Questions Flashcards
A 76 year old man presents to his General Practitioner with a red, tender, painful metatarso-phalangeal joint of the hallux. He is diagnosed with gout, an accumulation of uric acid crystals in the joint. How is urine acid formed
It is formed by the breakdown of purines
A bodybuilder flexes his biceps muscles in a competition. Which of the following descriptions best fits the changes that occur during contraction of skeletal muscle?
A-band remains unchanged in length, I-band shortens
In order to achieve accurate control of movement the muscles contain two types of sensors, muscle spindles and Golgi tendon organs. Which statement regarding the muscle spindle cells is correct?
They are innervated by γ (gamma) motor-neurons and detect the amount and rate of change of muscle length
student doctor examining a histology slide is not sure what kind of muscle he is looking at. Which of the following features should allow the student to determine that he is looking at a sample of cardiac muscle?
Intercalated discs
The synovial membrane is a specialised connective tissue.Which is the main physiological function of the synovial membrane?
Secretes important components into the synovial fluid
A 23 year old man twisted his knee and ruptured the anterior cruciate ligament. Which statement about the anterior cruciate ligament is correct?
stops forward movement of the tibia.
During running only one foot is in contact with the ground at any one time. Which bone of the foot supports ALL the body weight?
Talus
The FRAX® score considers various risk factors in generating the 10-year probability of major osteoporotic fracture.
Which risk factor is not in the model?
Current smoking status.
B.
Current use of glucocorticosteriods.
C.
Diagnosis of rheumatoid arthritis.
D.
Family history of parental hip fracture.
E.
Regular exercise.
Regular exercise
22-year-old mountain biker falls and sustains fractures of their right radius and ulna.
Which of the following is an early complication following bone fracture?
Compartment syndrome
Compartment syndrome
This is an acute potentially limb threatening complication of fractures especially lower limb.
• The muscles are enclosed in fascial compartments with little room for expansion therefore if swelling of the muscle occurs then the pressure in the compartment rises which can compromise the blood flow to the muscle.
The action of parathyroid hormone results in the changes to urinary calcium and phosphate levels?
Which of the following best describes these changes?
Urinary calcium decreases & urinary phosphate increases
Defective mineralisation of bone can lead to serious complications.
Which of the following terms describes defective mineralisation of bone matrix in an adult?
Osteomalacia
Human bone contains a variety of differing cell types.
Which of these is not a cell type present in bone?
Macrophage.
B.
Osteoblast.
C.
Osteoclast.
D.
Osteocyte.
.
Osteoid.
Osteoid
Paget’s disease is a benign disease of bone of unknown aetiology.
Which of the following best describes the blood test results for the bone profile of a patient with Paget’s disease?
Normal calcium, normal phosphate, raised Alk Phos, normal PTH
Pager’s disease
Paget’s disease of bone is a benign condition.
• This disease of uncertain etiology is characterized by excessive and unorganized deposition and resorption of bone. The result is structurally weakened bone that has an abundance of cement lines, sometimes referred to as a mosaic pattern.
• The bone profile shows - Normal calcium, normal phosphate, raised Alkaline Phosphatase, normal PTH.
• The raised levels of alkaline phosphatase reflect the increased bone turnover
t is recommended that for some patients they take a Vitamin D supplement during the winter months.
What is the role of ultraviolet light in vitamin D metabolism?
Converts 7-dehydrocholesterol to cholecalciferol
78-year-old lady suffers a wrist fracture due to osteoporosis.
Which of the following best describes the blood test results for the bone profile of this patient?
Normal calcium, normal phosphate, normal Alk Phos, normal PTH
Human bone contains a variety of differing cell types.
Which cell type is involved in the resorption of bone during the remodelling process?
Osteoclasts
Sunlight plays an essential part of the synthesis of Vitamin D.
Where is 1-25-dihydroxyvitamin D formed?
Kidney
Parathyroid hormone is involved in the regulation of calcium.
Which of the following stimulates the secretion of parathyroid hormone?
Decreased plasma calcium levels
Synthesis of the active form of vitamin D (1,25-dihydroxycholecalciferol) occurs in the kidneys. Which hormone is responsible for this activation?
Parathyroid hormone
Hydroxyapatite is a mineral present in human bone.
What is hydroxyapatite made of?
Calcium and phosphate
22-year-old is admitted with osteomalacia secondary to Vitamin D deficiency.
Which of the following best describes the blood test results for the bone profile of this patient?
Decreased calcium, decreased phosphate, increased Alk Phos, raised PTH
Osteomalacia
Most common cause is hypophosphataemia (low phosphate) due to hyperparathyroidism (raised PTH) secondary to Vit D deficiency.
• The Vit D deficiency also reduces the intestinal absorption of calcium (low calcium)
• Alk Phos is raised in over 90% of cases
Bone mass loss during the menopause can increase the risk of fractures.
Which of the following terms describes a reduction in bone mass (greater than 2.5 standard deviations below the mean value for a young adult of the same sex) with normal mineralisation?
Osteoporosis
Osteogenesis imperfecta
genetic condition which results in bones that break easily – also known as ‘brittle bone disease’.
What is the third stage of fracture healing?
Repair
Which is true of both tendons and ligaments?
Can sustain high tensile strength
What is the function of the anterior cruciate ligament?
Resists anterior translation of the tibia
Which is true of skeletal muscle?
Contraction is generated by attachment and detachment of myosin heads on actin filaments
Which bone cells sense strain in the skeleton?
Osteocytes
