Block 2 Quiz (2019) Flashcards
Which of the following mechanical receptors in human skin are spindle -shaped and respond to the stretch of skin?
Ruffini organ
Which bones make up the lower limb?
Tibia and fibula
A 45 year old female with rheumatoid arthritis is prescribed indomethacin. Inhibition of the production of which of the following substances causes the relief of swelling and tenderness of her joints?
Prostaglandins
An 18 month old girl has short stature, difficulty walking and bowing of her legs. Which of the following is defective in bone in cases of vitamin D deficiency?
Calcification of bone matrix
Opioid drugs, such as morphine, impact the activity of neurons. What receptor/s does morphine bind to?
μ, κ and δ
From which source do chondrocytes receive nutrition in an adult synovial joint?
Synovial fluid
Which of the following factors is the most important predictor of future fracture risk in a patient with osteoporosis?
Existing low-trauma fracture
The initial event following a bone fracture is?
Haemorrhage and haematoma formation
All of the following cause muscle atrophy, EXCEPT?
Exercise
A 63 year old woman had her thyroid gland removed to treat thyroid cancer. She presents soon after with hypocalcaemia and tetany. Which is the most likely explanation for this presentation?
Damage to parathyroid glands
In vertebrates, which neurotransmitter release is needed to depolarise the muscle fibre, and result in muscle contraction?
Acetylcholine
What aspect of bone does the disease, osteoporosis affect?
Bone density
The LEAST common site for a mandibular fracture to occur is:
Coronoid process
The most likely diagnosis in a 23-year-old, mentally alert, male of short stature with disproportionate arm and leg to body growth, prominent forehead, and retruded maxilla is:
Achondroplasia
A 66 year old man has a dull aching pain in his right hip and right knee that has become progressively worse over the past 8 years. His hands have bony growths over the medical and lateral aspects of the distal interphalangeal joints. What characteristics would you expect in the hip and knee joints?
Joint immobility
Which mechanism is involved in the aetiology of osteoporosis when a patient is taking excess glucocorticoids?
Increased caspase-3 production
During life, bone remodelling occurs continually. What does the RANK ligand stimulate?
Pre-osteoclasts
30 year old Maria Sweeting has occasional tension headaches. She normally treats this pain with paracetamol.
Which of the following statements paracetamol is true?
Therapeutic dose is close to toxic dose
Which structure in skeletal muscle acts as a reservoir for calcium ions ?
Terminal cisterna
What is the outer section of an intervertebral disc comprising tough elastic tissue called?
Annulus fibrosis
Which of the following is a feature of hyperparathyroidism that can be detected radiographically?
Lytic lesions
Damage of a motor nerve fibre to a muscle can result in any of the following, EXCEPT?
Sensory loss
Which of the following is a drug used to obtain local anaesthesia?
Lignocaine
Felypressin is a vasoconstrictor used in combination with a local anaestehics. Nitrous oxide and isoflurane are inhalational GA drugs. Propofol is an IV GA drug.
In rheumatoid arthritis, what is the principal cytokine which induces GM-CSF resulting in T cell proliferation, increased proliferation and differentiation of B cells and induced expression of adhesion molecules?
TNF-alpha
Which is a feature of smooth muscle?
Well developed sarcoplasmic reticulum
Which type of fracture occurs when abnormal bone is placed under minimal stress?
Pathologic
Which of the following diseases is associated with an altered epidermal cell cycle, where there is hyperproliferation of epidermal cells, and an accelerated cell turn over rate? Lesions of this disease are red papules, covered by silvery scales.
Psoriasis
Which is the most serious type of bone fracture in older people, in terms of both individual and societal impacts?
Hip
Which is the most common clinical pattern of rheumatoid arthritis?
Alternating periods of activity and quiescence
Which enzymes do NSAID drugs inhibit?
Cyclooxygenase
Which structures are specialised stretch receptors that regulate posture and movement by detecting changes in muscle length?
Muscle spindles
Which of the following bone disorders would typically cause raised serum alkaline phosphatase?
Paget’s disease
Which of the following organs is NOT involved in regulating plasma calcium levels?
Lungs
The brachial plexus is a group of spinal nerves supplying the arm. Which spinal nerves make up the brachial plexus?
C5-C8 and T1
A 53 year old woman makes an emergency dental appointment. She has a three day history of bilateral aching pain in her ‘jaw joint’ and has been having difficulty chewing and talking for any length of time. The patient has a history of chronic arthritis, affecting her hands and wrists, along with left knee and hip joints. The examination reveals a temperature of 36.9°C and there is no facial asymmetry or evidence of scarring. Both the right and left temporomandibular joints are swollen, painful and tender on palpation but there was no clicking. Mandibular opening is limited.
Which condition is this patient most likely to have?
Rheumatoid arthritis
TMJ is affected in up to 17% of people with Rh arthritis. Usually bilateral. Pain, tenderness and stiffness indicate inflammation. Acute otitis media may present with hearing loss, unlikely to be bilateral. Osteomyelitis - presents with patient more systemically unwell. - fever, malaise.
A 69 year old woman’s blood results indicate that she has low Vitamin D levels. She is diagnosed with a condition where there is insufficient calcium and phosphate to mineralise newly formed osteoid. Which of the following conditions does she have?
Osteomalacia
For a patient with osteoarthritis who is taking NSAIDs, all of the following may be limitations to dental management, EXCEPT:
Adrenal suppression
A bone disorder characterised by infection and inflammation of bone is called:
Osteomyelitis
Mrs Betty Smith is a 75 year old woman who presents to her GP with a six-month history of pain in her right knee, which is worse with prolonged walking. She has no relevant past history. Physical examination reveals a small effusion and crepitus on movement. Her body mass index is 35. A diagnosis of osteoarthritis is made.
Which of the following is the most important initial aspect of treatment?
Weight loss
The symptoms and function of patients with early osteoarthritis are best improved by lifestyle measures. This includes weight loss, activity modification, physiotherapy exercises, mobility aids. Paracetamol is the pharmacological agent of first choice for pain relief. NSAIDs commonly cause peptic ulcer disease in the elderly. Surgical options are best reserve for late, debilitating osteoarthritis.
Which describes current understandings about prosthetic joints and dental treatment?
Patients at high risk of joint infection should be identified before dental treatment
The vertebral column comprises how many thoracic vertebrae?
12
A 39 year old dental practitioner has paraesthesia of sections of the right hand, and is diagnosed with entrapment of the median nerve. All are risk factors for this condition, EXCEPT?
Male gender
Peak bone mass is an important consideration in determining risk of osteoporosis. All the following influence peak bone mass, EXCEPT?
Childhood fracture
The most common manifestation of systemic lupus erythematosis (SLE) is?
Polyarthritis
Regarding the bone, the atlas, which of the following is correct?
It contains a groove for the vertebral artery
With respect to normal bone, which of the following is correct?
Bone remodelling is due to bone deposition and bone resorption
The most effective treatment strategy for mechanical lower back pain is?
Light activity
The adult spinal cord ends at which vertebral level?
L2
A Facial nerve palsy would result in?
A drooping mouth
What is the name given to the area of skin innervated by sensory fibres from a single spinal nerve?
Dermatome
A 48 year old male patient has a six month history of dry, gritty eyes and a dry mouth. He has new dental carious lesions, after a caries-free period of 18 years. Both parotid glands are swollen, exhibited by mild bilateral facial swelling. Minor salivary gland biopsy would show?
Lymphocytic infiltration
Which of the following muscle proteins play an important role in contraction of both smooth and striated muscle?
Actin
Osteonecrosis of the jaws can result from dental trauma in patients taking which medication?
Risedronate
Facial fractures are common in road accidents, falls and fights. In a Le Fort type 2 fracture, the fracture line would pass through which of the following structures?
Inferior orbital rim
A 59 year old woman has gradual onset of pain and stiffness of the proximal interphalangeal joint of the index and middle fingers of both hands. Which type of arthritis is this patient most likely to have?
Rheumatoid arthritis
Which is the main feature of the pannus of the joint in rheumatoid arthritis?
Proliferative and invasive granulation tissue
Which of the following is a pure opioid antagonist that can be used in the treatment of opioid overdose?
Naloxone
Rheumatoid arthritis is a systemic disease. In addition to joint disease, a patient with rheumatoid arthritis could experience the following, EXCEPT?
Thyroiditis
Which is a feature of group C nerve fibres?
Are more associated with dull or burning pain
Osteoarthritis of the knee is a major cause of disability in Australia. Which is the single most important risk factor for OA of the knee?
Obesity
