Basic Science Flashcards
1
Q
Types of bone (2)
A
- Lamellar 2. Woven
2
Q
Subtypes of Lamellar Bone (2)
A
- Cortical 2. Cancellous
3
Q
Subtypes of Woven Bone (2)
A
- Immature 2. Pathologic
4
Q
_____ bone is stress-oriented. _____ bone is not.
A
Lamellar Woven
5
Q
Cortical bone constitutes ____% of skeleton.
A
80%
6
Q
These cells form bone by generating organic, non-mineralized matrix.
A
Osteoblasts
7
Q
Osteoblasts are derived from these.
A
Undifferentiated mesenchymal stem cells.
8
Q
This transcription factor directs mesenchymal cells to the osteoblast lineage.
A
RUNX2
9
Q
Osteoblasts have more of these organelles than do most other cells (3).
A
- Endoplasmic reticulum 2. Golgi apparatus 3. Mitochondria
10
Q
Osteoblast receptors (5).
A
- PTH 2. 1,25 (OH)2 Vitamin D3 3. Glucocorticoids 4. Prostaglandins 5. Estrogen
11
Q
Osteoblasts produce (5).
A
- Alkaline phosphatase 2. Osteocalcin 3. Type I collagen 4. Bone sialoprotein 5. RANKL
12
Q
Osteoblasts are stimulated by ______ exposure to PTH.
A
intermittent (pulsatile)
13
Q
Osteoblast activity inhibited by ____.
A
TNF-alpha
14
Q
These cells maintain bone.
A
Osteocytes.
15
Q
These cells constitute 90% of cells in the mature skeleton.
A
Osteocytes.
16
Q
Osteocytes have _____ nuclear/cytoplasmic ratio.
A
high
17
Q
Osteocytes are important for extracellular concentrations of these.
A
Calcium and Phosphorous.
18
Q
Osteocytes are directly stimulated by _____.
A
calcitonin
19
Q
Osteocytes are inhibited by _____.
A
PTH.
20
Q
These cells resorb bone.
A
Osteoclasts.
21
Q
Osteoclast description.
A
Multinucleated, irregular giant cells.
22
Q
Osteoclasts are derived from this lineage.
A
Hematopoietic cells in macrophage line.
23
Q
Purpose of osteoclast ruffled border.
A
Increase surface area for resorption.
24
Q
Location of bone resorption.
A
Howship’s lacunae.
25
These proteins allow osteoclasts to bind to bone surfaces.
Integrins.
26
This osteoclast protein produces acidic environment for bone resportion.
Carbonic anhydrase.
27
Acidity effect on hydroxyapatite.
Increases solubility.
28
This lysosomal enzyme digests organic bone matrix.
Cathepsin K.
29
Calcitonin effect.
Inhibition of osteoclastic resorption.
30
Effect of IL-1 on bone.
Stimulates osteoclast differentiation and bone resorption.
31
Effect of IL-10 on osteoclasts.
Suppresses them.
32
Bisphosphonates do this.
Inhibit osteoclastic bone resorption.
33
Categories of bisphosphonates (2).
1. Nitrogen-containing. 2. Non-nitrogen-containing.
34
Examples of nitrogen-containing bisphosphonates (2).
1. Zoledronic acid (Zometa) 2. Alendronate (Fosamax)
35
Nitrogen-containing or non-nitrogen-containing bisphosphonates are more potent? By how much?
Nitrogen-containing, 1000-fold
36
Mechanism of action of nitrogen-containing bisphosphonates (3).
1. Block farnesyl pryophosphate synthase. 2. Loss of guanosine triphosphatase (GTPase) formation. 3. Ruffled border formation inhibited.
37
Pathway inhibited by nitrogen-containing bisphosphonates.
Mevalonate pathway.
38
Mechanism of action of non-nitrogen-containing bisphonsphonates.
Metabolized into a nonfunctional ATP analog, inducing apoptosis.
39
These medications decrease skeletal events in multiple myeloma.
Bisphosphonates.
40
These medications are associated with osteonecrosis of the jaw.
Bisphosphonates.
41
Bisphosphonates have this effect on spinal fusion in animal model.
Reduced rate of fusion.
42
Types of bone matrix (2).
1. Organic 2. Inorganic
43
Components of organic bone matrix (4).
1. Collagen 2. Proteoglycans 3. Non-collagenous matrix proteins 4. Growth factors and cytokines
44
Collagen constitutes \_\_\_% of the organic bone matrix.
90%
45
Function of collagen in organic bone matrix.
Provides tensile strength.
46
Function of proteoglycans in bone matrix.
Compressive strength.
47
Noncollagenous bone matrix proteins (3).
1. Osteocalcin 2. Osteonectin 3. Osteopontin
48
Most abundant noncollagenous bone matrix protein.
Osteocalcin.
49
Function of osteocalcin.
Attracts osteoclasts.
50
Function of osteopontin.
Cell-binding protein, similar to an integrin.
51
Examples of growth factors and cytokines in bone (5).
1. TGF-beta 2. IGF 3. IL-1 4. IL-6 5. BMPs
52
Most of inorganic bone matrix composed of this.
Calcium hydroxyapatite.
53
Components of inorganic bone matrix (2).
1. Calcium hydroxyapatite 2. Osteocalcium phosphate
54
Formula of calcium hydroxyapatite.
Ca10(PO4)6(OH)2
55
Function of calcium hydroxyapatite.
Compressive strength.
56
Collagen type in bone.
Type I.
57
Collagen cross-linking effects (2).
1. Decreases collagen solubility. 2. Increases tensile strength.
58
Regulators of osteocalcin (2).
1. Inhibited by PTH 2. Stimulated by 1,25-dihydroxyvitamin D3
59
This protein can be measure in serum or urine as a marker of bone turnover.
Osteocalcin.
60
Inorganic components of bone comprise \_\_\_% of the dry weight of bone.
60%
61
Wolff's law.
Bone remodelling occurs in response to mechanical stress.
62
Hueter-Volkmann law.
Compressive forces inhibit bone growth, tension stimulates it.
63
Bone receives \_\_\_% to \_\_\_% of cardiac output.
5-10%.
64
Long bones receive blood from three sources (3).
1. Nutrient artery system 2. Metaphyseal-epiphyseal system 3. Periosteal system
65
Direction of arterial flow in mature bone is \_\_\_\_.
Centrifugal (inside to outside).
66
Blood pressure in the nutrient artery system is \_\_\_\_.
High.
67
Blood pressure in the periosteal system is \_\_\_\_.
Low.
68
Blood flow direction in fractured bone.
Centripetal (outside to inside).
69
Venous flow direction in mature bone.
Centripetal (outside to inside).
70
Inner periostem.
Cambium.
71
Red marrow composition (3).
1. 40% water 2. 40% fat 3. 20% protein
72
Yellow marrow composition (3).
1. 15% water 2. 80% fat 3. 5% protein
73
Types of ossification (3).
1. Enchondral 2. Intramembranous 3. Appositional
74
Bone replaces cartilage model.
Enchondral ossification.
75
Embyronic formation of long bones is this type of ossification.
Enchondral ossification.
76
Longitudinal physeal growth is this type of ossification.
Enchondral ossification.
77
Fracture callus is this type of ossification.
Enchondral ossification.
78
Bone formed with demineralized bone matrix is this type of ossification.
Enchondral ossification.
79
Major source of nutrition of the growth plate.
Perichondral artery.
80
Multiple epiphyseal dysplasia affects the \_\_\_\_\_.
Epiphysis.
81
Spondyloepiphyseal dysplasia affects growth at the \_\_\_\_\_.
Physis.
82
Acromegaly affects growth at the \_\_\_\_.
Physis.
83
In this physeal zone, cells store lipids, glycogen, and proteoglycan aggregates.
Reserve zone.
84
Lysosomal storage diseases affect this physeal zone.
Reserve zone.
85
Physeal zone characterized by matrix production, stacking of chondrocytes, and longitudinal growth.
Proliferative zone.
86
Achondroplasia causes defects in this physeal zone.
Proliferative zone.
87
Growth hormone exerts effects in this physeal zone.
Proliferative zone.
88
These make up the hypertrophic zone (3).
1. Maturation 2. Degeneration 3. Provisional calcification
89
Normal matrix mineralization occurs in this physeal zone.
Hypertrophic zone.
90
This physeal zone widens in rickets.
Hypertrophic zone.
91
Enchondromas originate in this physeal zone.
Hypertrophic zone.
92
SCFE occurs in this physeal zone.
Hypertrophic zone.
93
Supplies chondrocytes to the periphery for lateral growth (width).
Groove of Ranvier.
94
Dense fibrous tissue anchoring the periphery of the physis.
Perichondrial ring of La Croix.
95
Undifferentiated mesenchymal cells aggregate into layers, differentiate into osteoblasts, and deposit an organic matrix that materializes.
Intramembranous ossification.
96
Embryonic flat bone formation is an example of this.
Intramembranous ossification.
97
Bone formation during distriction osteogenesis is an example of this.
Intramembranous ossification.
98
Blastema bone in young children with amputations is an example of this.
Intramembranous ossification.
99
Periosteal bone enlargement (width) is an example of this type of ossification.
Appositional ossification.
100
This protein stimulates bone formation by inducing metaplasia of mesenchymal cells into osteoblasts.
Bone morphogenic proteins (BMP).
101
BMP-2 use.
Acute open tibia fractures.
102
BMP-7 use.
Tibial non-unions.
103
BMP-3 use.
No osteogenic activity.
104
Cyclooxygenase-2 (COX-2) activity is required for this.
Normal enchondral ossification.
105
These antibiotics are toxic to chondrocytes and inhibit fracture healing.
Quinolones.
106
Fresh frozen allograft preserves \_\_\_\_.
BMP
107
Cortical allograft has ____ incorporation compared to cancellous.
Slower.
108
Fresh allograft has the highest _______ of the allograft types.
Immunogenicity.
109
Osteoconductive matrix.
Acts as a scaffold or framework for bone growth.
110
Osteoinductive factors.
Growth factors that stimulate bone formation (BMP).
111
Osteogenic cells.
Primitive mesenchymal cells, osteoblasts, osteocytes.
112
Demineralized bone matrix is _____ and \_\_\_\_\_.
Osteoconductive and osteoinductive.
113
Calcium is absorbed in this area of the GI tract.
Jejunum.
114
Calcium is absorbed in the gut by this mechanism.
Passive diffusion.
115
Calcium is filtered by the glomeruli and then \_\_\_\_.
Reabsorbed.
116
This percentage of calcium is reabsorbed by the kidneys.
98%
117
Primary regulators of serum calcium (2).
1. PTH 2. 1,25(OH)2-vitamin D3
118
Dietary requirement of elemental calcium for children.
600 mg/day
119
Dietary requirement of elemental calcium for adolescents and young adults.
1300 mg/day
120
Dietary requirement of elemental calcium for adults.
750 mg/day
121
Dietary requirement of elemental calcium for postmenopausal women.
1500 mg/day
122
Dietary requirement of elemental calcium for lactating women.
2000 mg/day
123
Dietary requirement of elemental calcium for pregnant women.
1500 mg/day
124
Dietary requirement of elemental calcium for patients healing fracture in long bone.
1500 mg/day
125
This percentage of body's phosphate stored in bones.
85%
126
Majority of calcium absorbed in this area of the kidney.
Proximal tubule.
127
Daily phosphate requirement.
1000 to 1500 mg.
128
PTH is comprised of ____ amino acids.
84
129
PTH is synthesized and secreted from here.
Chief cells of the parathyroid glands.
130
The active portion of PTH.
The N-terminal fragment (1-34).
131
Synthetic form of recombinant human PTH.
Teriparatide.
132
Effect of PTH is mediated by this mechanism.
cAMP.
133
Calcitonin is produced here.
Clear cells in parafollicles of the thyroid gland.
134
Active form of vitamin D.
1,25(OH)2-vitamin D3
135
Inactive vitamin D metabolite.
24,25(OH)2-vitamin D3
136
25-OHase is located here.
Liver.
137
1-OHase is located here.
Kidney.
138
Corticosteroids affect bone mineralization. True or False.
False.
139
Effects of corticosteroids on bone (2).
1. Decreased gut absorption of calcium by decreased binding proteins. 2. Inhibition of collagen synthesis.
140
Peak bone mass occurs between these ages.
16-25 years.
141
After peak, bone loss occurs at a rate of ____ to ____ per year.
0.3 to 0.5% per year
142
Rate of bone loss in women 6 - 10 years after menopause.
2-3% per year
143
Osteoporotic long bones have ______ inner diameter and _____ outer diameter.
Increased inner and outer diameters.
144
Elevated in urine when bone resorption occurs.
Hydroxyproline.
145
Brown tumors.
Primary hyperparathyroidism.
146
Pseudohypoparathyroidism.
PTH receptor abnormality.
147
Type I hereditary vitamin-D dependent rickets.
Defect in renal 1-alpha hydroxylase.
148
Type II hereditary vitamin-D dependent rickets.
Defect in intracellular receptor for 1,25(OH)2-Vitamin D.
149
Most commonly encountered form of rickets.
Hypophosphatemic rickets.
150
Hypophosphatemic rickets.
Inborn error of phosphate transport causing failure of phosphate reabsorption in the kidney.
151
Chronically elevated serum PTH results in.
Secondary hyperparathyroidism with hyperplasia of chief cells of parathyroid gland.
152
Causes of rickets and osteomalacia (5).
1. Nutritional deficiency 2. Phosphorous deficiency 3. GI absorption defects 4. Renal tubular defects 5. Renal osteodystrophy
153
Rickets.
Failure of mineralization, leading to changes in the physis in the zone of provisional calcification.
154
Serum calcium level in nutritional rickets.
Low-normal (maintained by high PTH).
155
Serum phosphate level in nutritional rickets.
Low (excreted due to effect of PTH).
156
Alkaline phosphatase level in nutritional rickets.
Increased.
157
Vitamin D level in nutritional rickets.
Low.
158
PTH level in nutritional rickets.
Increased (leads to increased bone resorption).
159
Types of hereditary vitamin D dependent rickets.
1. Type I -- Defect in renal 25(OH) 1alpha-hydroxylase 2. Type II -- Defect in intracellular receptor of 1,25(OH) - Vitamin D
160
Inheritance pattern of familial hypophosphatemic rickets.
X-linked dominant.
161
Vitamin D - resistant rickets.
Familial hypophosphatemic rickets.
162
Mechanism of hypophosphatemic rickets.
Impaired renal tubular reabsorption of phosphate.
163
Treatment of familial hypophosphatemic rickets.
1. Phosphate replacement 2. High dose vitamin D3
164
Inheritance pattern of hypophosphatasia.
Autosomal recessive.
165
Error in tissue-nonspecific isoenzyme of anklaline phosphatase.
Hypophosphatasia.
166
Diagnosis of hypophosphatasia.
Increased urinary phosphoenthanolamine.
167
This process remains normal in osteoporosis.
Mineralization
168
WHO definition of osteoporosis.
L2-L4 bone density 2.5 or more standard deviations less than peak bone mass of healthy 25 year old. (T-score)
169
WHO definition of osteopenia.
Bone density 1.0 to 2.5 standard deviations less than mean peak bone mass of healthy 25 year old. (T-score)
170
Risk for second vertebral osteoporotic compression fracture after the first.
20%
171
Lifetime risk of fracture in white women after 50 years of age.
75%
172
Life risk of hip fracture in white women after 50 years of age.
15-20%
173
Type I osteoporosis.
Post-menopausal.
174
Type II osteoporosis.
Age-related.
175
Plain radiographs may be normal in osteoporotic patients until decrease in bone mass exceeds this value.
30%
176
DEXA stands for.
Dual-energy x-ray absorptiometry.
177
Histologic changes in osteoporosis (3).
1. Thinning trabeculae 2. Decreased osteon size 3. Enlarged haversian and marrow spaces
178
Defect of bone mineralization in adults.
Osteomalacia.
179
Histologic finding in osteomalacia.
Widened osteoid seams.
180
Causes a decrease in chondroitin sulfate synthesis.
Vitamin C (ascorbic acid) deficiency.
181
Defects in vitamin C deficiency (2).
1. Defective collagen growth and repair 2. Impaired intracellular hydroxylation of collagen peptides.
182
Physis histology with vitamin C deficiency.
Widening of zone of provisional calcification.
183
Failure of normal collagen cross-linking as a result of glycine substitutions in pro-collagen.
Osteogenesis imperfecta.
184
Albers-Schonberg disease.
Benign osteopetrosis.
185
Rugger jersey spine.
Osteopetrosis.
186
Articular cartilage receives nutrients and oxygen primarily through this mechanism.
Diffusion.
187
pH of cartilage.
7.4
188
Composition of articular cartilage.
1. Water 65-80% 2. Collagen 10-20% 3. Proteoglycans 10-15% 4. Chondrocytes 5%
189
This amino acid is unique to collagen.
Hydroxyproline.
190
95% of collagen in articular cartilage.
Type II.
191
Type of collagen produced by chondrocytes during enchondral ossification.
Type X.
192
Subtypes of glycosaminoglycans (2).
1. Chondroitin sulfate 2. Keratin sulfate
193
Master switch of chondrocytes.
SOX9 transcriptional factor.
194
Chondrocytes are least active in this zone.
Calcified zone.
195
Articular cartilage layers (5).
1. Gliding zone (superficial) 2. Transitional zone (middle) 3. Radial zone (deep) 4. Tidemark 5. Calcified zone
196
Articular cartilage gliding zone function.
Opposes shear.
197
Articular cartilage transitional zone function.
Opposes compression.
198
Articular cartilage radial zone function.
Opposes compression.
199
Articular cartilage tidemark zone function.
Opposes shear.
200
Articular cartilage calcified zone function.
Anchor.
201
Superficial articular cartilage zone.
Gliding zone.
202
Middle articular cartilage zone.
Transitional zone.
203
Deep articular cartilage zone.
Radial zone.
204
Orientation of collagen in the gliding articular cartilage zone.
Tangential.
205
Orientation of collagen in the transitional articular cartilage zone.
Oblique.
206
Orientation of collagen in the radial articular cartilage zone.
Vertical.
207
Predominant mechanism of lubrication during dynamic joint function.
Elastohydrodynamic lubrication.
208
The peripheral \_\_\_\_% of the meniscus is supplied by vessels. The remainder receives nutrition through \_\_\_\_.
25%, diffusion
209
This cell type is responsible for meniscal healing.
Fibrochondrocyte.
210
These meniscus tears heal the best.
Peripheral, acute with rim width larger than 4mm.
211
Osteoarthritis cartilage has _____ water content.
Increased.
212
Chondroitin/keratin sulfate ratio in osteoarthritis cartilage.
Increased.
213
Most common cause of upper extremity neuropathic arthropathy.
Syringomyelia.
214
Technitium bone scan in Charcot arthropathy.
May be positive in both infection and Charcot.
215
Indium leukocyte scan in Charcot arthropathy.
Negative in Charcot. Positive in osteomyelitis.
216
Degenerative arthritis resulting from alkaptonuria.
Ochronosis.
217
The most common inflammatory arthritis.
Rheumatoid arthritis.
218
Conditions in which rheumatoid factor may be positive (4).
1. Rheumatoid arthritis 2. Sjogren's syndrome 3. Sarcoid 4. SLE
219
Conditions in which ANA may be positive (3).
1. SLE 2. Sjogren's syndrome 3. Scleroderma
220
Primary cellular mediators of tissue destruction in RA.
Mononuclear cells.
221
RF is directed against this molecule.
IgG.
222
RF is most commonly this type of immunoglobulin.
IgM.
223
Acute-onset juvenile RA with fever, rash, and splenogmegaly.
Still's disease.
224
Mortality in SLE is related to ____ involvement.
Renal.
225
Butterfly malar rash.
SLE.
226
Most common feature of SLE.
Joint involvement.
227
Aching and stiffness of the shoulder and pelvic girdle.
Polymyalgia rheumatica.
228
Has an association with temporal arteritis.
Polymyalgia rheumatica.
229
Marginal syndesmophytes.
Ankylosing spondylitis.
230
Conjunctivitis, urethritis, and oligoarticular arthritis.
Reiter's syndrome.
231
Sausage digits.
Psoriatic arthropathy.
232
Pencil-in-cup deformity.
Psoriatic arthropathy.
233
Monosodium urate crystal deposition.
Gout.
234
Second most affected organ in gout.
Kidneys.
235
Thin, negatively birefringent crystals.
Monosodium urate.
236
Mechanism of allopurinol.
Xanthine oxidase inhibitor.
237
Xanthine oxidase is needed for these reactions (2).
1. Hypoxanthine to xanthine 2. Xanthine to uric acid
238
Calcium pyrophosphate deposition.
Pseudogout.
239
Short, rhomboid-shaped positively birefringent crystals.
Calcium pyrophosphate.
240
The crystal is blue when long axis of the crystal in parallel to the compensator of the microscope.
Positive birefringence.
241
The crystal is yellow when long axis of the crystal in parallel to the compensator of the microscope.
Negative birefringence.
242
Borrelia burgdorferi causes this disease.
Lyme disease.
243
Recurrent knee effusion with history of erythema migrans.
Lyme disease.
244
Lyme disease treatment.
Doxycycline
245
Hemophilic arthropathy associated with these deficiencies (2).
1. Factor VIII deficiency 2. Factor IX defeciency
246
Most characteristic organism causing osteomyelitis in sickle cell patients.
Salmonella.
247
Most common organism causing osteomyelitis in sickle cell patients.
Staphylococcus.
248
Pigmented synovial histiocytes.
PVNS
249
Sarcomere lines and bands (5).
1. Z line 2. M line 3. H band 4. I band 5. A band
250
Surrounds individual muscle bundles.
Epimysium.
251
Surrounds muscle fascicles.
Perimysium.
252
Surrounds individual fibers.
Endomysium.
253
Contains only myosin (thick) filaments.
H-band.
254
Contains only actin (thin) filaments.
I-band.
255
Lies between I bands and contains the H-band.
A band.
256
Thin (actin) filaments are attached to this.
Z-line.
257
Shortage of acetylcholine receptors.
Myesthenia gravis.
258
Blocks presynaptic acetylcholine release.
Botulinum toxin.
259
Troponin is located on actin or myosin?
Actin (thin filaments).
260
Constant muscle tension
Isotonic.
261
Muscle length remains unchanged.
Isometric.
262
Muscle contracts at constant velocity.
Isokinetic.
263
Type I muscle fibers (3).
1. Slow twitch 2. Oxidative 3. Red
264
Type II muscle fibers (3).
1. Fast twitch 2. Glycolytic 3. White
265
Muscle energy systems (3) and time courses.
1. ATP-creatine phosphate system (10-20 sec) 2. Lactic anaerobic system (20-120 sec) 3. Aerobic system (longer duration)
266
Female athlete triad (3)
1. Amenorrhea 2. Osteoporosis 3. Anorexia
267
Most common sports injury.
Muscle strain.
268
Muscle strains occur at this location in these muscles.
Myotendinous junction, muscle crossing two joints
269
Hypotension with bradycardia.
Spinal (neurogenic) shock.
270
These nerve fibers originate in receptors in muscle, skin, and sense organs of the head.
Somatic afferent fibers.
271
These cells are responsible for myelinating peripheral nerve axons.
Schwann cells.
272
Meissner's corpuscle detects \_\_\_\_.
touch
273
Pacini's corpuscle detects \_\_\_\_.
flutter
274
Ruffini's corpuscle detects \_\_\_\_\_.
vibration
275
Merkel's receptor detects \_\_\_\_\_.
Steady skin indentation
276
Gaps between Schwann cells.
Nodes of Ranvier.
277
Complete nerve division with disruption of the endoneurium.
Neurotmesis.
278
Disruption of the axon and myelin sheath but leaving epineurium intact.
Axonotmesis.
279
Selective demylination of the axon sheath, generally due to local ischemia.
Neurapraxia.
280
First sensation to return after nerve injury.
Pain.
281
In brachial plexus injury, positive histamine response implies this.
That reflex arc is intact.
282
A positie histamine response indicates that the lesion is proximal to this location.
Ganglion (preganglionic).
283
Predominant cell type in tendons.
Fibroblasts.
284
Early tendinous healing with this type of collagen.
Type III.
285
After surgical repair, tendon is weakest at this timepoint.
7-10 days
286
Maximum tendon strength achieved at this time post repair.
6 months
287
Most of original tendon strength regained at time period after repair.
21-28 days
288
The two types of ligament insertion.
1. Acute angles into periosteum 2. 90 degree angle into bone
289
Two components of the intervertebral disc (2).
1. Central nucleus pulposus 2. Surrounding annulus fibrosis
290
Content of nucleus pulposus.
High glycosaminoglycan/low collagen
291
Content of annulus fibrosis.
High collagen/low glycosaminoglycan
292
How intervertebral discs obtain nutrition.
Diffusion through hyaline cartilage endplates.
293
Aging intervertebral discs have decreased ___ content.
water
294
Aging discs have a decrease in the concentration of this molecular and increase in the concentration of thi molecule.
Decrease in proteoglycan concentration. Increase in keratin sulfate concentration.
295
Osteoarticular allografts preserved with cryopreservation.
No viable chondrocytes after clinical preservation.
296
Method of allograft preservation in which there is a controlled rate freezing in a protective medium.
Cryopreservation.
297
Synthetic ligaments are associated with these.
Sterile joint effusions.
298
Identifies a particular DNA sequence in an extract of mixed DNA.
Southern blotting.
299
Identifies a particular RNA sequence in an extract of mixed RNA.
Northern blotting.
300
Identifies a particular protein in an extract of mixed proteins.
Western blotting.
301
Used to reverse transcribe RNA to complementary DNA.
Reverse transcriptase.
302
The production of genetically identical biologic entities.
Cloning.
303
Cell involved in specific immune responses (2).
B and T cells.
304
Adaptive immune response broken down into these two.
1. Cell mediated 2. Humoral
305
B lymphocytes mature here.
Lymph nodes.
306
T lymphocytes originate here.
Bone marrow.
307
Immune responses are evoked by these.
Antigens.
308
Five classes of immunoglobulins.
1. IgA 2. IgM 3. IgG 4. IgD 5. IgE
309
Growth control genes
Oncogenes
310
Tumor supressor genes
Antioncogenes
311
Most common sites of primary tumors that metastasize to bone (5).
1. Breast 2. Prostate 3. Lung 4. Kidney 5. Thyroid
312
Quantify the amount of DNA in cells.
Flow cytometry.
313
Modes of mendelian inheritance (4).
1. Autosomal dominant 2. Autosomal recessive 3. X-linked dominant 4. X-linked recessive
314
All daughters of an affected father have the trait but no sons.
X-linked dominant.
315
Genetic disease becomes progressively more severe in each subsequent generation.
Anticipation.
316
Abnormal number of chromosomes.
Aneuploidy.
317
Three copies of chromosomes.
Triploidy.
318
One chromosome pair has an extra chromosome.
Trisomy.
319
A section of one chromosomes is absent.
Deletion.
320
Extra section of one chromosome is present.
Duplication.
321
Portion of one chromosome is exchanged with a portion of another chromosome.
Translocation.
322
Broken portion of a chromosome reattaches to the same chromosome in the same location but reverse direction.
Inversion.
323
Inheritance pattern of achondroplasia.
Autosomal dominant.
324
Inheritance pattern of diastrophic dysplasia.
Autosomal recessive.
325
Inheritance pattern of McCune-Albright syndrome.
Sporadic mutation.
326
Inheritance pattern of multiple epiphyseal dysplasia.
Autosomal dominant.
327
Inheritance pattern of hypophasphatemic rickets.
X-linked dominant.
328
Inheritance pattern of hereditary vitamin D-dependent rickets.
Autosomal recessive.
329
Inheritance pattern of Marfan's syndrome.
Autosomal dominant.
330
Inheritance pattern of Ehlers-Danlos syndrome.
Autosomal dominant.
331
Inheritance pattern of Duchenne's muscular dystrophy.
X-linked recessive.
332
Inheritance pattern of Becker's muscular dystrophy.
X-linked recessive.
333
Inheritance pattern of hemophilia A and B.
X-linked recessive.
334
Inheritance pattern of sickle cell anemia.
Autosomal recessive.
335
Inheritance pattern of Gaucher's disease.
Autosomal recessive.
336
Inheritance pattern of hemochromatosis.
Autosomal recessive.
337
Inheritance pattern of Charcot-Marie-Tooth disease.
Autosomal dominant.
338
Inheritance pattern of neurofibromatosis.
Autosomal dominant.
339
Streptococcus viridans source.
Human bite.
340
Pasteurella canis source.
Dog bite.
341
Pasteurella multocida source.
Cat bite.
342
Most common risk factor for necrotizing fasciitis.
Diabetes.
343
Types of necrotizing fasciitis infections (4).
1. Type 1 - polymicrobial 2. Type 2 - group A beta-hemolytic strep 3. Type 3 - marine vibrios 4. Type 4 - MRSA
344
Characteristic osteomyelitis organism of sickle cell anemia.
Salmonella.
345
Nail through sole of shoe.
Pseudomonas aeruginosa.
346
HIV risk of seroconversion from contaminated needle stick.
0.3%
347
Risk of HIV transmission through blood transfusion.
1/500,000 per unit transfused.
348
Cat scratch fever organism.
Bartonella henselae.
349
Cat scratch fever treatment.
Azithromycin.
350
Inhibit cross-linking of polysaccharides in the cell wall by blocking transpeptidase enzyme.
Beta-lactams.
351
Beta-lactam antibiotic examples (2).
1. Penicillin 2. Cephalosporins
352
Inhibit protein synthesis through binding to 30S-ribosomal subunit.
Aminoglycosides.
353
Aminoglycoside examples (2).
1. Gentamicin 2. Tobramycin
354
Inhibit dissociation of peptidyl-transfer RNA from ribosomes during translocation (50S-ribosomal subunit).
Clindamycin and macrolides.
355
Examples of macrolides (3).
1. Erythromycin 2. Clarithromycin 3. Azithromycin
356
Vancomycin mechanism.
Interfere with insertion of glycan subunits into cell wall.
357
Inhibits RNA polymerase F.
Rifampinin.
358
Inhibit DNA gyrase.
Quinolones.
359
This amount of antibiotic powder in cement does not affect the compressive strength of the PMMA.
2g abx per 40g powdered PMMA
360
Virchow's triad.
1. endothelial damage 2. venous stasis 3. hypercoagulability
361
Gold standard for diagnosing DVT.
Venography.
362
Warfarin mechanism of action.
Inhibition of vitamin K 2,3-epoxide reductase in the liver.
363
Total lymphocyte count threshold to promote healing.
1500/mm3
364
Transcutaneous oxygen level above this threshold promotes healing.
30mmHg
365
Treatment for malignant hyperthermia.
Dantrolene sodium.
366
First signs of malignant hyperthermia (2).
1. Increased end-tidal Co2 2. Tachycardia
367
Gold standard for neuromonitoring intraop.
Wake up test.
368
These herbal medicines increase the risk of perioperative bleeding (3).
1. Garlic 2. Ginkgo biloba 3. Ginseng
369
Technitium bone scan detects (3).
1. Infection 2. Trauma 3. Tumor
370
Phases of three phase bone scans.
1. Blood flow, immediate 2. Blood pool, 30 min 3. Delayed, 4 hrs
371
Indium scans are specific for.
Inflammation.
372
Type of stainless steel used in orthopaedic implants.
316L
373
Elements found in stainless steel (6).
1. Iron 2. Carbon 3. Chromium 4. Nickel 5. Molybdenum 6. Manganese
374
Healing below melting point.
Annealing.
375
Polyethylene particles of this size are most reactive.
0.1 - 1.0 micrometers
376
Main determinant of elastic modulus of cortical bone.
Mineral content.
377
Distance between threads in a screw.
Pitch.
378
To maximize pullout strength of screw (3).
1. Large outer diameter 2. Small root diameter 3. Fine pitch
379
Nail bending rigidity related to this.
4th power of nail's radius.
380
Force within a joint in response to forces acting on the joint.
Joint reaction force.
381
Coefficient of friction for human joints.
0.002 to 0.04
382
Coefficient of friction for metal-on-poly.
0.05 to 0.15
383
Primary lubrication mechanism for articular cartilage during dynamic function.
Elastohydrodynamic lubrication.
384
Screw home mechanism of knee.
External tibial rotation during last 15 degrees of extension.
385
This characteristic of the knee increases maximum knee flexion.
Posterior rollback.
386
Amount of rotation through C1-C2.
45 degrees.
387
Amount of rotation through subaxial cervical spine.
10 degrees.
388
Spine coupled motion.
Axial rotation with lateral bending.
389
Glenohumeral abduction.
120 deg
390
Scapulothoracic shoulder abduction.
60 deg.
391
Most important static stabilizer of the shoulder.
Inferior glenohumeral ligament.
392
Glenohumeral arthrodesis position (3).
15-20 deg abduction 20-25 deg forward flexion 40-50 deg internal rotation
393
Humeral head inclination
125 deg
394
Humeral head position relative to shaft
25 deg retroversion
395
Functional elbow ROM.
30-130.
396
Elbow carrying angle for men and women.
Men 7 deg, women 13 deg.
