival 
A) Osteoclast apoptosis 
B) Osteoblast survival 
C) Osteoprotegerin 
D) Osteoclast survival

Question 11

A patient seen in the clinic has tissue degeneration or irritation of the extensor carpi radialis brevis tendon. What diagnosis does the health care professional document?

Accepted Answer

A) Lateral epicondylopathy 
B) Medial epicondylopathy 
C) Bursitis 
D) Lateral tendinitis 
A) Lateral epicondylopathy 
B) Medial epicondylopathy 
C) Bursitis 
D) Lateral tendinitis

Question 12

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

Accepted Answer

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

Question 13

A health care professional is providing education to a group of seasonal athletes. What type of fracture does the professional warn them to avoid?

Accepted Answer

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

Question 14

A professor has taught the class about giant cell bone tumors. Which statement by a student would require the professor to review the material?

Accepted Answer

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

Question 15

A health care professional determines that the student needs more education when the student makes which statement about treating bone infection?

Accepted Answer

A) Bone contains multiple microscopic channels that are impermeable to the cells and biochemicals 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; consequently, the antibiotics cannot penetrate the infected area. 
A) Bone contains multiple microscopic channels that are impermeable to the cells and biochemicals 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; consequently, the antibiotics cannot penetrate the infected area.

Question 16

The health care professional is caring for a person who has a pathologic fracture. The patient asks the professional to explain the condition. What response by the professional is best?

Accepted Answer

A) The outer surface of the bone is disrupted, but the inside is intact. 
B) A stable fracture where the cortex of the bone bends but doesn't break. 
C) A fracture that happens at the site of an abnormality already in that bone. 
D) It was caused by the cumulative effects of stress on the bone over time. 
A) The outer surface of the bone is disrupted, but the inside is intact. 
B) A stable fracture where the cortex of the bone bends but doesn't break. 
C) A fracture that happens at the site of an abnormality already in that bone. 
D) It was caused by the cumulative effects of stress on the bone over time.

Question 17

A patient in the clinic had a femur x-ray that was read as having a "moth-eaten" appearance. What treatment option does the health care professional discuss with the patient?

Accepted Answer

A) Limb-salvaging surgery 
B) Amputation 
C) Oral bisphosphonates 
D) Calcium and vitamin D supplements 
A) Limb-salvaging surgery 
B) Amputation 
C) Oral bisphosphonates 
D) Calcium and vitamin D supplements

Question 18

Which hormone exerts antiapoptotic effects on osteoblasts but proapoptotic effects on osteoclasts?

Accepted Answer

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

Question 19

A patient is brought to the Emergency Department after being found by neighbors. The patient says she has been lying on the floor in the house for 3 days. What action by the health care professional is best?

Accepted Answer

A) Order a serum creatine kinase (CK) level 
B) Obtain an x-ray of the patient's hips 
C) Arrange for the patient to have a DXA scan 
D) Perform the Fracture Risk Assessment 
A) Order a serum creatine kinase (CK) level 
B) Obtain an x-ray of the patient's hips 
C) Arrange for the patient to have a DXA scan 
D) Perform the Fracture Risk Assessment

Question 20

What are the primary sources of bacterial infections that lead to hematogenous bone infection? (Select all that apply.)

Accepted Answer

A) Sinus 
B) Ear 
C) Dental 
D) Cutaneous 
E) Throat 
A) Sinus 
B) Ear 
C) Dental 
D) Cutaneous 
E) Throat

Exam 45: Alterations of Musculoskeletal Function

A student studying osteomyelitis and asks for an explanation of the term "sequestrum." What response by the professor is best?

The health care professional teaches a group of seniors that the most common clinical manifestation of osteoporosis is which of these?

The pathophysiologic presentation of gout is closely linked to the metabolism of which chemical?

By the time osteoporosis is visible on an x-ray examination, up to what percent of bone has been lost?

What is the primary pathologic alteration resulting from ankylosing spondylitis (AS)?

A patient in the clinic is worried about having fibromyalgia. For which symptoms should the health care professional assess the patient for?

A patient has been diagnosed with Paget disease. What explanation of the disease does the health care professional provide the patient?

What is the tear in a ligament referred to as?

What event is associated with the beginning of bone loss in women?

In osteoporosis, the receptor activator of nuclear factor kB (RANK) activates what?

A patient seen in the clinic has tissue degeneration or irritation of the extensor carpi radialis brevis tendon. What diagnosis does the health care professional document?

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

A health care professional is providing education to a group of seasonal athletes. What type of fracture does the professional warn them to avoid?

A professor has taught the class about giant cell bone tumors. Which statement by a student would require the professor to review the material?

A health care professional determines that the student needs more education when the student makes which statement about treating bone infection?

The health care professional is caring for a person who has a pathologic fracture. The patient asks the professional to explain the condition. What response by the professional is best?

A patient in the clinic had a femur x-ray that was read as having a "moth-eaten" appearance. What treatment option does the health care professional discuss with the patient?

Which hormone exerts antiapoptotic effects on osteoblasts but proapoptotic effects on osteoclasts?

A patient is brought to the Emergency Department after being found by neighbors. The patient says she has been lying on the floor in the house for 3 days. What action by the health care professional is best?

What are the primary sources of bacterial infections that lead to hematogenous bone infection? (Select all that apply.)

Cellular Biology

Altered Cellular and Tissue Biology: Environmental Agents

The Cellular Environment: Fluids and Electrolytes, Acids and Bases

Genes and Genetic Diseases

Genes, Environment-Lifestyle, and Common Diseases

Epigenetics and Disease

Innate Immunity: Inflammation and Wound Healing

Adaptive Immunity

Alterations in Immunity and Inflammation

Infection

Stress and Disease

Cancer Biology

Cancer Epidemiology

Cancer in Children

Structure and Function of the Neurologic System

Pain, Temperature Regulation, Sleep, and Sensory Function

Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function

Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction

Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders

Alterations of Neurologic Function in Children

Mechanisms of Hormonal Regulation

Alterations of Hormonal Regulation

Obesity and Disorders of Nutrition

Structure and Function of the Reproductive Systems

Alterations of the Female Reproductive System

Alterations of the Male Reproductive System

Sexually Transmitted Infections

Structure and Function of the Hematologic System

Alterations of Erythrocytes, Platelets, and Hemostatic Function

Alterations of Leukocyte and Lymphoid Function

Alterations of Hematologic Function in Children

Structure and Function of the Cardiovascular and Lymphatic Systems

Alterations of Cardiovascular Function

Alterations of Cardiovascular Function in Children

Structure and Function of the Pulmonary System

Alterations of Pulmonary Function

Alterations of Pulmonary Function in Children

Structure and Function of the Renal and Urologic Systems

Alterations of Renal and Urinary Tract Function

Alterations of Renal and Urinary Tract Function in Children

Structure and Function of the Digestive System

Alterations of Digestive Function

Alterations of Digestive Function in Children

Structure and Function of the Musculoskeletal System

Alterations of Musculoskeletal Function in Children

Structure, Function, and Disorders of the Integument

Alterations of the Integument in Children

Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children

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