Day 11 - Ms2 Quiz

Question 1

Lab values: Paget’s disease

Answer 1

Elevates Alk Phos; Otherwise, normal PT, serum phosphate, Ca

Question 2

Lab values: Osteomalacia & Rickets

Answer 2

Vit D def; Serum Ca low, High PTH, Low Phosphate; Alk Phos normal or elevated

Question 3

Lab values: Chronic kidney disease

Answer 3

Also Vit D def (but kidneys unable to respond to PTH); Serum Ca low, High PTH, High Phosphate; Alk Phos normal or elevated

Question 4

Lab values: Osteoporosis & Osteopetrosis

Answer 4

All normal - Ca, PTH, Phosphate, Alk Phos

Question 5

Lab values: Primary hyperparathyroidism

Answer 5

Elevated PTH, High serum Ca, Low Phosphate, Increase Alk Phos

Question 6

Lab values: Hypoparathyroidism

Answer 6

Low PTH, Low serum Ca, High Phosphate, Normal Alk Phos

Question 7

Lab values: Pseudohypoparathyroidism

Answer 7

End receptors not respond to PTH (i.e., high PTH but looks like hypoparathyroidism); High PTH, Low serum Ca, High Phosphate, Normal Alk Phos

Question 8

3 Studies can be used to make dx osteoarthritis

Answer 8

MRI, Bone scan, Tagged WBC scan

Question 9

Dx by joints involved: DIP & PIP

Answer 9

Osteoarthritis

Question 10

Dx by joints involved: PIP, MCP, NOT DIP

Answer 10

Rheumatoid arthritis

Question 11

Dx by joints involved: Isolated MCP with squared off bone ends and hook-like osteophytes of metaphalengeals

Answer 11

Hemochromatosis

Question 12

Most common causes of bony metastasis

Answer 12

Breast, Lung, Prostate, RCC, Thyroid, Lymphoma

Question 13

Classic radiograph of osteosarcoma

Answer 13

Sunburst appearance +/- Codman triangle

Question 14

Classic radiograph of Ewing sarcoma

Answer 14

Codman triangle and/or onion-skinning (periosteal reactions)

Question 15

Tx Lyme disease

Answer 15

Early disease: Doxycycline, Amoxicillin, or Cefuroxime; Late disease: Ceftriaxone

Question 16

Tx RMSF

Answer 16

Doxycycline or Chloramphenicol

Question 17

Meds tx acute gout

Answer 17

NSAIDs (especially Indomethacin), Colchicine, Steroids; NOT probenecid or allopurinol (these are used for chronic gout)

Question 18

Tx pseudogout

Answer 18

NSAIDs or Colchicine

Question 19

Tx osteoporosis

Answer 19

Ca, Vit D, exercise; Stopping steroid; Estrogen, testosterone replacement; Bisphosphonates; Pulsatile PTH (teriparatide)

Question 20

Endocrine causes of osteoporosis

Answer 20

Hypogonadism, Cushing syndrome, Hyperthyroidism, Hyperparathyroidism

Question 21

Knee x-ray shows calcifications of meniscus

Answer 21

Pseudogout

Question 22

Hats no longer fit, deafness

Answer 22

Paget’s disease or Osteopetrosis

Question 23

Needle-shaped negatively birefringent crystals

Answer 23

Gout

Question 24

Bone pain, tenderness w/ elevated CRP & ESR

Answer 24

Most commonly due to Osteomyelitis

Question 25

Low trauma fractures

Answer 25

Osteogenesis imperfecta

Question 26

Narrowing of marrow cavity, resulting in low H & H

Answer 26

Osteopetrosis

Question 27

55 yo F trips and sustains distal radius fracture

Answer 27

Colles fracture (osteoporosis may be cause)

Question 28

Empiric tx septic arthritis

Answer 28

Presume S. aureus, start IV vancomycin; If N. gonorrhea, ceftriaxone with 10 days of doxycycline