The incidence of fractures of the pelvis is highest in:
a.
Preadolescent boys
b.
Adolescent boys
c.
Adolescent girls
d.
Older adults
d

A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, transverse fracture of the femur. Which of the following statements best describes this type of fracture?
a.
The fracture line is parallel to the bone.
b.
The fracture line is straight across the bone.
c.
The fracture line is perpendicular to the bone.
d.
The fracture line is vertical to the shaft of the bone.
b

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?
a.
Fatigue fracture
b.
Stress fracture
c.
Pathologic fracture
d.
Greenstick fracture
c

A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This is referred to as a what type of fracture?
a.
Comminuted
b.
Greenstick
c.
Fatigue
d.
Compound
c

Transchondral fractures are most prevalent in:
a.
Adolescents
b.
Older adults
c.
Infants
d.
Premenopausal females
a

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:
a.
Dislocation
b.
Subluxation
c.
Distortion
d.
Nonunion
b

A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. This condition is known as a:
a.
Sprain
b.
Strain
c.
Disunion
d.
Subluxation
a

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:
a.
Periostitis
b.
Muscle strain
c.
Bursitis
d.
Epicondylopathy
d

An important and useful clinical measure in the diagnosis of rhabdomyolysis is measurement of which laboratory value?
a.
White blood cell count
b.
Antinuclear antibodies
c.
Aspartate aminotransferase
d.
Creatine kinase (CK)
d

Which of the following clinical findings would be expected in the patient with rhabdomyolysis?
a.
Sweating
b.
Dark urine
c.
Yellow color to the skin
d.
Lower extremity swelling
b

A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase in bone:
a.
Density
b.
Formation
c.
Resorption
d.
Mineralization
c

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:
a.
Increased androgen levels
b.
Decreased estrogen levels
c.
Strenuous exercise
d.
Excessive dietary calcium
b

A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:
a.
Bone infections
b.
Joint injuries
c.
Pathologic bone fractures
d.
Ssteomalacia
c

An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by:
a.
Collagen breakdown in the bone matrix
b.
Excessive bone resorption
c.
Crowding of bone marrow by excessive bone growth
d.
Inadequate bone mineralization
d

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?
a.
Impaired phosphate absorption
b.
Increased calcium excretion
c.
Vitamin D deficiency
d.
Impaired vitamin C metabolism
c

A disorder similar to osteomalacia that occurs in growing bones of children is termed:
a.
Paget disease
b.
Rickets
c.
Osteomyelitis
d.
Osteosarcoma
b

The cause of Paget disease is:
a.
Fluoride deficiency
b.
Unknown at present
c.
Excess vitamin A
d.
Osteogenic sarcoma
b

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 primary organism causing this condition is:
a.
Staphylococcus aureus
b.
Salmonella
c.
Mycobacterium
d.
Haemophilus influenza
a

A 54-year-old female was recently diagnosed with degenerative joint disease. This condition is characterized by loss of:
a.
The epiphyses
b.
Articular cartilage
c.
Synovial fluid
d.
The joint capsule
b

A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA). Which of the following is the expected treatment of choice?
a.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
b.
Gold salts
c.
Methotrexate
d.
Hydroxychloroquine
c

Researchers now believe that RA is:
a.
Curable with antiviral agents
b.
An autoimmune disease
c.
A complication of rheumatic fever
d.
Related superficial joint injury
b

A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in the:
a.
Synovial membrane
b.
Articular cartilage
c.
Subchondral bone
d.
Surrounding ligaments
a

A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis (AS). The first joint to be affected would be the:
a.
Sacroiliac
b.
Carpal
c.
Shoulder
d.
Knee
a

Which of the following people is at highest risk for the development of gout?
a.
Men aged 40 to 50 years
b.
Premenopausal women
c.
Male adolescents
d.
Female children
a

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. The symptoms he experienced are caused by the crystallization of _____ within the synovial fluid.
a.
Purines
b.
Pyrimidines
c.
Uric acid
d.
Acetic acid
c

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. He is at risk for developing:
a.
Cholelithiasis
b.
Myocarditis
c.
Renal stones
d.
Liver failure
c

A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?
a.
Trauma
b.
Anemia
c.
High-fat foods
d.
Lack of exercise
a

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:
a.
Monarticular arthritis
b.
Tophaceous gout
c.
Asymptomatic hyperuricemia
d.
Complicated gout
b

A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as:
a.
Myodysplasia
b.
Ischemic atrophy
c.
Disuse atrophy
d.
Deconditioning hypoplasia
c

Fibromyalgia is a chronic musculoskeletal disorder characterized by:
a.
Pain resulting from joint and muscle inflammation
b.
Muscle pain in the back and gastrointestinal symptoms
c.
Neurologic pain in the skeletal muscles
d.
Diffuse pain, fatigue, and tender points
d

Myotonia is characterized by:
a.
Prolonged depolarization of muscle cell membranes
b.
Absence of adenosine triphosphate (ATP) for muscle contraction
c.
Delayed muscle contraction
d.
Hyperactive reflexes
a

A 13-year-old female is admitted to the hospital for evaluation and treatment of an osteosarcoma in her left distal femur. Which statement best describes osteosarcoma?
a.
Myelogenic, develops in red bone marrow only
b.
Benign, develops in spongy bone tissue
c.
Collagenic, originates in the periosteum
d.
Osteogenic, most often develops in the bone marrow
d

A 60-year-old male presents with swelling and pain in the knee. CT reveals a tumor of spongy bone. His diagnosis would be:
a.
Chondrosarcoma
b.
Rhabdomyoma
c.
Rhabdomyosarcoma
d.
Fibrosarcoma
a

The most common cause of toxic myopathy is:
a.
Infection
b.
A tumor
c.
Alcoholism
d.
Osteoporosis
c

A malignant tumor of striated muscle tissue origin is called:
a.
Myelogenic tumor
b.
Giant cell tumor
c.
Rhabdomyosarcoma
d.
Rhabdomyoma
c

A 35-year-old female presents with impaired motor function and visual disturbances. The diagnosis is Paget disease. What additional symptoms would be expected? (Select all that apply.)
a.
Skull thickness
b.
Dementia
c.
Deafness
d.
Headache
e.
Hypertension
a, b, c, d

Signs and symptoms of subluxation include (select all that apply):
a.
Pain
b.
Swelling
c.
Hemorrhage
d.
Limitation of movement
e.
Joint deformity
a, b, d, e

A 29-year-old male was recently diagnosed with AS. He is interested in obtaining more information about his disease. Patient teaching would include which of the following? (Select all that apply.)
a.
A diagnosis is made from history, physical examination, x-rays, and genetic analysis.
b.
Inflammation of the fibrocartilage in cartilaginous joints results in the erosion of bone structure, scar tissue formation, and joint fusion.
c.
The more common signs and symptoms of early disease include restricted joint movement and increased pain after physical activity.
d.
The usual treatment includes anti-inflammatory and analgesic medications, exercises, and physical therapy.
e.
The spine becomes bent forward as the normal convex curve of the lower spine diminishes.
a, b, d, e

The pattern of bone destruction indicative of an aggressive malignant tumor is known as J_____ pattern. (Select all that apply.)
a.
Moth-eaten
b.
Permeative
c.
Geographic
d.
Radial
e.
Selective
a, b, c

To make a diagnosis of fibromyalgia, tenderness must be present in ____ of the 18 points necessary for diagnosis.
11

The incidence of fractures of the pelvis is highest in: elderly adults 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 …

Fractures a break in a bone What is the pathophysiology of a fracture and healing? bleeding–> clot/ hematoma around fracture site–> surrounding tissue becomes necrotic (necrosis)–> inflammation–> dilation of blood vessels and exudate–> increased osteoblast activity (callous)–> new bone–> remodeling …

Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bones are altered. Osteoporosis can cause …

Common Fractures Closed fracture In this fracture the bone breaks but does not damage the skin. Open fractures or compound fractures This means the broken bone is sticking out of the skin. Hairline fractures This means that the line of …

Common Fractures Closed fracture In this fracture the bone breaks but does not damage the skin. Open fractures or compound fractures This means the broken bone is sticking out of the skin. Hairline fractures This means that the line of …

As we age we deal with many unpleasant side effects. Some side effects and diseases come with the territory while others are preventable. In this paper we have a closer look at the causes of osteoporosis, osteoarthritis, and muscular atrophy. …

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