MSK ( 5% ) Flashcards
1
Q
- Osteoporosis
- a. Always involves the entire skeleton
- b. Is associated with decreased IL-1 level
- c. Can be reliably detected on radiographs with 20% bone loss. Not detected until 40%
- d. Is associated with anticoagulant use
- e. May be caused by vitamin A deficiency
A
d. Is associated with anticoagulant use
- c. Can be reliably detected on radiographs only with >40% bone loss
- Can involve isolated portions of skeleton
- Associated with increased IL-1 and IL-6 levels
2
Q
- Which of the following is true concerning rhabdomyolysis?
- a. It is caused by injury to smooth muscle
- b. Its diagnosis depends on the presence of characteristic physical findings
- c. The final common pathway of injury involves damage to the sarcolemma
- d. Renal failure is due to acute glomerular nephritis
- e. Occurs only in trauma
A
c. The final common pathway of injury involves damage to the sarcolemma
- Injury to skeletal muscle, diagnosis depends on characteristic biochemical findings.*
- Renal failure occurs due to accumulation of myoglobin in the nephons -> ATN*
- Occurs in trauma, some drug overdoses, metabolic conditions, exercise, ischaemia (eg compartment syndrome)*
3
Q
- Which of the following tumours is benign?
- a. Chondrosarcoma
- b. Osteochondroma
- c. Chondroblastoma
- d. Ewing’s tumour
- e. None of the above
A
c. Chondroblastoma
4
Q
- A 50 year old woman presents with back pain. Xrays suggest a malignant deposit in the 10th thoracic vertebra. The least likely primary site is
- a. Breast
- b. Ovary
- c. Thyroid
- d. Kidney
- e. Colon
A
b. Ovary
5
Q
- Which of the following is a disturbance of mineralisation homeostasis?
- a. Ricketts
- b. Osteoporosis
- c. Pagets disease
- d. HPOA
A
a. Ricketts
- Occurs due to Vit D deficiency*
- Pagets is excess unorganised and structurally unsound bone*
6
Q
- Osteomalacia
- a. Decreased osteoid matrix deposition
- b. Increased bone production
- c. Vitamin D deficiency
- d. Increased Ca absorption from the gut
- e. Decreased PTH
A
c. Vitamin D deficiency
7
Q
- Bone metastases originate least often from carcinoma of
- a. breast
- b. prostate
- c. testis
- d. thyroid
- e. kidney
A
c. testis
And ovaries
8
Q
- Fracture healing
- a. Involves formation of an osseous callus in the second stage.
- b. Occurs at the same speed for all types of fractures
- c. Is not affected by alignment
- d. Is better in comminuted fractures
- e. Involves organisation of haematoma in the first stage
A
e. Involves organisation of haematoma in the first stage
- Haematoma formation (hours)
- Procallus formation (days)
- Organisation of callus and fibrocartilagenous callus formation (1 week)
- Callus ossification (2-3 weeks)
- Bone remodelling
- a. Involves formation of a cartilagenous callus in the second stage.
- b. Occurs at different speed for all types of fractures
- c. Is affected by alignment
- d. Is worse in comminuted fractures - more pieces to move and fuck out I assume, with more interuppted blood supply
9
Q
- Regarding fracture healing
- a. Bone callus offers no structural rigidity for weightbearing
- b. Cytokines stimulate production of osteoclasts and osteoblasts
- c. Complete fracture healing can be expected regardless of age
- d. Cartilage formation is not a feature
- e. Bony fracture fragments enhance healing
A
b. Cytokines stimulate production of osteoclasts and osteoblasts
10
Q
- Stress facture of bone
- a. Occurs when the bone is subjected to large axial loads
- b. Is common in Paget’s disease
- c. Is caused by secondary hypoparathyroidism
- d. Is rapidly developed in athletes due to repetitive training.
- e. Develops slowly and is repaired without cartilage in the callus
A
e. Develops slowly and is repaired without cartilage in the callus
- Develops gradually in athletes and other people*
- Pagets = pathological fractures*
11
Q
- Stress fractures
- a. Do not incite a paracortical reaction
- e. result from repetitive stresses or abnormal axial loading
A
e. result from repetitive stresses or abnormal axial loading
12
Q
- In bone healing
- a. Woven bone forms in the periosteum of the medullary cavity.
- b. Osteoblasts lay down woven bone over the procallus to repair the fracture line
- c. PTH acts directly on osteoclasts to increase absorption
- d. Haematoma at the fracture site plays little role in the development of procallus.
- e. Inadequate immobilization aids the formation of normal callus.
A
b. Osteoblasts lay down woven bone over the procallus to repair the fracture line
- a. Woven bone forms in the endosteum of the medullary cavity.
- c. PTH acts indirectly on osteoclasts to increase absorption
- d. Haematoma at the fracture site plays an important role in the development of procallus.
- e. adequate immobilization aids the formation of normal callus.
13
Q
- Which occurs first in fracture healing?
- a. Neutrophil invasion
- b. Procallus formation
- c. Woven bone ossification
- d. Lamellar bone ossification
- e. Collagen deposition
A
- a. Fibroblast and inflammatory cell invasion
- b. Procallus formation
- e. Collagen deposition
- c. Woven bone ossification
- d. Lamellar bone ossification
14
Q
Regarding fracture healing
- Conversion of the procallus to a fibrocartilaginous callus precedes haematoma organization
- Osseous callus precedes the fibrocartilaginous callus
- Almost perfect repair can be accomplished if the original weightbearing strains are restored
- Speed and perfection of healing does not depend on the type of fracture
- Comminuted fractures heal quicker than greenstick fractures
A
Almost perfect repair can be accomplished if the original weightbearing strains are restored
- Conversion of the procallus to a fibrocartilaginous callus follows haematoma organization
- Osseous callus follows the fibrocartilaginous callus
- Speed and perfection of healing does depend on the type of fracture
- Presumably a massively comminuted, open fracture will hesal slower and less well
- Comminuted fractures heal slower than greenstick fractures - more bone needs to remodel and develop
15
Q
- Subchondral necrosis
- a. Is rarely idiopathic
- b. Associated with diving injuries
- c. Rarely involves ischaemia.
- d. Caused by embolus
- e. Precursor to OA.
A
Apparently noted as b. Associated with diving injuries
However
e. Precursor to OA.
R&C states subchondral infarcts may lead to severe OA, and no mention is made of diving injuries
And a case could be made for d) too, so who knows.
- a. Is ?often idiopathic
- c. Often/always involves ischaemia.
- d. Caused by embolus - noted as a cause of osteonecrosis
