Week 6 Review Qs Flashcards
While inspiration, the ribs are rotating in a pump-handle movement to increase the antero-posterior dimension. Which part of the rib bone act as an axis for the rotation? A) angle B) head C) neck D) body
C) neck
40-year-old male has difficulty with walking for 4 months. Recently he feels tightness in the thigh radiating to his foot when walking for more than 1 km after that he is forced to rest for 5 min*(should be 10-15min). He fell on his back 9 months ago at work. No history of smoking, night pain, or rest pain and no constitutional symptoms. On examination, neurological test was good, but had reduced spinal function on extension. What is the diagnosis?
A) bone metastatic tumor B) intermittent claudication C) osteoarthritis D) spinal cord stenosis E) fracture of vertebra
D) spinal cord stenosis
Which imaging modality is the best to see ACL and MCL? A. MRI B. Fluoroscopy C. CT D. Nuclear imaging E. Ultrasound
A) MRI
A 40 years old drug addict complains of fever and right knee swelling and knee pain while walking due to severe pain.
A) septic arthritis B) fracture C) OA D) RA E) joint dislocation F) gout attack
A) septic arthritis
A 23-year-old salesman with purulent urethral discharge and septic arthritis is likely to be affected by which of these pathogens?
N. Gonorrhea
A 2 yr old boy with acute pain, swelling and tenderness on left thigh.
Hemophilus influenzae
Which condition shows 'sun burst' on a plain x-ray? A) fibrous dysplasia B) multiple myeloma C) osteochondroma D) osteosarcoma E) synovial sarcoma
D) osteosarcoma
A 45-year-old presented with retroperitoneal mass, diagnosed with liposarcoma. what is the histopathology of the lipoblasts?
A) small round cells
B) vacuolated cytoplasm, atypical nucleus
C) vacuolated cytoplasm, scalloped nucleus
D) spindle shaped with polymorphic nucleus
C) vacuolated cytoplasm, scalloped nucleus
Why does copper deficiency result in defective collagen formation?
A) Reduced activity of lysyl oxidase
B) Reduced activity of prolyl hydroxylase
C) Cleavage of procollagen C and N terminal
D) Reduced glycosylation of lysine
A) Reduced activity of lysyl oxidase
Which is the first step in collagen fibril formation?
A) procollagen triple helix formation
B) secretion if procollagen into ECM
C) cleavage of n and c terminus of procollagen
D) hydroxylation of proline residues
D) hydroxylation of proline residues
What will be most obvious on inspection? A) 10-degree kyphosis B) Vertebral Fracture C) Osteomyelitis? D) Thoracolumbar scoliosis
D) Thoracolumbar scoliosis
Surgical incision to relieve pressure on the spinal cord A) Transverse process B) Lamina C) IVD D) Articular process E) Pars interarticularis
B) Lamina
Horizontal on cervical vertebra A) Transverse process B) Lamina C) IVD D) Articular process E) Pars interarticularis
A) Transverse process
A patient with lumbar and thoracic compression fractures and kyphosis, what would have a high radiodensity in the x-ray
A) cortical rim
B) spinous process
C) transverse process
A) cortical rim
Radiograph showed injury of facet joint between L3-L4, which part of L4 spinal nerve will be compressed? A) Posterior cord B) Anterior cord C) Ventral rami D) Trunk E) Recurrent
D) Trunk
A 50-year-old male had an intervertebral prolapse and loss sensation of lateral leg, dorsal aspect of foot and big toe A) L3 B) L4 C) L5 D) S1 E) S2
C) L5
A bone tumor in the metaphyseal area
Osteosarcoma
Homer-wright rosettes are found in which tumor?
Ewing Sarcoma
What is used to non-enzymatically stabilize collagen/cross link extracellularly?
Allysine
What restricts the movement of the vertebra?
Articular process
A 40-year old man, a drug addict, experiences tight knee pain, swelling and fever for last 2 days. What is the diagnosis?
Septic arthritis
Which part of the lumbar vertebra attaches to the body of the lumbar vertebra? A) Pedicle B) Lamina C) Transverse process D) Spinous process E) Mammilary body
A) Pedicle
A patient with poor glycemic control had septic arthritis. What could be the causative
agent?
- Streptococcus agalactiae
Its high concentration in blood indicate collagen production?
- CP II
What is the amino acid in the first position of the triplet structure in the collagen?
A) Glycine
B) Alinine
C) Valine
A) Glycine
Severe deficiency in what causes impaired collagen production?
Vitamin C
Mass on chest wall after lymphadenectomy and breast radiation?
- Angiosarcoma
What is the mutation found in Ewing sarcoma?
- Translocation (11, 22)
in the processing of procollagen, which part is removed?
A) B sheet
B) Random coil
C) Linked coil
C) Linked coil
A diabetic with septic arthritis what is the causative organism
A) Streptococcus agalactiae
B) Pseudomonas aeruginosa
A) Streptococcus agalactiae
[if it was osteomyelitis in a diabetic the answer would be Pseudomonas aeruginosa]
A patient presented with severe pain in his leg that gets worse at night, and relieved by NSAIDs, histology showed lytic lesion lined with reactive bone “osteoblasts”. What’s the diagnosis?
- Osteoid osteoma
(Note: osteaoblastoma is similar to osteoid osteoma but is larger (>2cm), arises in vertebrae, & presents with bone pain that does NOT respond to NSAIDs)
A nasal mass in a 5 year old showed round cells with little cytoplasm which were positive for desmin & myo1D
A) Rhabdomyosarcoma
B) Ewing carcinoma
C) Fibroblastoma
A) Rhabdomyosarcoma
[The diagnosis of rhabdomyosarcoma is based on the demonstration of skeletal muscle differentiation, either in the form of sarcomeres under the electron microscope or by immunohistochemical demonstration of skeletal muscle–specific transcription factors such as myogenin and MYOD-1, and the muscle-associated intermediate filament desmin.]
what is the most frequent amino acid sequence in cartilage?
- Gly-X-Y
What is the best modality used to check for a cruciate ligament tear? A) Ultrasound B) CT C) MRI D) Nuclear study E) Fluoroscopy
C) MRI
A 34 year old male with subcutaneous nodule containing mature adipocytes progressed for 3 years, what is the most likely diagnosis?
A) Lipoma
B) Liposarcoma
C) Lipoblastoma
A) Lipoma
Which vein directly drains vertebral body? A) Basivertebral B) Intervertebral C) Vertebral D) Spinal
A) Basivertebral
Covalent interaction between these elements stabilize mature collagen fibril
- Collagen triple helices
What part of the vertebral column fractured in spondylolisthesis?
Pars interarticularis
A 7 year old child presented with a red, swollen, tender, and painful monoarthritis, what is the condition? A) Infective osteomyelitis B) Malignancy C) Septic arthritis D) Acute viral infection E) Chronic fungal infectio
C) Septic arthritis
A section of a retroperitoneal large tumor revealed adipose tissue with large lipoblasts with numerous pleomorphic atypical cells. It was positive for S-100. What is most likely the tumor?
A) Liposarcoma B) Leiomyosarcoma C) Osteochondroma D) Ewing's sarcoma E) Rabdhomyosarcoma
A) Liposarcoma
What is the best diagnostic test of tear of labrum?
A) MRI
B) X-ray
C) CT
A) MRI
[best modality for soft tissues is MRI]
Which of the following permits and restricts movement between adjacent vertebras?
Articular process
What prevents vertebra from slipping over the vertebra below? A) Transverse process B) Spinous process C) Vertebral arch D) Intervertebral disc E) Lamina F) Pedicle. G) articular process
G) articular process
What is the reason for secondary curvature of the vertebral column?
IVD thicker anteriorly
A patient complains from lower back pain, associated with loss of sensation over the lateral side of the foot & weakness in eversion, what clinical examination would confirm your diagnosis?
A) Brisk ankle reflex
B) Positive straight leg raise test (nerve root irritation)
C) Absent knee reflex
B) Positive straight leg raise test (nerve root irritation)
Which protein regulates bone formation?
- Osteocalcin
Back strain leads to microscopic tearing of fibers of which structure? A) Erector spinae muscle B) Anterior longitudinal ligament C) Posterior longitudinal ligament D) Psoas major muscle
A) Erector spinae muscle
Which intrinsic muscle of the back is innervated by posterior ramus of the spinal cord? A) Rhomboids B) Erector spinals C) Trapezius D) Legatos scalene
B) Erector spinals
What feature of lumbar vertebrae makes it able to bear weight?
A) Kidney shaped body
B) Thick spinal process
A) Kidney shaped body
An HIV patient developed RA, what is the possible causative agent?
Mycobacterium
What is the best radiological modality to see the spinal cord?
a) MRI
b) X-ray
c) CT
a) MRI
What pathological condition is associated with collagen type 1 synthesis and exretion?
Osteogeneisis imperfecta
What is the structure of collagen?
- Triple helix
A young patient presented with bone pain, worse at night, relieved by NSAIDs, what is the diagnosis?
- Osteoid osteoma
Which of the following is responsible for restriction of movement of the spine?
- Articular process
Which of the following in encroaching in L5 vertebral body?
- Pedicles
A patient with Sickle cell anemia suffers from osteomyelitis, what is the most likely etiological organism?
- Salmonella Typhi
A patient presented with septic arthritis and severe diarrhea, what is most likely etiological pathogen?
- Salmonella Typhi
What is the muscle responsible for flexing an extended spine?
- Psoas major
Back strains lead to microscopic tearing of fibers of this muscle?
- Erector spinae
What do you find in the urine in case of collagen destruction/breakdown?
- Hydroxyproline
Which spinal nerve supplies the intrinsic muscle of the back? A) Anterior rami B) Anterior roots C) Posterior rami D) Posterior roots
C) Posterior rami
Which nerve innervates the intrinsic muscle of the vertebral column?
- Dorsal rami
Tumor with sunburst appearance on x-ray?
- Osteosarcoma
Radiological sign of anterior cruciate ligament tear?
Tibial spine in x-ray (X-ray will show “avulsion of tibial attachment”)
Bilateral contraction of the erector spinae leads to which movement mainly?
- Extension of spine, head, and neck
A dislocation of zygapophyseal joint at L2&3. Which nerve root is affected?
A) L3
B) L2
B) L2
A 15 year old is complaining of pain and swelling in his leg. Needle core biopsy of a
tumor in his femur shows lace-like pink material, atypical cells with dark nuclei and mitosis. What is the diagnosis?
Osteosarcoma
A 60 year old woman with back pain. On radiological studies there was compression fracture in L3 and hyperlucency in the vertebrae, what will you find in histology?
Thin trabeculae
Removal of these elements happens in procollagen processing?
- Disulfide linkage
An amino acid undergoing change to produce a reactive group linking collagen together.
A) Lysine
B) Glycine
C) Leporine
A) Lysine
What is the most important function of the intervertebral disk?
- Shock absorber
A 15-year-old boy is complaining of pain and swelling in his leg. Needle core biopsy of a tumor in his femur shows lace-like pink material, atypical cells with dark nuclei, and mitosis. What is the diagnosis?
Osteosarcoma
A patient presents with a deep-seated tumor in the thigh. Biopsy shows bundles of spindle-shaped cells with cigar shaped nuclei, necrosis, mitosis, and nuclear atypia. What is the diagnosis?
Leiomyosarcoma
A patient presents with a superficial well-defined tumor composed of mature adipocytes. What is the diagnosis?
Lipoma
A histological specimen from a well-defined tumor showed vascular spaces filled with blood. What is the diagnosis?
Hemangioma
Which amino acid is modified to generate covalent cross-linkage in collagen molecules?
Lysine
Which of the following is a characteristic of vertebrae in the lumbar region?
- A spinous process that is thick and short
To which of the following parts of the vertebra are the spinal ganglia related to?
- Intervertebral foramen
Contraction of this muscle bilaterally will lead to flexion of the vertebral column:
Rectus abdominus
Urinary levels of which of the following indicate the rate of degradation of collagen?
Hydroxyproline
A 70-year old man with bronchogenic carcinoma presents with lytic lesions on the lumbar vertebra in an X-ray. A biopsy of these lesions reveals a glandular pattern. What is the diagnosis?
- Metastatic carcinoma
