Learning Topic Review Q's Flashcards
LEARNING TOPICS 1. Behavioural Science: Psychological Aspects of Pain (1-12) 2. Pathology: Pathology of non-neoplastic diseases of Bone (13-33) 3. Nuclear Medicine: The Bone Scan (34-36) 4. Microbiology: Fungal Infections of the musculoskeletal system in immunocompromised patients (37-50) 5. Epidemiology/Prevention: Epidemiology of Rheumatoid Arthritis (51-56) 6. Pathology: Non-neoplastic diseases of Skeletal Muscle (57-78)
Which of the following pain types is described as maladaptive?
a. acute
b. prechronic
c. chronic
c. chronic
T/F: prechronic pain is described as the transition between acute to chronic pain
false, its the critical time in which the patient heals OR proceeds to chronic pain
Which of the following pain types is induced when a patient undergoes surgery?
a. acute
b. prechronic
c. chronic
a. acute
Which of the following is often used by children?
a. 0-10 rating scale
b. face scale
c. visual analog scale
b. face scale
Which is the most reliable indicator of pain?
a. electromyography
b. physiological measures
c. behavioral observation
c. behavioral observation
Which of the following would recover from pain faster?
a. a person who takes a sick day to lay in bed and heal
b. a person who would carry on with their regular lives
b. a person who would carry on with their regular lives
Which of the following is believed to increase pain perception?
a. positive reinforcement
b. negative reinforcement
a. positive reinforcement
Which of the following methods is used when a patient uses hypnosis to relieve pain?
a. behavioral method
b. cognitive method
c. respondent method
c. respondent method
Which of the following methods is used when a patient uses Socratic questions to relieve pain?
a. behavioral method
b. cognitive method
c. respondent method
b. cognitive method
Which of the following methods is used when a patient uses reinforcements to relieve pain?
a. behavioral method
b. cognitive method
c. respondent method
a. behavioral method
Which of the following methods is used when a patient uses exercise to relieve pain?
a. behavioral method
b. cognitive method
c. respondent method
a. behavioral method
Which of the following methods is used when a patient uses attention diversion to relieve pain?
a. behavioral method
b. cognitive method
c. respondent method
b. cognitive method
Which of the following arises from the mononuclear phagocytic system?
a. osteoblasts
b. osteocytes
c. osteoclasts
c. osteoclasts
Which is randomly organized in an irregular manner?
a. woven bone
b. spongy
c. compact bones
a. woven bone
Which of the following causes fatal anemia?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
b. Osteopetrosis
Which of the following is characterized by a blue sclera?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
c. Osteogenesis Imperfecta
Which of the following is characterized by excessive callus formation?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
c. Osteogenesis Imperfecta
Which of the following is caused by a mutation in the short arm of chromosome 4?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
a. Achondroplasia
Which of the following is characterized by thick bones?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
b. Osteopetrosis
Which of the following is causes blindness and deafness?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
b. Osteopetrosis
Which of the following is caused by mutation of FGFR3?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
a. Achondroplasia
Which of the following results in disordered remodeling?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Paget’s disease
d. Paget’s disease
Which of the following is caused by osteoclast dysfunction?
a. Achondroplasia
b. Rickets
c. Osteogenesis Imperfecta
d. Paget’s disease
d. Paget’s disease
Which of the following is caused by a defect in the function of osteoclasts?
a. Achondroplasia
b. Osteopetrosis
c. Osteogenesis Imperfecta
d. Rickets
b. Osteopetrosis
After taking a biopsy from a patient, his bone appears to be porous. What’s the most likely disease?
a. Hyperparathyroidism
b. Rickets
c. Osteoporosis
d. Paget’s disease
c. Osteoporosis
After taking a biopsy from a patient, his bone appears to have a mosaic pattern. What’s the most likely disease?
a. Hyperparathyroidism
b. Rickets
c. Osteoporosis
d. Paget’s disease
d. Paget’s disease
Which is associated with secondary hyperparathyroidism?
a. parathyroid adenoma
b. parathyroid hyperplasia
c. parathyroid hypoplasia
b. parathyroid hyperplasia
Which is due to estorgen deficiency?
a. Postmenopausal osteoporosis
b. Senile osteoporosis
a. Postmenopausal osteoporosis
Which is associated with primary hyperparathyroidism?
a. parathyroid adenoma
b. parathyroid hyperplasia
c. parathyroid hypoplasia
a. parathyroid adenoma
Which occurs in men and women?
a. Postmenopausal osteoporosis
b. Senile osteoporosis
b. Senile osteoporosis
occurs due to increase in age
Bone has a wedge-shaped pale yellow infarct. Which is most likely?
a. Osteoporosis
b. AVN
c. Osteonecrosis
c. Osteonecrosis
How do you treat femoral AVN?
arthroplasty (prosthetic replacement of the femoral hip)
Which of the following can be caused by sickle cell anemia?
a. Osteoporosis
b. AVN
c. Osteonecrosis
c. Osteonecrosis
Which of the following only sees bone structural changes when they increase or decrease 50%?
a. radiograph
b. scintillation camera
c. radiotracers
a. radiograph
Which phase of the multiphase bone scan indicates the presence of a bony reaction?
a. Flow phase
b. Blood pool
c. Delayed image
c. Delayed image
Which of the following would have a negative delayed image?
a. cellulitis
b. osteomyelitis
a. cellulitis
biopsy specimens shows acutely branched septate hyphae. Which organism is most likely to be found?
a. Coccidioidomycosis
b. Histoplasmosis
c. Blastomycosis
d. Cryptococcosis
e. Aspergillosis
e. Aspergillosis
Which of the following organisms can be diagnosed using serum or urine tests?
a. Coccidioidomycosis
b. Histoplasmosis
c. Blastomycosis
d. Cryptococcosis
e. Aspergillosis
b. Histoplasmosis
Synovial fluid examination showed cloudy or frankly purulent fluid with high protein and WBC count. broad-based budding cells can also be seen. Which is most likely?
a. Coccidioidomycosis
b. Histoplasmosis
c. Blastomycosis
d. Cryptococcosis
e. Aspergillosis
c. Blastomycosis
Which of the following organisms can be diagnosed using India ink examination or agglutination test?
a. Coccidioidomycosis
b. Histoplasmosis
c. Blastomycosis
d. Cryptococcosis
e. Aspergillosis
d. Cryptococcosis
Microscopic examination of the infected tissue shows endosporulating spherules with granulomatous inflammatory changes. Which is most likely?
a. Coccidioidomycosis
b. Histoplasmosis
c. Blastomycosis
d. Cryptococcosis
e. Aspergillosis
a. Coccidioidomycosis
Which is the most frequent fungal pathogen seen in intravenous drug abusers?
a. Candidiasis
b. Coccidioides immitis
c. Aspergillus
d. Histoplasma capsulatum
e. Blastomyces dermatitidis
f. Cryptococcus neoformans
a. Candidiasis
Which of the following is associated with a sterile immune complex arthritis (desert rheumatism)?
a. Candidiasis
b. Coccidioides immitis
c. Aspergillus
d. Histoplasma capsulatum
e. Blastomyces dermatitidis
f. Cryptococcus neoformans
b. Coccidioides immitis
Which of the following can be diagnosed by demonstrating budding yeast cells with pseudohyphae?
a. Candidiasis
b. Coccidioides immitis
c. Aspergillus
d. Histoplasma capsulatum
e. Blastomyces dermatitidis
f. Cryptococcus neoformans
a. Candidiasis
Which TWO are associated with necrotizing granulomas?
a. blastomycosis
b. coccidioidomycosis
c. histoplasmosis
b. coccidioidomycosis
&
c. histoplasmosis
Which causes Tenosynovitis?
a. Cryptococcus neoformans
b. Sporothrix schenckii
c. Aspergillus
d. Histoplasma capsulatum
b. Sporothrix schenckii
&Candida & Coccidioides immitis
Which is associated with pyogenic granulomas?
a. coccidioidomycosis
b. histoplasmosis
b. coccidioidomycosis
A neonate with a low birth weight aquired bone and joint disease. Which is the most likely cause?
a. Cryptococcus neoformans
b. Coccidioides immitis
c. Aspergillus
d. Candidiasis
d. Candidiasis
Which is associated with pyogranuloma?
a. blastomycosis
b. histoplasmosis
a. blastomycosis
Which organism is inhaled as spores and may cause nodular and ulcerative skin lesions?
a. Candidiasis
b. Coccidioides immitis
c. Blastomyces dermatitidis
d. Histoplasma capsulatum
c. Blastomyces dermatitidis
Which of the following can you conclude form the fact that the incidence of RA is decreasing but the prevalence is increasing?
a. RA can be spread
b. we cured RA
c. people with RA are dying more
d. people with RA are surviving longer
d. people with RA are surviving longer
Prevalence= Incidence X Duration
What drugs have been developed for RA patients that decrease mortality?
disease-modifying anti-rheumatic drugs (DMARDS)
Who is affected more by RA?
a. teen boys
b. women
c. men
d. 2-year-olds
b. women
Which of the following cause RA?
a. bacterial infections
b. viral infections
c. both
d. neither
d. neither
these are triggers! not everyone with a viral illness will develop RA
Who has a very high risk of developing RA when they smoke?
Genetically susceptible individuals
Those with positive anti-cyclic citrullinated peptide (anti-CCP) antibodies.
What stops out the primary prevention of RA?
limited knowledge on its etiology
Describe the pattern of normal human muscle fibers
mosaic pattern (checkerboard)
Which of the following is where nerves, blood vessels, and muscle spindles are located
a. epimysium
b. endomysium
c. perimysium
c. perimysium
Which of the following is a sign of neurogenic muscular atrophy?
a. target fibers
b. angular fibers
c. both
d. neither
c. both
they’re two names of the same thing!
Five-year-old presents with a waddling gait & enlarged calves. His parents are both healthy. What’s the diagnosis
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
a. duchenne muscular dystrophy (DMD)
1/2 of the cases are sporadic; it’s also X linked
Which of the following is a neuromuscular disease that leads to varying degrees of skeletal muscle weakness affecting muscles of the eyes, face, and swallowing?
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
b. myasthenia gravis
Which is known as type 5 glycogen storage disease?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. McArdle’s disease
d. McArdle’s disease
Which of the following is characterized by facial rash?
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
d. dermatomyositis
In which of the following are the patients most likely to die due to cardio-respiratory failure before age 2?
a. Duchenne muscular dystrophy
b. Myasthenia gravis
c. Pompe’s disease
d. McArdle’s disease
c. Pompe’s Disease
Which is known as type 2 glycogen storage disease?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. McArdle’s disease
a. Pompe’s Disease
In which of the following are the patients most likely to die young due to respiratory insufficiency?
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
a. duchenne muscular dystrophy
Which of the following enzymes are low in Pompe’s Disease patients?
a. alpha glucosidase
b. acid maltase
c. both
d. neither
c. both
they’re different names for the same thing!!
Which of the following is an indicator of proximal weakness?
a. anti-dystrophin antibody presence
b. gowers maneuver
c. mosaic pattern muscle fibers
d. high creatine kinase
b. gowers maneuver
You suspect that a patient has duchenne muscular dystrophy, what tests do you run?
1- a blood test for common deletions
2- stain muscle with anti-dystrophin antibody presence
Perifascicular atrophy is a characteristic of
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
e. pompe’s Disease
f. central core disease
d. dermatomyositis
A female patient comes in with pain and aching in muscles, Proximal weakness, and Elevated creatinine kinase. No rash or myofibers atrophy is present. Which is more likely?
a. duchenne muscular dystrophy
b. myasthenia gravis
c. polymyositis
d. dermatomyositis
c. polymyositis
eliminate dermatomyositis because no rash or Perifascicular atrophy, those the only differences between them
Which of the following is due to a RYR1 gene mutation?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. McArdle’s disease
c. Central core disease
Which of the following is maternally passed?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
b. Mitochondrial myopathy
Which of the following is autosomal dominant?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. Dermatomyositis
c. Central core disease
Which of the following are positive for Ragged Red Fibers?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. Dermatomyositis
b. Mitochondrial myopathy
Which of the following lacks oxidative enzymes?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. dermatomyositis
e. polymyositis
c. Central core disease
Which of the following diseases has a strong association with malignant hyperthermia?
a. Pompe’s Disease
b. Mitochondrial myopathy
c. Central core disease
d. Dermatomyositis
e. Polymyositis
c. Central core disease
Which muscle type does Central core disease affect?
a. type 1
b. type 2
a. type 1
slow twitch
Why is a lupus screening test not recommended?
no cost-effective tests or sufficiently accurate tests are available
Which gene is most associated with SLE?
a. HLA-S9
b. HLA-A9
c. HLA-B8
d. HLA-G8
c. HLA-B8
What is the TREX-1 gene and what happens if it’s defective?
Encodes repair enzymes that degrades DNA. A defective TREX-1 gene is associated with SLE
T/F: most new SLE cases are linked to familial clustering
F, most new cases are sporadic
Why is most likely to get SLE?
a. 18 y/o boy
b. 18 y/o black girl
c. 18 y/o white girl
b. 18 y/o black girl
Which if the following country types have the greatest burden of OA?
a. developing countries
b. developed countries
a. developing countries
The sole use of which of the following methods leads tp the over estimation of the burden of disease for OA?
a. symptoms
b. radiological changes
c. pathological changes
b. radiological changes
they’re not always accompanied by symptoms
Which of the following more commonly causes gout?
a. high uric acid production
b. high uric acid consumption
c. body has problems removing it
c. body has problems removing it
Which of the following was concluded by recent studies?
a. smokers have a lower prevalence for OA
b. smokers have a higher prevalence for OA
a. smokers have a lower prevalence for OA
(this is probably because they dont live as long, so they dont get OA from age, or because they’re more skinny, which puts less pressure on the knees)
Which of the following is a risk factor for gout?
a. solid organ transplants
b. the medication used for the transplants
c. both
c. both
Which is false about OA?
a. having a healthy weight is the best prevention method
b. taking vitamin supplements is another prevention method
c. having protection from injury is another prevention method
b. taking vitamin supplements is another prevention method
no evidence of this
Which NSAID is often used for gout treatment?
a. prednisone
b. aspirin
c. colchicine
d. indomethacin
c. indomethacin
Which is used for patients who cannot have NSAIDs?
a. naproxen
b. aspirin
c. febuxostat
d. indomethacin
e. prednisone
e. prednisone
Which of the following makes gout worse?
a. naproxen
b. aspirin
c. febuxostat
d. indomethacin
e. prednisone
b. aspirin
Why shouldn’t we give aspirin to gout patients?
it inhibits uric acid secretion
Which of the following has side effects of nausea, vomiting, and diarrhea?
a. allopurinol
b. febuxostat
c. colchicine
d. indomethacin
e. prednisone
c. colchicine
Which of the following are Xanthine oxidase inhibitors?
a. allopurinol
b. febuxostat
c. colchicine
d. indomethacin
e. prednisone
a. allopurinol
&
b. febuxostat
Which of the following is safer to use in patients with kidney transplants?
a. allopurinol
b. febuxostat
b. febuxostat
metabolized in the liver
Which of the following inhibit uric acid reabsorption?
a. indomethacin
b. probenecid
c. febuxostat
d. pegloticase
b. probenecid
Which of the following uric acid reabsorption inhibitors causes urinary stones or uric acid deposition?
a. losartan
b. probenecid
b. probenecid
A isn’t on the drug list. uricosuric drugs excrete uric acid so it can build up and cause stone formation
Which of the following disrupts granulocyte migration to the joint?
a. allopurinol
b. febuxostat
c. colchicine
d. indomethacin
e. prednisone
c. colchicine
by binding to tubulin and becoming a mitotic prison
Which of the following is an analog of hypoxanthine?
a. allopurinol
b. febuxostat
a. allopurinol
Which of the following can have side effects of gastrointestinal disturbances?
a. allopurinol
b. febuxostat
a. allopurinol
Which of the following is a non-purine inhibitor of XO?
a. allopurinol
b. febuxostat
b. febuxostat
What is the function of urate oxidase? and why is it important?
its an enzyme that converts uric acid to allantoin. its important because allantoin is much more excretable in the urine.
A technician lab tests the urine of a disobedient patient and finds allantoin. What can you conclude?
That’s not human urine because we don’t have urate oxidase, which makes allantoin. (so the patient gave us animal urine. I don’t know why I made a whole story either…)
Patient comes with preserved joint motion and tenderness upon palpitation. Is it likely that he has arthritis?
No
Patient comes with monoarticular joint pain and constitutional symptoms (fever, malaise). Whats a likely diagnosis?
infectious arthritis
Patient comes with monoarticular joint pain and a limited range of motion. Whats a likely diagnosis?
bursitis, tendinitis, or muscle injury
When is the use of computed tomography appropriate?
joint aspirations of difficult to access places ex/ hips, sacroiliac, sternoclavicular joints
Patient comes with bloody synovial fluid and no evidence of trauma. What tests should you order?
prothrombin (PT), partial tissue thromboplastin time (PTT), platelet count, and bleeding time
Patient comes with refractory monoarthritis, you suspect an atypical agent. What tests should you order?
synovial biopsy (to diagnose tuberculosis, fungus, and sarcoidosis)
Which of the following is most commonly reported?
a. upper back pain
b. lower back pain
b. lower back pain
Whats FALSE about back pain?
a. stress may induce it
b. smoking may induce it
c. it occurs to more men than women
d. whole-body vibrations induce it
e. regular exercise may prevent it
c. it occurs to more men than women
What forms a border between the intervertebral disks and the neural canal?
PLL
Why do 95% of lumbar disc herniations occur at the L4-5 and L5-S1 levels?
because PLL thins as it runs inferiorly from L1 to S1
Which vertebral ligament may thicken and cause spinal stenosis with age?
ligamentum flavu
Where does the spinal cord end?
L1-L2
Which pain fibers supply structures in the lumbosacral region?
posterior rami and sinuvertebral nerves
Which vertebral structures have no pain receptors?
nucleus pulposus and inner annular fibers
What percent of disc patients are asymptomatic?
20% to 30% (this is because there are no pain receptors in some areas)
Which of the following is exacerbated by sitting, bending, coughing, and straining?
a. Spinal Infection
b. Fracture
c. Sciatica
d. Cauda Equina Syndrome
e. Spinal Stenosis
g. Sciatica
Which of the following is relieved by sitting down?
a. Spinal Infection
b. Fracture
c. Sciatica
d. Herniated Disk
e. Spinal Stenosis
e. Spinal Stenosis
A patient with a history of osteoporosis comes in after a minor fall complaining of muscle spasms in the back. What’s more likely?
a. Spinal Stenosis
b. Fracture
c. Herniated Disk
d. Sciatica
b. Fracture
Patient comes in saying that they have pain going downhill but not uphill. Whats most likely?
a. Spinal Stenosis
b. Fracture
c. Herniated Disk
d. Sciatica
a. Spinal Stenosis
Which of the following is relieved by lying in a supine position?
a. Spinal Infection
b. Fracture
c. Sciatica
d. Cauda Equina Syndrome
e. Spinal Stenosis
c. Sciatica
Patient comes in with back pain, which doesn’t get better after rest, and fever but no neurologic symptoms. Which is most likely?
a. Spinal Infection
b. Fracture
c. Herniated Disk
d. Cauda Equina Syndrome
a. Spinal Infection
1/2 of patients has no neurologic symptoms, and 1/2 of patients have no fever.
Which of the following doesn’t have relieving factors, and any motion exacerbates the symptoms?
a. Spinal Infection
b. Fracture
c. Herniated Disk
d. Cauda Equina Syndrome
c. Herniated Disk
Which of the following has a high mortality rate?
a. Spinal Infection
b. Fracture
c. Herniated Disk
d. Cauda Equina Syndrome
a. Spinal Infection
Patient comes in complaining of pain and lack of sensation over the buttocks and upper posterior thighs. Rectal exam also showed decreased sphincter tone. Whats more likely?
a. Spinal Stenosis
b. Malignancy
c. Sciatica
d. Cauda Equina Syndrome
d. Cauda Equina Syndrome
diagnose via MRI
Patient comes in with chronic back pain thats worse at hight and weightloss. Which is likely?
a. Spinal Infection
b. Fracture
c. Herniated Disk
d. Malignancy
d. Malignancy
Which vertebral malignancy is more common?
a. primary
b. metastatic
b. metastatic
Patient complains that when they walk for too long or use their arm, they go numb for 15 minutes before sensation returns. They also have back pain, what’s the diagnosis?
a. Spinal Infection
b. Fracture
c. Herniated Disk
d. Spinal Stenosis
d. Spinal Stenosis
Vascular claudication is the numbness after use; pseudoclaudication is when it lasts for more than 5 minutes
Which is true?
a. positive SLR test usually means a person has sciatica
b. a negative SLR test usually means a person doesn’t have sciatica
c. both
d. neither
b. a negative SLR test usually means a person doesn’t have sciatica
(sensitivity of 80% but a specificity of 40%, so the negative test accurate)
How do you diagnose a patient with a suspected spinal infection?
MRI
