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AD ABOS Part I > Basic Science > Flashcards

Basic Science Flashcards

1
Q

Types of bone (2)

A
  1. Lamellar 2. Woven
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2
Q

Subtypes of Lamellar Bone (2)

A
  1. Cortical 2. Cancellous
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3
Q

Subtypes of Woven Bone (2)

A
  1. Immature 2. Pathologic
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4
Q

_____ bone is stress-oriented. _____ bone is not.

A

Lamellar Woven

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5
Q

Cortical bone constitutes ____% of skeleton.

A

80%

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6
Q

These cells form bone by generating organic, non-mineralized matrix.

A

Osteoblasts

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7
Q

Osteoblasts are derived from these.

A

Undifferentiated mesenchymal stem cells.

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8
Q

This transcription factor directs mesenchymal cells to the osteoblast lineage.

A

RUNX2

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9
Q

Osteoblasts have more of these organelles than do most other cells (3).

A
  1. Endoplasmic reticulum 2. Golgi apparatus 3. Mitochondria
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10
Q

Osteoblast receptors (5).

A
  1. PTH 2. 1,25 (OH)2 Vitamin D3 3. Glucocorticoids 4. Prostaglandins 5. Estrogen
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11
Q

Osteoblasts produce (5).

A
  1. Alkaline phosphatase 2. Osteocalcin 3. Type I collagen 4. Bone sialoprotein 5. RANKL
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12
Q

Osteoblasts are stimulated by ______ exposure to PTH.

A

intermittent (pulsatile)

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13
Q

Osteoblast activity inhibited by ____.

A

TNF-alpha

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14
Q

These cells maintain bone.

A

Osteocytes.

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15
Q

These cells constitute 90% of cells in the mature skeleton.

A

Osteocytes.

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16
Q

Osteocytes have _____ nuclear/cytoplasmic ratio.

A

high

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17
Q

Osteocytes are important for extracellular concentrations of these.

A

Calcium and Phosphorous.

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18
Q

Osteocytes are directly stimulated by _____.

A

calcitonin

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19
Q

Osteocytes are inhibited by _____.

A

PTH.

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20
Q

These cells resorb bone.

A

Osteoclasts.

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21
Q

Osteoclast description.

A

Multinucleated, irregular giant cells.

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22
Q

Osteoclasts are derived from this lineage.

A

Hematopoietic cells in macrophage line.

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23
Q

Purpose of osteoclast ruffled border.

A

Increase surface area for resorption.

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24
Q

Location of bone resorption.

A

Howship’s lacunae.

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25
Q

These proteins allow osteoclasts to bind to bone surfaces.

A

Integrins.

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26
Q

This osteoclast protein produces acidic environment for bone resportion.

A

Carbonic anhydrase.

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27
Q

Acidity effect on hydroxyapatite.

A

Increases solubility.

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28
Q

This lysosomal enzyme digests organic bone matrix.

A

Cathepsin K.

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29
Q

Calcitonin effect.

A

Inhibition of osteoclastic resorption.

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30
Q

Effect of IL-1 on bone.

A

Stimulates osteoclast differentiation and bone resorption.

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31
Q

Effect of IL-10 on osteoclasts.

A

Suppresses them.

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32
Q

Bisphosphonates do this.

A

Inhibit osteoclastic bone resorption.

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33
Q

Categories of bisphosphonates (2).

A
  1. Nitrogen-containing. 2. Non-nitrogen-containing.
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34
Q

Examples of nitrogen-containing bisphosphonates (2).

A
  1. Zoledronic acid (Zometa) 2. Alendronate (Fosamax)
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35
Q

Nitrogen-containing or non-nitrogen-containing bisphosphonates are more potent? By how much?

A

Nitrogen-containing, 1000-fold

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36
Q

Mechanism of action of nitrogen-containing bisphosphonates (3).

A
  1. Block farnesyl pryophosphate synthase. 2. Loss of guanosine triphosphatase (GTPase) formation. 3. Ruffled border formation inhibited.
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37
Q

Pathway inhibited by nitrogen-containing bisphosphonates.

A

Mevalonate pathway.

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38
Q

Mechanism of action of non-nitrogen-containing bisphonsphonates.

A

Metabolized into a nonfunctional ATP analog, inducing apoptosis.

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39
Q

These medications decrease skeletal events in multiple myeloma.

A

Bisphosphonates.

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40
Q

These medications are associated with osteonecrosis of the jaw.

A

Bisphosphonates.

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41
Q

Bisphosphonates have this effect on spinal fusion in animal model.

A

Reduced rate of fusion.

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42
Q

Types of bone matrix (2).

A
  1. Organic 2. Inorganic
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43
Q

Components of organic bone matrix (4).

A
  1. Collagen 2. Proteoglycans 3. Non-collagenous matrix proteins 4. Growth factors and cytokines
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44
Q

Collagen constitutes ___% of the organic bone matrix.

A

90%

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45
Q

Function of collagen in organic bone matrix.

A

Provides tensile strength.

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46
Q

Function of proteoglycans in bone matrix.

A

Compressive strength.

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47
Q

Noncollagenous bone matrix proteins (3).

A
  1. Osteocalcin 2. Osteonectin 3. Osteopontin
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48
Q

Most abundant noncollagenous bone matrix protein.

A

Osteocalcin.

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49
Q

Function of osteocalcin.

A

Attracts osteoclasts.

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50
Q

Function of osteopontin.

A

Cell-binding protein, similar to an integrin.

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51
Q

Examples of growth factors and cytokines in bone (5).

A
  1. TGF-beta 2. IGF 3. IL-1 4. IL-6 5. BMPs
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52
Q

Most of inorganic bone matrix composed of this.

A

Calcium hydroxyapatite.

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53
Q

Components of inorganic bone matrix (2).

A
  1. Calcium hydroxyapatite 2. Osteocalcium phosphate
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54
Q

Formula of calcium hydroxyapatite.

A

Ca10(PO4)6(OH)2

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55
Q

Function of calcium hydroxyapatite.

A

Compressive strength.

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56
Q

Collagen type in bone.

A

Type I.

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57
Q

Collagen cross-linking effects (2).

A
  1. Decreases collagen solubility. 2. Increases tensile strength.
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58
Q

Regulators of osteocalcin (2).

A
  1. Inhibited by PTH 2. Stimulated by 1,25-dihydroxyvitamin D3
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59
Q

This protein can be measure in serum or urine as a marker of bone turnover.

A

Osteocalcin.

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60
Q

Inorganic components of bone comprise ___% of the dry weight of bone.

A

60%

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61
Q

Wolff’s law.

A

Bone remodelling occurs in response to mechanical stress.

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62
Q

Hueter-Volkmann law.

A

Compressive forces inhibit bone growth, tension stimulates it.

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63
Q

Bone receives ___% to ___% of cardiac output.

A

5-10%.

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64
Q

Long bones receive blood from three sources (3).

A
  1. Nutrient artery system 2. Metaphyseal-epiphyseal system 3. Periosteal system
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65
Q

Direction of arterial flow in mature bone is ____.

A

Centrifugal (inside to outside).

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66
Q

Blood pressure in the nutrient artery system is ____.

A

High.

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67
Q

Blood pressure in the periosteal system is ____.

A

Low.

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68
Q

Blood flow direction in fractured bone.

A

Centripetal (outside to inside).

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69
Q

Venous flow direction in mature bone.

A

Centripetal (outside to inside).

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70
Q

Inner periostem.

A

Cambium.

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71
Q

Red marrow composition (3).

A
  1. 40% water 2. 40% fat 3. 20% protein
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72
Q

Yellow marrow composition (3).

A
  1. 15% water 2. 80% fat 3. 5% protein
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73
Q

Types of ossification (3).

A
  1. Enchondral 2. Intramembranous 3. Appositional
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74
Q

Bone replaces cartilage model.

A

Enchondral ossification.

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75
Q

Embyronic formation of long bones is this type of ossification.

A

Enchondral ossification.

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76
Q

Longitudinal physeal growth is this type of ossification.

A

Enchondral ossification.

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77
Q

Fracture callus is this type of ossification.

A

Enchondral ossification.

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78
Q

Bone formed with demineralized bone matrix is this type of ossification.

A

Enchondral ossification.

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79
Q

Major source of nutrition of the growth plate.

A

Perichondral artery.

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80
Q

Multiple epiphyseal dysplasia affects the _____.

A

Epiphysis.

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81
Q

Spondyloepiphyseal dysplasia affects growth at the _____.

A

Physis.

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82
Q

Acromegaly affects growth at the ____.

A

Physis.

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83
Q

In this physeal zone, cells store lipids, glycogen, and proteoglycan aggregates.

A

Reserve zone.

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84
Q

Lysosomal storage diseases affect this physeal zone.

A

Reserve zone.

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85
Q

Physeal zone characterized by matrix production, stacking of chondrocytes, and longitudinal growth.

A

Proliferative zone.

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86
Q

Achondroplasia causes defects in this physeal zone.

A

Proliferative zone.

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87
Q

Growth hormone exerts effects in this physeal zone.

A

Proliferative zone.

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88
Q

These make up the hypertrophic zone (3).

A
  1. Maturation 2. Degeneration 3. Provisional calcification
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89
Q

Normal matrix mineralization occurs in this physeal zone.

A

Hypertrophic zone.

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90
Q

This physeal zone widens in rickets.

A

Hypertrophic zone.

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91
Q

Enchondromas originate in this physeal zone.

A

Hypertrophic zone.

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92
Q

SCFE occurs in this physeal zone.

A

Hypertrophic zone.

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93
Q

Supplies chondrocytes to the periphery for lateral growth (width).

A

Groove of Ranvier.

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94
Q

Dense fibrous tissue anchoring the periphery of the physis.

A

Perichondrial ring of La Croix.

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95
Q

Undifferentiated mesenchymal cells aggregate into layers, differentiate into osteoblasts, and deposit an organic matrix that materializes.

A

Intramembranous ossification.

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96
Q

Embryonic flat bone formation is an example of this.

A

Intramembranous ossification.

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97
Q

Bone formation during distriction osteogenesis is an example of this.

A

Intramembranous ossification.

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98
Q

Blastema bone in young children with amputations is an example of this.

A

Intramembranous ossification.

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99
Q

Periosteal bone enlargement (width) is an example of this type of ossification.

A

Appositional ossification.

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100
Q

This protein stimulates bone formation by inducing metaplasia of mesenchymal cells into osteoblasts.

A

Bone morphogenic proteins (BMP).

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101
Q

BMP-2 use.

A

Acute open tibia fractures.

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102
Q

BMP-7 use.

A

Tibial non-unions.

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103
Q

BMP-3 use.

A

No osteogenic activity.

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104
Q

Cyclooxygenase-2 (COX-2) activity is required for this.

A

Normal enchondral ossification.

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105
Q

These antibiotics are toxic to chondrocytes and inhibit fracture healing.

A

Quinolones.

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106
Q

Fresh frozen allograft preserves ____.

A

BMP

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107
Q

Cortical allograft has ____ incorporation compared to cancellous.

A

Slower.

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108
Q

Fresh allograft has the highest _______ of the allograft types.

A

Immunogenicity.

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109
Q

Osteoconductive matrix.

A

Acts as a scaffold or framework for bone growth.

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110
Q

Osteoinductive factors.

A

Growth factors that stimulate bone formation (BMP).

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111
Q

Osteogenic cells.

A

Primitive mesenchymal cells, osteoblasts, osteocytes.

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112
Q

Demineralized bone matrix is _____ and _____.

A

Osteoconductive and osteoinductive.

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113
Q

Calcium is absorbed in this area of the GI tract.

A

Jejunum.

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114
Q

Calcium is absorbed in the gut by this mechanism.

A

Passive diffusion.

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115
Q

Calcium is filtered by the glomeruli and then ____.

A

Reabsorbed.

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116
Q

This percentage of calcium is reabsorbed by the kidneys.

A

98%

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117
Q

Primary regulators of serum calcium (2).

A
  1. PTH 2. 1,25(OH)2-vitamin D3
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118
Q

Dietary requirement of elemental calcium for children.

A

600 mg/day

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119
Q

Dietary requirement of elemental calcium for adolescents and young adults.

A

1300 mg/day

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120
Q

Dietary requirement of elemental calcium for adults.

A

750 mg/day

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121
Q

Dietary requirement of elemental calcium for postmenopausal women.

A

1500 mg/day

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122
Q

Dietary requirement of elemental calcium for lactating women.

A

2000 mg/day

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123
Q

Dietary requirement of elemental calcium for pregnant women.

A

1500 mg/day

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124
Q

Dietary requirement of elemental calcium for patients healing fracture in long bone.

A

1500 mg/day

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125
Q

This percentage of body’s phosphate stored in bones.

A

85%

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126
Q

Majority of calcium absorbed in this area of the kidney.

A

Proximal tubule.

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127
Q

Daily phosphate requirement.

A

1000 to 1500 mg.

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128
Q

PTH is comprised of ____ amino acids.

A

84

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129
Q

PTH is synthesized and secreted from here.

A

Chief cells of the parathyroid glands.

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130
Q

The active portion of PTH.

A

The N-terminal fragment (1-34).

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131
Q

Synthetic form of recombinant human PTH.

A

Teriparatide.

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132
Q

Effect of PTH is mediated by this mechanism.

A

cAMP.

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133
Q

Calcitonin is produced here.

A

Clear cells in parafollicles of the thyroid gland.

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134
Q

Active form of vitamin D.

A

1,25(OH)2-vitamin D3

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135
Q

Inactive vitamin D metabolite.

A

24,25(OH)2-vitamin D3

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136
Q

25-OHase is located here.

A

Liver.

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137
Q

1-OHase is located here.

A

Kidney.

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138
Q

Corticosteroids affect bone mineralization. True or False.

A

False.

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139
Q

Effects of corticosteroids on bone (2).

A
  1. Decreased gut absorption of calcium by decreased binding proteins. 2. Inhibition of collagen synthesis.
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140
Q

Peak bone mass occurs between these ages.

A

16-25 years.

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141
Q

After peak, bone loss occurs at a rate of ____ to ____ per year.

A

0.3 to 0.5% per year

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142
Q

Rate of bone loss in women 6 - 10 years after menopause.

A

2-3% per year

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143
Q

Osteoporotic long bones have ______ inner diameter and _____ outer diameter.

A

Increased inner and outer diameters.

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144
Q

Elevated in urine when bone resorption occurs.

A

Hydroxyproline.

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145
Q

Brown tumors.

A

Primary hyperparathyroidism.

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146
Q

Pseudohypoparathyroidism.

A

PTH receptor abnormality.

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147
Q

Type I hereditary vitamin-D dependent rickets.

A

Defect in renal 1-alpha hydroxylase.

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148
Q

Type II hereditary vitamin-D dependent rickets.

A

Defect in intracellular receptor for 1,25(OH)2-Vitamin D.

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149
Q

Most commonly encountered form of rickets.

A

Hypophosphatemic rickets.

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150
Q

Hypophosphatemic rickets.

A

Inborn error of phosphate transport causing failure of phosphate reabsorption in the kidney.

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151
Q

Chronically elevated serum PTH results in.

A

Secondary hyperparathyroidism with hyperplasia of chief cells of parathyroid gland.

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152
Q

Causes of rickets and osteomalacia (5).

A
  1. Nutritional deficiency 2. Phosphorous deficiency 3. GI absorption defects 4. Renal tubular defects 5. Renal osteodystrophy
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153
Q

Rickets.

A

Failure of mineralization, leading to changes in the physis in the zone of provisional calcification.

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154
Q

Serum calcium level in nutritional rickets.

A

Low-normal (maintained by high PTH).

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155
Q

Serum phosphate level in nutritional rickets.

A

Low (excreted due to effect of PTH).

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156
Q

Alkaline phosphatase level in nutritional rickets.

A

Increased.

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157
Q

Vitamin D level in nutritional rickets.

A

Low.

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158
Q

PTH level in nutritional rickets.

A

Increased (leads to increased bone resorption).

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159
Q

Types of hereditary vitamin D dependent rickets.

A
  1. Type I – Defect in renal 25(OH) 1alpha-hydroxylase 2. Type II – Defect in intracellular receptor of 1,25(OH) - Vitamin D
160
Q

Inheritance pattern of familial hypophosphatemic rickets.

A

X-linked dominant.

161
Q

Vitamin D - resistant rickets.

A

Familial hypophosphatemic rickets.

162
Q

Mechanism of hypophosphatemic rickets.

A

Impaired renal tubular reabsorption of phosphate.

163
Q

Treatment of familial hypophosphatemic rickets.

A
  1. Phosphate replacement 2. High dose vitamin D3
164
Q

Inheritance pattern of hypophosphatasia.

A

Autosomal recessive.

165
Q

Error in tissue-nonspecific isoenzyme of anklaline phosphatase.

A

Hypophosphatasia.

166
Q

Diagnosis of hypophosphatasia.

A

Increased urinary phosphoenthanolamine.

167
Q

This process remains normal in osteoporosis.

A

Mineralization

168
Q

WHO definition of osteoporosis.

A

L2-L4 bone density 2.5 or more standard deviations less than peak bone mass of healthy 25 year old. (T-score)

169
Q

WHO definition of osteopenia.

A

Bone density 1.0 to 2.5 standard deviations less than mean peak bone mass of healthy 25 year old. (T-score)

170
Q

Risk for second vertebral osteoporotic compression fracture after the first.

A

20%

171
Q

Lifetime risk of fracture in white women after 50 years of age.

A

75%

172
Q

Life risk of hip fracture in white women after 50 years of age.

A

15-20%

173
Q

Type I osteoporosis.

A

Post-menopausal.

174
Q

Type II osteoporosis.

A

Age-related.

175
Q

Plain radiographs may be normal in osteoporotic patients until decrease in bone mass exceeds this value.

A

30%

176
Q

DEXA stands for.

A

Dual-energy x-ray absorptiometry.

177
Q

Histologic changes in osteoporosis (3).

A
  1. Thinning trabeculae 2. Decreased osteon size 3. Enlarged haversian and marrow spaces
178
Q

Defect of bone mineralization in adults.

A

Osteomalacia.

179
Q

Histologic finding in osteomalacia.

A

Widened osteoid seams.

180
Q

Causes a decrease in chondroitin sulfate synthesis.

A

Vitamin C (ascorbic acid) deficiency.

181
Q

Defects in vitamin C deficiency (2).

A
  1. Defective collagen growth and repair 2. Impaired intracellular hydroxylation of collagen peptides.
182
Q

Physis histology with vitamin C deficiency.

A

Widening of zone of provisional calcification.

183
Q

Failure of normal collagen cross-linking as a result of glycine substitutions in pro-collagen.

A

Osteogenesis imperfecta.

184
Q

Albers-Schonberg disease.

A

Benign osteopetrosis.

185
Q

Rugger jersey spine.

A

Osteopetrosis.

186
Q

Articular cartilage receives nutrients and oxygen primarily through this mechanism.

A

Diffusion.

187
Q

pH of cartilage.

A

7.4

188
Q

Composition of articular cartilage.

A
  1. Water 65-80% 2. Collagen 10-20% 3. Proteoglycans 10-15% 4. Chondrocytes 5%
189
Q

This amino acid is unique to collagen.

A

Hydroxyproline.

190
Q

95% of collagen in articular cartilage.

A

Type II.

191
Q

Type of collagen produced by chondrocytes during enchondral ossification.

A

Type X.

192
Q

Subtypes of glycosaminoglycans (2).

A
  1. Chondroitin sulfate 2. Keratin sulfate
193
Q

Master switch of chondrocytes.

A

SOX9 transcriptional factor.

194
Q

Chondrocytes are least active in this zone.

A

Calcified zone.

195
Q

Articular cartilage layers (5).

A
  1. Gliding zone (superficial) 2. Transitional zone (middle) 3. Radial zone (deep) 4. Tidemark 5. Calcified zone
196
Q

Articular cartilage gliding zone function.

A

Opposes shear.

197
Q

Articular cartilage transitional zone function.

A

Opposes compression.

198
Q

Articular cartilage radial zone function.

A

Opposes compression.

199
Q

Articular cartilage tidemark zone function.

A

Opposes shear.

200
Q

Articular cartilage calcified zone function.

A

Anchor.

201
Q

Superficial articular cartilage zone.

A

Gliding zone.

202
Q

Middle articular cartilage zone.

A

Transitional zone.

203
Q

Deep articular cartilage zone.

A

Radial zone.

204
Q

Orientation of collagen in the gliding articular cartilage zone.

A

Tangential.

205
Q

Orientation of collagen in the transitional articular cartilage zone.

A

Oblique.

206
Q

Orientation of collagen in the radial articular cartilage zone.

A

Vertical.

207
Q

Predominant mechanism of lubrication during dynamic joint function.

A

Elastohydrodynamic lubrication.

208
Q

The peripheral ____% of the meniscus is supplied by vessels. The remainder receives nutrition through ____.

A

25%, diffusion

209
Q

This cell type is responsible for meniscal healing.

A

Fibrochondrocyte.

210
Q

These meniscus tears heal the best.

A

Peripheral, acute with rim width larger than 4mm.

211
Q

Osteoarthritis cartilage has _____ water content.

A

Increased.

212
Q

Chondroitin/keratin sulfate ratio in osteoarthritis cartilage.

A

Increased.

213
Q

Most common cause of upper extremity neuropathic arthropathy.

A

Syringomyelia.

214
Q

Technitium bone scan in Charcot arthropathy.

A

May be positive in both infection and Charcot.

215
Q

Indium leukocyte scan in Charcot arthropathy.

A

Negative in Charcot. Positive in osteomyelitis.

216
Q

Degenerative arthritis resulting from alkaptonuria.

A

Ochronosis.

217
Q

The most common inflammatory arthritis.

A

Rheumatoid arthritis.

218
Q

Conditions in which rheumatoid factor may be positive (4).

A
  1. Rheumatoid arthritis 2. Sjogren’s syndrome 3. Sarcoid 4. SLE
219
Q

Conditions in which ANA may be positive (3).

A
  1. SLE 2. Sjogren’s syndrome 3. Scleroderma
220
Q

Primary cellular mediators of tissue destruction in RA.

A

Mononuclear cells.

221
Q

RF is directed against this molecule.

A

IgG.

222
Q

RF is most commonly this type of immunoglobulin.

A

IgM.

223
Q

Acute-onset juvenile RA with fever, rash, and splenogmegaly.

A

Still’s disease.

224
Q

Mortality in SLE is related to ____ involvement.

A

Renal.

225
Q

Butterfly malar rash.

A

SLE.

226
Q

Most common feature of SLE.

A

Joint involvement.

227
Q

Aching and stiffness of the shoulder and pelvic girdle.

A

Polymyalgia rheumatica.

228
Q

Has an association with temporal arteritis.

A

Polymyalgia rheumatica.

229
Q

Marginal syndesmophytes.

A

Ankylosing spondylitis.

230
Q

Conjunctivitis, urethritis, and oligoarticular arthritis.

A

Reiter’s syndrome.

231
Q

Sausage digits.

A

Psoriatic arthropathy.

232
Q

Pencil-in-cup deformity.

A

Psoriatic arthropathy.

233
Q

Monosodium urate crystal deposition.

A

Gout.

234
Q

Second most affected organ in gout.

A

Kidneys.

235
Q

Thin, negatively birefringent crystals.

A

Monosodium urate.

236
Q

Mechanism of allopurinol.

A

Xanthine oxidase inhibitor.

237
Q

Xanthine oxidase is needed for these reactions (2).

A
  1. Hypoxanthine to xanthine 2. Xanthine to uric acid
238
Q

Calcium pyrophosphate deposition.

A

Pseudogout.

239
Q

Short, rhomboid-shaped positively birefringent crystals.

A

Calcium pyrophosphate.

240
Q

The crystal is blue when long axis of the crystal in parallel to the compensator of the microscope.

A

Positive birefringence.

241
Q

The crystal is yellow when long axis of the crystal in parallel to the compensator of the microscope.

A

Negative birefringence.

242
Q

Borrelia burgdorferi causes this disease.

A

Lyme disease.

243
Q

Recurrent knee effusion with history of erythema migrans.

A

Lyme disease.

244
Q

Lyme disease treatment.

A

Doxycycline

245
Q

Hemophilic arthropathy associated with these deficiencies (2).

A
  1. Factor VIII deficiency 2. Factor IX defeciency
246
Q

Most characteristic organism causing osteomyelitis in sickle cell patients.

A

Salmonella.

247
Q

Most common organism causing osteomyelitis in sickle cell patients.

A

Staphylococcus.

248
Q

Pigmented synovial histiocytes.

A

PVNS

249
Q

Sarcomere lines and bands (5).

A
  1. Z line 2. M line 3. H band 4. I band 5. A band
250
Q

Surrounds individual muscle bundles.

A

Epimysium.

251
Q

Surrounds muscle fascicles.

A

Perimysium.

252
Q

Surrounds individual fibers.

A

Endomysium.

253
Q

Contains only myosin (thick) filaments.

A

H-band.

254
Q

Contains only actin (thin) filaments.

A

I-band.

255
Q

Lies between I bands and contains the H-band.

A

A band.

256
Q

Thin (actin) filaments are attached to this.

A

Z-line.

257
Q

Shortage of acetylcholine receptors.

A

Myesthenia gravis.

258
Q

Blocks presynaptic acetylcholine release.

A

Botulinum toxin.

259
Q

Troponin is located on actin or myosin?

A

Actin (thin filaments).

260
Q

Constant muscle tension

A

Isotonic.

261
Q

Muscle length remains unchanged.

A

Isometric.

262
Q

Muscle contracts at constant velocity.

A

Isokinetic.

263
Q

Type I muscle fibers (3).

A
  1. Slow twitch 2. Oxidative 3. Red
264
Q

Type II muscle fibers (3).

A
  1. Fast twitch 2. Glycolytic 3. White
265
Q

Muscle energy systems (3) and time courses.

A
  1. ATP-creatine phosphate system (10-20 sec) 2. Lactic anaerobic system (20-120 sec) 3. Aerobic system (longer duration)
266
Q

Female athlete triad (3)

A
  1. Amenorrhea 2. Osteoporosis 3. Anorexia
267
Q

Most common sports injury.

A

Muscle strain.

268
Q

Muscle strains occur at this location in these muscles.

A

Myotendinous junction, muscle crossing two joints

269
Q

Hypotension with bradycardia.

A

Spinal (neurogenic) shock.

270
Q

These nerve fibers originate in receptors in muscle, skin, and sense organs of the head.

A

Somatic afferent fibers.

271
Q

These cells are responsible for myelinating peripheral nerve axons.

A

Schwann cells.

272
Q

Meissner’s corpuscle detects ____.

A

touch

273
Q

Pacini’s corpuscle detects ____.

A

flutter

274
Q

Ruffini’s corpuscle detects _____.

A

vibration

275
Q

Merkel’s receptor detects _____.

A

Steady skin indentation

276
Q

Gaps between Schwann cells.

A

Nodes of Ranvier.

277
Q

Complete nerve division with disruption of the endoneurium.

A

Neurotmesis.

278
Q

Disruption of the axon and myelin sheath but leaving epineurium intact.

A

Axonotmesis.

279
Q

Selective demylination of the axon sheath, generally due to local ischemia.

A

Neurapraxia.

280
Q

First sensation to return after nerve injury.

A

Pain.

281
Q

In brachial plexus injury, positive histamine response implies this.

A

That reflex arc is intact.

282
Q

A positie histamine response indicates that the lesion is proximal to this location.

A

Ganglion (preganglionic).

283
Q

Predominant cell type in tendons.

A

Fibroblasts.

284
Q

Early tendinous healing with this type of collagen.

A

Type III.

285
Q

After surgical repair, tendon is weakest at this timepoint.

A

7-10 days

286
Q

Maximum tendon strength achieved at this time post repair.

A

6 months

287
Q

Most of original tendon strength regained at time period after repair.

A

21-28 days

288
Q

The two types of ligament insertion.

A
  1. Acute angles into periosteum 2. 90 degree angle into bone
289
Q

Two components of the intervertebral disc (2).

A
  1. Central nucleus pulposus 2. Surrounding annulus fibrosis
290
Q

Content of nucleus pulposus.

A

High glycosaminoglycan/low collagen

291
Q

Content of annulus fibrosis.

A

High collagen/low glycosaminoglycan

292
Q

How intervertebral discs obtain nutrition.

A

Diffusion through hyaline cartilage endplates.

293
Q

Aging intervertebral discs have decreased ___ content.

A

water

294
Q

Aging discs have a decrease in the concentration of this molecular and increase in the concentration of thi molecule.

A

Decrease in proteoglycan concentration. Increase in keratin sulfate concentration.

295
Q

Osteoarticular allografts preserved with cryopreservation.

A

No viable chondrocytes after clinical preservation.

296
Q

Method of allograft preservation in which there is a controlled rate freezing in a protective medium.

A

Cryopreservation.

297
Q

Synthetic ligaments are associated with these.

A

Sterile joint effusions.

298
Q

Identifies a particular DNA sequence in an extract of mixed DNA.

A

Southern blotting.

299
Q

Identifies a particular RNA sequence in an extract of mixed RNA.

A

Northern blotting.

300
Q

Identifies a particular protein in an extract of mixed proteins.

A

Western blotting.

301
Q

Used to reverse transcribe RNA to complementary DNA.

A

Reverse transcriptase.

302
Q

The production of genetically identical biologic entities.

A

Cloning.

303
Q

Cell involved in specific immune responses (2).

A

B and T cells.

304
Q

Adaptive immune response broken down into these two.

A
  1. Cell mediated 2. Humoral
305
Q

B lymphocytes mature here.

A

Lymph nodes.

306
Q

T lymphocytes originate here.

A

Bone marrow.

307
Q

Immune responses are evoked by these.

A

Antigens.

308
Q

Five classes of immunoglobulins.

A
  1. IgA 2. IgM 3. IgG 4. IgD 5. IgE
309
Q

Growth control genes

A

Oncogenes

310
Q

Tumor supressor genes

A

Antioncogenes

311
Q

Most common sites of primary tumors that metastasize to bone (5).

A
  1. Breast 2. Prostate 3. Lung 4. Kidney 5. Thyroid
312
Q

Quantify the amount of DNA in cells.

A

Flow cytometry.

313
Q

Modes of mendelian inheritance (4).

A
  1. Autosomal dominant 2. Autosomal recessive 3. X-linked dominant 4. X-linked recessive
314
Q

All daughters of an affected father have the trait but no sons.

A

X-linked dominant.

315
Q

Genetic disease becomes progressively more severe in each subsequent generation.

A

Anticipation.

316
Q

Abnormal number of chromosomes.

A

Aneuploidy.

317
Q

Three copies of chromosomes.

A

Triploidy.

318
Q

One chromosome pair has an extra chromosome.

A

Trisomy.

319
Q

A section of one chromosomes is absent.

A

Deletion.

320
Q

Extra section of one chromosome is present.

A

Duplication.

321
Q

Portion of one chromosome is exchanged with a portion of another chromosome.

A

Translocation.

322
Q

Broken portion of a chromosome reattaches to the same chromosome in the same location but reverse direction.

A

Inversion.

323
Q

Inheritance pattern of achondroplasia.

A

Autosomal dominant.

324
Q

Inheritance pattern of diastrophic dysplasia.

A

Autosomal recessive.

325
Q

Inheritance pattern of McCune-Albright syndrome.

A

Sporadic mutation.

326
Q

Inheritance pattern of multiple epiphyseal dysplasia.

A

Autosomal dominant.

327
Q

Inheritance pattern of hypophasphatemic rickets.

A

X-linked dominant.

328
Q

Inheritance pattern of hereditary vitamin D-dependent rickets.

A

Autosomal recessive.

329
Q

Inheritance pattern of Marfan’s syndrome.

A

Autosomal dominant.

330
Q

Inheritance pattern of Ehlers-Danlos syndrome.

A

Autosomal dominant.

331
Q

Inheritance pattern of Duchenne’s muscular dystrophy.

A

X-linked recessive.

332
Q

Inheritance pattern of Becker’s muscular dystrophy.

A

X-linked recessive.

333
Q

Inheritance pattern of hemophilia A and B.

A

X-linked recessive.

334
Q

Inheritance pattern of sickle cell anemia.

A

Autosomal recessive.

335
Q

Inheritance pattern of Gaucher’s disease.

A

Autosomal recessive.

336
Q

Inheritance pattern of hemochromatosis.

A

Autosomal recessive.

337
Q

Inheritance pattern of Charcot-Marie-Tooth disease.

A

Autosomal dominant.

338
Q

Inheritance pattern of neurofibromatosis.

A

Autosomal dominant.

339
Q

Streptococcus viridans source.

A

Human bite.

340
Q

Pasteurella canis source.

A

Dog bite.

341
Q

Pasteurella multocida source.

A

Cat bite.

342
Q

Most common risk factor for necrotizing fasciitis.

A

Diabetes.

343
Q

Types of necrotizing fasciitis infections (4).

A
  1. Type 1 - polymicrobial 2. Type 2 - group A beta-hemolytic strep 3. Type 3 - marine vibrios 4. Type 4 - MRSA
344
Q

Characteristic osteomyelitis organism of sickle cell anemia.

A

Salmonella.

345
Q

Nail through sole of shoe.

A

Pseudomonas aeruginosa.

346
Q

HIV risk of seroconversion from contaminated needle stick.

A

0.3%

347
Q

Risk of HIV transmission through blood transfusion.

A

1/500,000 per unit transfused.

348
Q

Cat scratch fever organism.

A

Bartonella henselae.

349
Q

Cat scratch fever treatment.

A

Azithromycin.

350
Q

Inhibit cross-linking of polysaccharides in the cell wall by blocking transpeptidase enzyme.

A

Beta-lactams.

351
Q

Beta-lactam antibiotic examples (2).

A
  1. Penicillin 2. Cephalosporins
352
Q

Inhibit protein synthesis through binding to 30S-ribosomal subunit.

A

Aminoglycosides.

353
Q

Aminoglycoside examples (2).

A
  1. Gentamicin 2. Tobramycin
354
Q

Inhibit dissociation of peptidyl-transfer RNA from ribosomes during translocation (50S-ribosomal subunit).

A

Clindamycin and macrolides.

355
Q

Examples of macrolides (3).

A
  1. Erythromycin 2. Clarithromycin 3. Azithromycin
356
Q

Vancomycin mechanism.

A

Interfere with insertion of glycan subunits into cell wall.

357
Q

Inhibits RNA polymerase F.

A

Rifampinin.

358
Q

Inhibit DNA gyrase.

A

Quinolones.

359
Q

This amount of antibiotic powder in cement does not affect the compressive strength of the PMMA.

A

2g abx per 40g powdered PMMA

360
Q

Virchow’s triad.

A
  1. endothelial damage 2. venous stasis 3. hypercoagulability
361
Q

Gold standard for diagnosing DVT.

A

Venography.

362
Q

Warfarin mechanism of action.

A

Inhibition of vitamin K 2,3-epoxide reductase in the liver.

363
Q

Total lymphocyte count threshold to promote healing.

A

1500/mm3

364
Q

Transcutaneous oxygen level above this threshold promotes healing.

A

30mmHg

365
Q

Treatment for malignant hyperthermia.

A

Dantrolene sodium.

366
Q

First signs of malignant hyperthermia (2).

A
  1. Increased end-tidal Co2 2. Tachycardia
367
Q

Gold standard for neuromonitoring intraop.

A

Wake up test.

368
Q

These herbal medicines increase the risk of perioperative bleeding (3).

A
  1. Garlic 2. Ginkgo biloba 3. Ginseng
369
Q

Technitium bone scan detects (3).

A
  1. Infection 2. Trauma 3. Tumor
370
Q

Phases of three phase bone scans.

A
  1. Blood flow, immediate 2. Blood pool, 30 min 3. Delayed, 4 hrs
371
Q

Indium scans are specific for.

A

Inflammation.

372
Q

Type of stainless steel used in orthopaedic implants.

A

316L

373
Q

Elements found in stainless steel (6).

A
  1. Iron 2. Carbon 3. Chromium 4. Nickel 5. Molybdenum 6. Manganese
374
Q

Healing below melting point.

A

Annealing.

375
Q

Polyethylene particles of this size are most reactive.

A

0.1 - 1.0 micrometers

376
Q

Main determinant of elastic modulus of cortical bone.

A

Mineral content.

377
Q

Distance between threads in a screw.

A

Pitch.

378
Q

To maximize pullout strength of screw (3).

A
  1. Large outer diameter 2. Small root diameter 3. Fine pitch
379
Q

Nail bending rigidity related to this.

A

4th power of nail’s radius.

380
Q

Force within a joint in response to forces acting on the joint.

A

Joint reaction force.

381
Q

Coefficient of friction for human joints.

A

0.002 to 0.04

382
Q

Coefficient of friction for metal-on-poly.

A

0.05 to 0.15

383
Q

Primary lubrication mechanism for articular cartilage during dynamic function.

A

Elastohydrodynamic lubrication.

384
Q

Screw home mechanism of knee.

A

External tibial rotation during last 15 degrees of extension.

385
Q

This characteristic of the knee increases maximum knee flexion.

A

Posterior rollback.

386
Q

Amount of rotation through C1-C2.

A

45 degrees.

387
Q

Amount of rotation through subaxial cervical spine.

A

10 degrees.

388
Q

Spine coupled motion.

A

Axial rotation with lateral bending.

389
Q

Glenohumeral abduction.

A

120 deg

390
Q

Scapulothoracic shoulder abduction.

A

60 deg.

391
Q

Most important static stabilizer of the shoulder.

A

Inferior glenohumeral ligament.

392
Q

Glenohumeral arthrodesis position (3).

A

15-20 deg abduction 20-25 deg forward flexion 40-50 deg internal rotation

393
Q

Humeral head inclination

A

125 deg

394
Q

Humeral head position relative to shaft

A

25 deg retroversion

395
Q

Functional elbow ROM.

A

30-130.

396
Q

Elbow carrying angle for men and women.

A

Men 7 deg, women 13 deg.

AD ABOS Part I (9 decks)

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