[Ex4] - C42 - AP Flashcards
42-1. While performing an assessment of a 2-month-old child, the nurse notes a positive Ortolani
click. The nurse would suspect the child has:
a. a hip fracture.
b. hip dysplasia.
c. osteogenesis imperfecta.
d. osteomyelitis.
ANS: B
Ortolani click is symptomatic of developmental dysplasia of the hip. A hip fracture would be
evident by shortening of the leg and external rotation. Osteogenesis imperfecta is diagnosed
by fractures. Osteomyelitis is diagnosed by fever and infection.
42-2. A 9 month old was diagnosed with osteogenesis imperfecta (OI). This disease is caused by:
a. uterine teratogens.
b. a genetic defect.
c. malnutrition.
d. trauma.
ANS: B
OI (brittle bone disease) is a spectrum of disease caused by genetic mutation in the gene that
encodes for type I collagen, the main component of bone and blood vessels. OI (brittle bone
disease) is not due to teratogens, malnutrition, or a fracture.
42-3. A 9-month-old male was diagnosed with osteogenesis imperfecta (OI). This disease is caused
by errors in the synthesis of:
a. elastin.
b. glycoproteins.
c. collagen.
d. calcium salts.
ANS: C
OI (brittle bone disease) is a spectrum of disease caused by genetic mutation in the gene that
encodes for type I collagen. OI (brittle bone disease) is not caused by faulty synthesis of
elastin, glycoproteins, or calcium salts.
42-4. Children with osteogenesis imperfecta (OI) are at high risk for frequent:
a. bone fractures.
b. shoulder dislocations.
c. bone infections.
d. joint injuries.
ANS: A
Children with OI experience frequent bone fractures. They are not as susceptible for shoulder
dislocations, bone infections, or other joint injuries.
42-5. A 1-year-old female was diagnosed with osteogenesis imperfecta (OI). Which complication
must be monitored for?
a. Congestive heart failure
b. Liver failure
c. Aortic aneurysm
d. Pulmonary emboli
ANS: C
Because type I collagen is also the main component of blood vessels, vascular deformity, such
as aortic aneurysm, can occur. Neither congestive heart failure, liver failure, nor pulmonary
emboli are associated with osteogenesis imperfecta (OI).
42-6. Legg-Calvé-Perthes (LCP) disease affects which of the following joints?
a. Vertebral
b. Shoulder
c. Hip
d. Knee
ANS: C
LCP affects the hip. This condition is not associated with the vertebrae, the shoulder, or the
knee.
42-7. Osgood-Schlatter disease causes inflammation of the:
a. shoulder joint.
b. patellar tendon.
c. elbow ligaments.
d. hip cartilage.
ANS: B
Osgood-Schlatter affects the patella, not the shoulder, elbow, or hip.
42-8. Which type of scoliosis accounts for the majority of the cases of scoliosis?
a. Idiopathic
b. Infectious
c. Iatrogenic
d. Secondary
ANS: A
Eighty percent of all scoliosis is idiopathic.
42-9. The treatment of Osgood-Schlatter disease includes:
a. steroids.
b. restriction from physical activity.
c. intense physical therapy.
d. knee replacement surgery.
ANS: B
The primary treatment of Osgood-Schlatter disease includes restriction from physical activity.
The primary treatment does not include steroids, intense physical therapy, or knee
replacement.
42-10. Duchenne muscular dystrophy (DMD) has a(n) _____ inheritance pattern.
a. autosomal recessive
b. X-linked recessive
c. Y-linked dominant
d. autosomal dominant
ANS: B
DMD is X-linked, occurring only in boys.
42-11. The onset of Duchenne muscular dystrophy (DMD) most often occurs at:
a. 3–6 months of age.
b. preschool years.
c. school age.
d. the onset of puberty.
ANS: B
Boys with DMD will present in the preschool years with muscle weakness, difficulty walking,
and large calves.
42-12. A 3-year-old male is diagnosed with Duchenne muscular dystrophy. Treatment will include:
a. aspirin.
b. antivirals.
c. steroids.
d. chemotherapy.
ANS: C
Treatment with steroids can prolong the ability to walk by several years and improves life
expectancy. Treatment does not include aspirin, antivirals, or chemotherapy.
42-13. A 22-year-old female whose brother is diagnosed with Duchenne muscular dystrophy (DMD)
wants to know if her children will inherit it. A fairly accurate test to identify female carriers of
the disease is measurement of serum levels of:
a. dystrophin.
b. myoglobin.
c. creatine kinase (CK).
d. troponin 1.
ANS: C
Diagnosis is confirmed by measuring the blood CK level, which is sometimes 100 times the
normal level, with confirmation by genetic testing for mutations in the dystrophin gene. None
of the other options is relevant to this screening.
42-14. A 13 year old presents with pain at night, cough, and dyspnea and is diagnosed with a
metastasizing malignant bone tumor. The most likely type of tumor is:
a. nonossifying fibroma.
b. chondrosarcoma.
c. Ewing sarcoma.
d. osteosarcoma.
ANS: D
With osteosarcoma, the most common presenting complaint is pain. Night pain, awakening a
child from sleep, is a particularly foreboding sign. There may be swelling, warmth, and
redness caused by the vascularity of the tumor. Symptoms may also include cough, dyspnea,
and chest pain if lung metastasis is present. This symptomatology is not associated with the
other options.
42-15. Osteosarcoma is most likely present in the _____ of long bones.
a. epiphyses
b. metaphyses
c. marrow
d. osteocytes
ANS: B
Osteosarcoma occurs mainly in the metaphyses of long bones near sites of active physical
growth, not in the epiphyses. Osteosarcoma is not associated with the marrow or osteocytes.
