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~Ortho Boards~ > Basic Science > Flashcards

Basic Science Flashcards

1
Q

What is the most common culture isolate in necrotizing fasciitis?

A

Polymicrobial

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2
Q

What is the MOA of calcitonin?

A

Binds to osteoclast receptors, which decreases the ruffled border, followed by cell retraction, and therefore arrest of bone resorption

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3
Q

What is denosumab?

A

IgG2 monoclonal antibody against RANKL

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4
Q

What is teriparatide?

A

recombinant PTH; anabolic effect via activating osteoblasts

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5
Q

What effects does calcitonin have on osteocytes?

A

inhibits apoptosis and increased expression of sclerostin (a Wnt-signaling inhibitor)

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6
Q

What is the MOA of enoxaparin?

A

Enoxaparin binds to and increases the activity of antithrombin III

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7
Q

What is the MOA of osteoprotegrin?

A

Binds to and sequesters RANKL preventing osteoclastic differentiation

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8
Q

What artery provides the blood supply to the outer third the long bone diaphysis?

A

periosteal arteriole

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9
Q

What artery provides the blood supply to the inner two thirds of long bones?

A

Nutrient artery

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10
Q

Is DBM osteoconductive or osteoinductive?

A

It is both; but not osteogenic

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11
Q

Is BMP osteodconductive, osteoinductive, or osteogenic?

A

osteoinductive

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12
Q

What is the mechanism of BMP in bone formation?

A

activates mesenchymal cells to transform into osteoblasts and produce bone

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13
Q

What is the mechanism of osteoprotegrin in bone formation?

A

OPG inhibits both osteoclast activation and differentiation by acting as a decoy receptor for RANK-L.

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14
Q

Bridge plating relies on what kind of bone healing?

A

Relative stability; Secondary (endochondral) bone healing through chondrocytes proliferation and hypertrophy

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15
Q

Anatomic fracture reduction relies on what time of bone healing?

A

Absolute stability; primary (intramembranous) bone healing through Haversian canals and cutting cones

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16
Q

What is DBM made up of?

A

collagen, TGF-beta, BMP, and residual calcium; it is bone osteoinductive and osteoconductive but not osteogenic

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17
Q

What are the FDA indications for use of recombinant human (rh) BMP-2?

A

Acute open tibia shaft fractures treated within 14 days and single level ALIFs

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18
Q

What is the definition of strain?

A

Change in length / original length of an object due to an external force

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19
Q

Salter-Harris type I fractures typically occur through which zone of the physis?

A

Zone of provisional calcification

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20
Q

What region of the physis does collagen type X play a prominent role?

A

Type X collagen is important for bone mineralization and is produced by hypertrophic chondrocytes in the zone of hypertrophy.

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21
Q

What is the mechanism of Sclerostin?

A

Sclerostin impedes osteoblast proliferation and function by inhibiting the Wnt signaling pathways and thus inhibits bone formation.

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22
Q

What is the MOA of anakinra?

A

Receptor antagonist of IL-1

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23
Q

What agar does Neisseria grow on?

A

Thayer Martin

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24
Q

What agar does mycobacterium grow on?

A

Lowenstein Jensen

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25
Q

What agar does Kingella kingae grow on?

A

aerobic blood agar (can take a week)

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26
Q

Osteoclasts originate from hematopoietic cells from the […] cell lineage?

A

Macrophage

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27
Q

Mirror hand deformity is caused by abnormal duplication of the […]

A

Zone of polarizing activity

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28
Q

[…] are molecules essential for osteoclasts attachment to the bone surface.

A

Integrins

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29
Q

[…] bone formation occurs in longitudinal physeal growth

A

Endochondral

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30
Q

Embryonic long bone formation occurs due to […] bone formation

A

endochondral

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31
Q

Type […] collagen associated with endochondral ossification

A

X

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32
Q

Sox-9 gene regulates collagen types […] […] […]

A

II, IV, and XI

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33
Q

[…] delays differentiation of chondrocytes in the zone of hypertrophy

A

PTHrP

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34
Q

The […] artery is the major source of nutrition to physis

A

perichondral

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35
Q

What physeal zone is affected by Gaucher’s disease?

A

Reserve

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36
Q

The reserve physeal zone has […] oxygen tension

A

low

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37
Q

Which physeal zone has the highest rate of extracellular matrix production?

A

Proliferative zone

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38
Q

Which physeal zone has longitudinal growth and stacking of chondrocytes?

A

Proliferative zone

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39
Q

Which physeal zone has chondrocyte maturation and chondrocyte calcification?

A

Hypertrophic zone (also has chondrocyte hypertrophy in this zone)

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40
Q

Which phase of hypertrophic zone has 5x the chondrocyte growth?

A

Degenerative phase

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41
Q

In the hypertrophic physeal zone, the […] phase/zone haschondrocyte death which allows calcium release, allowing calcification of matrix

A

provisional calcification

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42
Q

Type […] collagenproduced by hypertrophic chondrocytes important for mineralization

A

X

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43
Q

Which physeal zone is affected by Rickets?

A

provisional zone of calcification in hypertrophic zone

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44
Q

Fractures most commonly occur through zone of […]

A

provisional calcification in the hypertrophic zone

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45
Q

Which physeal zone is affected by enchondromas?

A

Hypertrophic zone

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46
Q

Which physeal zone is affected by mucopolysaccharidoses?

A

hypertrophic zone

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47
Q

Metaphyseal “corner fracture” in child abuse affects the […] physeal zone

A

primary spongiosa

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48
Q

What physeal zone is affected by renal SCFE?

A

Secondary spongiosa

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49
Q

Which physeal zone is affected by achondroplasia?

A

proliferative zone

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50
Q

Which physeal zone is affected by giantism?

A

proliferative zone

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51
Q

The groove of Ranvier is affected by what bony tumor?

A

Osteochondroma

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52
Q

What physeal ring increases the mechanical strength of the physis and is responsible for appositional bone growths?

A

Groove of Ranvier

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53
Q

In embryonic long bone formation, […] cells differentiate into chondroblasts that form the hyaline cartilaginous skeletal precursor of the bones

A

mesenchymal

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54
Q

Which cells produce RANKL?

A

Osteoblasts

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55
Q

Which cells have RANK

A

Osteoclasts and osteoclast precursors

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56
Q

[…] is a decoy receptor produced by osteoblasts and stromal cells that binds to and sequesters RANKL

A

Osteoprotegerin

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57
Q

Osteoprotegerin […] osteoclast differentiation, fusion, and activation.

A

inhibits

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58
Q

Which cell produced osteoprotegerin?

A

Osteoblasts

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59
Q

Osteoclast Inhibition […] bone resorption

A

decreases

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60
Q

Transforming growth factor beta (TGF beta) increases […], thereby decreasing bone resorption

A

osteoprotegerin

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61
Q

Interleukin-[…] suppresses osteoclasts

A

10

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62
Q

RANKL (ligand) is secreted by […] and binds to the RANK receptor on […] and […] cells.

A

osteoblasts; osteoclast precursor; mature osteoclast

63
Q

PTH […] adenylyl cyclase, while estrogen […] adenylyl cyclase.

A

stimulates; inhibits

64
Q

PTH binds to cell-surface receptors on […] to stimulate production of RANKL and M-CSF

A

osteoblasts

65
Q

IL-[…] stimulates osteoclast differentiation and thus bone resorption

66
Q

when the strain is below […] percent, primary bone healing will occur

67
Q

When the strain is between […] percent, secondary bone healing will occur.

68
Q

Primary bone healing occurs with […] healing.

A

intramembranous

69
Q

Haversian remodeling is seen in […] bone healing

A

primary/intramembranous

70
Q

Intramembranous healing is […] bone healing

71
Q

Enchondral bone healing is […] bone healing

72
Q

Secondary bone healing occurs with […] bone healing.

A

endochondral

73
Q

During fracture healing […] tissue tolerates the greatest strain before failure

A

granulation

74
Q

Inhibition of COX-2 (ie NSAIDs) causes repression of […], which are critical for differentiation of osteoblastic cells

A

runx-2/osterix

75
Q

Type […] collagen is produced early in fracture healing and then followed by type […] collagen expression

A

Type II collagen (cartilage); Type I collagen (bone)

76
Q

Chondrocytes undergo terminal differentiation during which stage of fracture healing?

A

remodeling

77
Q

In fracture healing, Type […] collagen is expressed by hypertrophic chondrocytes as the extraarticular matrix undergoes calcification

78
Q

In fracture healing, Type X collagen is expressed by […] as the extraarticular matrix undergoes calcification

A

hypertrophic chondrocytes

79
Q

Low intensity pulsed ultrasound […] fracture healing and […] mechanical strength of callus (including torque and stiffness).

A

accelerates; increases

80
Q

Direct current bone stimulators decrease osteoclast activity and increase osteoblast activity by […] oxygen concentration and […] local tissue pH

A

reducing; increasing

81
Q

COX-2 promotes fracture healing by causing mesenchymal stem cells to differentiate into […]

A

osteoblasts

82
Q

What is the definition of strain?

A

change in length/original length (L)

83
Q

By what mechanism does calcitonin inhibit bone resorption?

A

Calcitonin inhibits osteoclastic bone resorption directly by binding to the osteoclast

84
Q

A deactivating mutation in the parathyroid hormone-related peptide (PTHrP) receptor would lead to […] maturation in the zone of hypertrophy

A

accelerated

85
Q

During the early callus phase of bone healing, MMP-13 is expressed by […] to degrade the cartilaginous extracellular matrix.

A

terminally differentiated chondrocytes

86
Q

BMP 2,4,6, and 7 all exhibit osteo-[…] activity.

87
Q

rhBMP-2 is approved for FDA use in what spine procedure?

A

Single level ALIF from L2 to S1 for degenerative disc disease

88
Q

rhBMP-2 is approved by FDA use in what trauma procedure?

A

open tibia shaft treated with IMN within 14 days

89
Q

TGF-beta stimulates production of Type […] collagen

90
Q

What bone graft substitute resorbs the fastest?

A

calcium sulfate

91
Q

What bone graft substitute resorbs the slowest?

A

hydroxyapatite

92
Q

5 years after implantation, allograft articular cartilage is completely […]

93
Q

An […] bone graft material acts as a structural framework for bone growth

A

osteoconductive

94
Q

BMP is an example of an osteo-[…] material.

95
Q

Which synthetic bone grafting material has the highest compressive strength?

A

Calcium phosphate

96
Q

An osteo-[…] material is a material that contains factors to stimulate bone growth.

97
Q

Calcium sulfate is osteo-[…] only

A

conductive

98
Q

DBM is both osteo-[…] and osteo-[…]

A

Osteoinductive and osteoconductive

99
Q

In iliac crest bone graft harvesting, there is a higher complication rate with […] versus […] harvesting

A

anterior; posterior

100
Q

Calcium […] bone graft substitute associated with increased serous wound drainage

101
Q

What is the MOA of botox?

A

Blocks acetylcholine release at end plate

102
Q

[…] are the most abundant cells early on after acute muscle injury

A

Neutrophils

103
Q

Bone morphogenetic proteins (BMPs) uses […] receptors to stimulate proliferation and differentiation of pluripotent mesenchymal stem cells into bone-forming cells.

A

serine-threonine kinase

104
Q

Type […] collagen makes up 85% of dry weight of tendons

105
Q

[…] is the most predominant proteoglycan in tendon

106
Q

What two types of collagen make up tendons?

A

Type I (85%); Type III (0-5%)

107
Q

[…] are predominant cell type seen in tendons.

A

fibroblasts

108
Q

Tendon repairs are weakest at […] days

109
Q

Hyaline cartilage is composed of type […] collagen

110
Q

Articular cartilage water content […] with osteoarthritis

111
Q

In hyaline (articular) cartilage, […] function to provide compressive strength and attract water

A

proteoglycans

112
Q

Which proteoglycan found in articular (hyaline) cartilage is most responsible for hydrophilic behavior?

113
Q

Normal articular cartilage is composed of […] zones and the tidemark

114
Q

Which zone of articular cartilage have cartilage progenitor cells been found in?

A

Superficial

115
Q

Which zone of articular cartilage are the collagen fibers parallel to the joint?

A

Superficial

116
Q

The […] zone of articular cartilage has thehighest concentration of collagen and lowest concentration of proteoglycans

A

superficial

117
Q

Which zone of articular cartilage is the thickest?

A

Intermediate

118
Q

Which growth factor is responsible for osteophyte formation?

119
Q

With age, articular chondrocytes […] in size

120
Q

With age, there is an […] in protein content of articular cartilage

121
Q

With age, there is a […] in absolute number of cells (chondrocytes) in articular cartilage.

122
Q

With age, there is a […] in water content of the articular cartilage.

A

decrease; (note: differentiates from osteoarthritis where water content actually increases)

123
Q

Predominant pathway of chondrocyte death in articular cartilage injury is believed to be via […].

A

apoptosis; (note: NOT necrosis)

124
Q

Deep articular cartilage injury (eg lacerations) lead to healing via formation of […] versus hyaline cartilage

A

Fibrocartilage (note: this response forms type I collagen)

125
Q

The superficial zone of articular cartilage has the […] content of collagen and the […] content of proteoglycans relative to the other zones

A

highest; lowest

126
Q

What is the inheritance pattern of Marfan’s syndrome?

127
Q

What is the inheritance pattern of Malignant Hyperthermia?

128
Q

What is the inheritance pattern of Ehlers-Danlos?

129
Q

What is the inheritance pattern of Osteogenesis imperfecta (types I-IV)?

130
Q

What is the inheritance pattern of hemophilia?

A

X-linked recessive

131
Q

What is the inheritance pattern of Charcot-Marie-Tooth?

132
Q

With […] deformation, the material returns to original shape when load is removed

133
Q

Is elastic deformation reversible or irreversible?

A

reversible

134
Q

Is plastic deformation reversible or irreversible?

A

Irreversible

135
Q

In […] deformation, material DOES NOT return to original shape when load is removed.

136
Q

The definition of […] is amount of energy per volume a material can absorb before failure.

137
Q

[…] is calculated as the area under the stress/strain curve

138
Q

The […] is the the transition point between elastic and plastic deformation

A

yield point

139
Q

The […] is defined as the load to failure.

A

Ultimate (Tensile) Strength

140
Q

A brittle material undergoes […] deformation only, and little to no […] deformation

A

elastic; plastic

141
Q

The bending rigidity of a plate is proportional to […]

A

thickness to the 3rd power

142
Q

An IMN is a load-[…] device.

143
Q

A plate construct is a load-[…] device.

144
Q

Bending rigidity is proportional to the radius to the […] power for a solid nail

145
Q

Bending rigidity is proportional to the radius to the […] power for a hollow nail

146
Q

Increasing femoral offset […] strain on medial cement mantle

147
Q

Increasing femoral offset increases strain on […] cement mantle.

148
Q

Crutch walking requires […] energy than walking with a prosthesis

149
Q

For upper extremity prostheses, there are better outcomes if prosthetic is fitted within […] days

150
Q

A higher modulus of elasticity indicates a […] material.

151
Q

Young’s modulus is a measure of the […] of a material in the elastic zone that is calculated by measuring the slope of the stress-strain curve in the elastic zone.

A

stiffness (ie - ability to resist deformation)

152
Q

[…] is defined as: progressive deformation of a material in response to a constant force over an extended period

153
Q

[…] is defined as: failure below the ultimate tensile strength after numerous loading cycles

~Ortho Boards~ (13 decks)

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