Basic Science 2014 Flashcards
Question 9
Abnormal development of which structure leads to altered orientation of the upper limb in mirror hand?
- Sclerotome
- Resting zone
- Progress zone
- Apical ectodermal ridge
- Zone of polarizing activity
- Zone of polarizing activity
RECOMMENDED READINGS
Herring JA, Mihran O. Tachdjian. Disorders of the upper extremity. In:Herring JA, ed. Tachdjian’s Pediatric Orthopaedics. Philadelphia, PA: Saunders Elsevier;2008:483-637.
Question 22
What role does collagen have in the viscoelastic properties of articular cartilage?
- Maintaining aggrecan orientation
- Restraining the swelling pressure of aggrecan
- Creating a barrier for synovial fluid entering the matrix
- Providing Arg-Gly-Asp (RDG) segments for cell membrane attachment
- Preventing water from being expressed under pressure
- Restraining the swelling pressure of aggrecan
RECOMMENDED READINGS
Maroudas A. Physio-chemical properties of articular cartilage. In: Mar F, ed. Adult Articular Cartilage. Tunbridge Wells, England:Pitman Medical;1979:215-90.
Question 24
The hierarchical structure of a peripheral nerve from inside out is correctly described as
- axon, endoneurium, perineurium, fascicles, epineurium, myelin sheath.
- axon, endoneurium, myelin sheath, perineurium, fascicles, epineurium.
- axon, myelin sheath, endoneurium, perineurium, fascicles, epineurium.
- endoneurium, axon, myelin sheath, perineurium, fascicles, epineurium.
- endoneurium, axon, perineurium, fascicles, epineurium, myelin sheath.
- axon, myelin sheath, endoneurium, perineurium, fascicles, epineurium.
RECOMMENDED READINGS
Bhandari, M. Statistics: practical applications for orthopaedics. In: Lieberman JR, ed. AAOS Comprehensive Orthopaedic Review. Rosemont, IL:American Academy of Orthopaedic Surgeons;2009:199-207.
O’Keefe RJ, Jacobs JJ, Chu CR, Einhorn TA , eds. Orthopaedic Basic Science: Foundations of Clinical Practice, 4th ed. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2013.
Question 52
After sustaining a muscle injury, the best initial rest and exercise approach involves immobilization for
- 3 to 5 days followed by eccentric exercise.
- 3 to 5 days followed by progressive strengthening and stretching.
- 2 weeks followed by eccentric exercise.
- 2 weeks followed by light concentric exercise.
- 4 weeks followed by gradual return to activity.
- 3 to 5 days followed by progressive strengthening and stretching.
RECOMMENDED READINGS
Menetrey J, Kasemkijwattana C, Fu FH, Moreland MS, Huard J. Suturing versus immobilization of a muscle laceration. A morphological and functional study in a mouse model. Am J Sports Med. 1999 Mar- Apr;27(2):222-9. PubMed PMID: 10102105.
Wright A, Gharaibeh B, Huard J. Form and function of skeletal muscle. In: O’Keefe RJ, Jacobs JJ, Chu CR, Einhorn TA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 4th ed. Rosemont, IL: American Academy of Orthopaedic Surgeons;2013:229-237.
Järvinen MJ, Lehto MU. The effects of early mobilisation and immobilisation on the healing process following muscle injuries. Sports Med. 1993 Feb;15(2):78-89. Review. PubMed PMID: 8446826.
Question 61
Proteoglycan content is highest in which portion of the intervertebral disk?
- Deep annulus
- Middle annulus
- Superficial annulus
- Nucleus pulposus
- Vertebral end plate
- Nucleus pulposus
RECOMMENDED READINGS
Bhandari, M. Statistics: practical applications for orthopaedics. In: Lieberman JR, ed. AAOS Comprehensive Orthopaedic Review. Rosemont, IL:American Academy of Orthopaedic Surgeons;2009:199-207.
O’Keefe RJ, Jacobs JJ, Chu CR, Einhorn TA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 4th ed. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2013.
Question 67
A study was designed to compare the frequency of infection among patients who underwent arthroplasty; one group received antibiotic cement and the other group received standard cement. Which statistical test can be used to compare the proportions of patients with infection in the 2 groups?
- t test
- Paired t test
- Chi-square test
- Analysis of variance
- Pearson correlation
- Chi-square test
RECOMMENDED READINGS
Losina E, Reichmann W, Katz, JN. Biostatistics in clinical research. In: O’Keefe RJ, Jacobs JJ, Chu CR, Einhorn TA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 4th ed. Rosemont, IL:American Academy of Orthopaedic Surgeons;2013:509-513.
Bhandari M. Statistics: practical applications for orthopaedics. In: Lieberman JR, ed. AAOS Comprehensive Orthopaedic Review. Rosemont, IL:American Academy of Orthopaedic Surgeons;2009:199-207.
Question 72
Which group of molecules is essential for osteoclast attachment to the bone surface?
- Actin
- Laminin
- Vimentin
- Integrins
- G proteins
- Integrins
RECOMMENDED READINGS
Bikle DD. Integrins, insulin like growth factors, and the skeletal response to load. Osteoporos Int. 2008 Sep;19(9):1237-46. doi: 10.1007/s00198-008-0597-z. Epub 2008 Mar 29. Review. PubMed PMID: 18373051.
Zuscik MJ, Drissi MH, Chen D, Rosier RN. Molecular and cell biology in orthopaedics. In: Einhorn TA, O’Keefe RJ, Buckwalter JA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 3rd ed. Rosemont,IL: American Academy of Orthopaedic Surgeons;2007:3-23.
Question 84
A 30-year-old man has pain and a mass aroudn his knee. Radiographs reveal a soft-tissue calcificiation and a soft-tissue mass around his knee. He underwent a biopsy and synovial sarcoma was diagnosed. Which test is most useful to determine the characteristic genetic abnormality associated with this malignancy?
- DNA ligation
- Genomic screening
- Cytogenetic analysis
- Polymerase chain reaction
- Restriction enzyme gel-electrophoresis
- Cytogenetic analysis
RECOMMENDED READINGS
Bhandari, M. Statistics: practical applications for orthopaedics. In: Lieberman JR, eds. AAOS Comprehensive Orthopaedic Review. 4th ed. Rosemont, IL:American Academy of Orthopaedic Surgeons;2009:199-207.
O’Keefe RJ, Jacobs JJ, Chu CR, Einhorn TA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 4th ed. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2013.
Question 87
Which feature of noncollagenous bone extracellular proteins allows interaction with integrins on bone cells?
- Triple helix
- Ruffled boarder
- Proline hydroxylation
- Quarter-stagger orientation
- Arg-Gly-Asp (RGD) sequence
- Arg-Gly-Asp (RGD) sequence
Question 100
Which matrix component is responsible for the toe region of a tendon’s stress strain curve?
- Elastin
- Fibrillin
- Aggrecan
- Type II collagen
- Alpha smooth muscle actin
- Elastin
RECOMMENDED READINGS
Kastelic J, Palley I, Baer E. A structural mechanical model for tendon crimping. J Biomech. 1980;13(10):887-93. PubMed PMID: 7462263.
Hansen KA, Weiss JA, Barton JK. Recruitment of tendon crimp with applied tensile strain. J Biomech Eng. 2002 Feb;124(1):72-7. PubMed PMID: 11871607.
Poitout DG, ed. Biomechanics and Biomaterials in Orthopedics. New York,NY:Springer Publishing Company;2004:551-563.
Question 106
Aminoglycoside antibiotics work by which mechanism of action?
- Inhibiting DNA gyrase
- Inhibiting RNA polymerase
- Inhibiting polysaccharide cross-linking
- Binding to the 30S-ribosomal subunit
- Binding of the 50S-ribosomal subunit
- Binding to the 30S-ribosomal subunit
RECOMMENDED READINGS
Bhandari, M. Statistics: Practical Applications for Orthopaedics. In: Lieberman JR, ed. AAOS Comprehensive Orthopaedic Review. Rosemont, IL:American Academy of Orthopaedic Surgeons;2009:199-207.
Gilbert DN, Moellering Jr RC, Eliopoulos GM, eds. The Sanford Guide to Antimicrobial Therapy, 40th ed. Sperryville, VA: Antimicrobial Therapy; 2010.
Question 115
What is the phenotype and mechanism of factor V Leiden disorder?
- Excessive bleeding attributable to protein C inactivation
- Excessive bleeding attributable to increased thrombin activation
- Excessive bleeding attributable to decreased thrombin activation
- Hypercoagulation attributable to increased thrombin activation
- Hypercoagulation attributable to decreased thrombin activation
- Hypercoagulation attributable to increased thrombin activation
RECOMMENDED READINGS
Conduah AH, Lieberman JR. Thromboembolism and pulmonary distress in thesetting of orthopaedic surgery. In: Einhorn TA, O’Keefe RJ, Buckwalter JA, eds. Orthopaedic Basic Science: Foundations of Clinical Practice. 3rd ed. Rosemont, IL: American Academy of Orthopaedic Surgeons;2007:105-113.
Bertina RM, Koeleman BP, Koster T, Rosendaal FR, Dirven RJ, de Ronde H, van der Velden PA, Reitsma PH. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature. 1994 May 5;369(6475):64-7. PubMed PMID: 8164741.
Vosmaer A, Pereira RR, Koenderman JS, Rosendaal FR, Cannegieter SC. Coagulation abnormalities in Legg-Calvé-Perthes disease. J Bone Joint Surg Am.2010 Jan;92(1):121-8. doi: 10.2106/JBJS.I.00157. PubMed PMID: 20048104.
Question 118
A 56-year-old woman has knee pain. Her degree of swelling and pain appears to exceed the relative appearance of radiographs, which show minimal change. Her body mass index is 38, and her current medical issues include hypertension, hypercholesterolemia, dyslipidemia, and insulin resistance. This condition is referred to as
- obesity syndrome.
- metabolic syndrome.
- inflammatory osteoarthritis syndrome
- insulin-fat disorder
- knee atherosclerosis disorder.
- metabolic syndrome.
RECOMMENDED READINGS
Inoue R, Ishibashi Y, Tsuda E, Yamamoto Y, Matsuzaka M, Takahashi I, Danjo K, Umeda T, Nakaji S, Toh S. Medical problems and risk factors of metabolic syndrome among radiographic knee osteoarthritis patients in the Japanese general population. J Orthop Sci. 2011 Nov;16(6):704-9. doi: 10.1007/s00776- 011-0157-9. Epub 2011 Sep 14. PubMed PMID: 21915668.
Engström G, Gerhardsson de Verdier M, Rollof J, Nilsson PM, Lohmander LS. C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study. Osteoarthritis Cartilage. 2009 Feb;17(2):168-73. doi: 10.1016/j.joca.2008.07.003. Epub 2008 Aug 29. PubMed PMID: 18760940.
Question 126
A patient who undergoes surgery for shoulder instability has increased CO2 production, tachycardia, and a core body temperature that rises soon after an inhalational anesthetic agent is used to induce anesthesia. This rare syndrome is associated with which inheritance pattern?
- Sporadic mutation
- X-linked recessive
- X-linked dominant
- Autosomal recessive
- Autosomal dominant
- Autosomal dominant
RECOMMENDED READINGS
Glahn KP, Ellis FR, Halsall PJ, Müller CR, Snoeck MM, Urwyler A, Wappler F; European Malignant Hyperthermia Group. Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. Br J Anaesth. 2010 Oct;105(4):417-20. doi: 10.1093/bja/ aeq243. PubMed PMID: 20837722.
MacLennan DH, Phillips MS. Malignant hyperthermia. Science. 1992 May 8;256(5058):789-94. Review. PubMed PMID: 1589759.
Question 134
A 50-year-old man had severe pain in his right neck and shoulder for 1 week, which resulted in an inability to abduct his right shoulder. Examination revealed winging of the scapula and weakness of the supraspinatus. There was no evidence of infection or glenohumeral pathology on the MR image. However, the supraspinatus had some fatty infiltration change. Electromyography (EMG) at 3 weeks showed acute denervation with positive sharp waves and fibrillation potentials (both peripheral nerve and nerve root distribution). By 6 weeks, he was improving. A repeat EMG performed 3 months after onset shows early reinnervation with polyphasic motor unit potentials. What is the most likely diagnosis?
- Pancost tumor
- C5 radiculopathy
- Postpolio syndrome
- Neuralgic amyotrophy
- Amyotrophic lateral sclerosis
- Neuralgic amyotrophy
RECOMMENDED READINGS
Tjoumakaris FP, Anakwenze OA, Kancherla V, Pulos N. Neuralgic amyotrophy (Parsonage-Turner syndrome). J Am Acad Orthop Surg. 2012 Jul;20(7):443-9. doi: 10.5435/JAAOS-20-07-443. Review. PubMed PMID: 22751163.
Stutz CM. Neuralgic amyotrophy: Parsonage-Turner Syndrome. J Hand Surg Am. 2010 Dec;35(12):2104- 6. doi: 10.1016/j.jhsa.2010.09.010. Epub 2010 Oct 30.Review. PubMed PMID: 21035964.