Exam 1

Question 1

General term for a developmental anomaly of bone

Answer 1

Dysostosis

Question 2

mutation which interfere with growth or homeostasis

Answer 2

Dysplasia

Question 3

T/F Osteodysplasia and chondrodysplasia are pre-cancerous

Answer 3

False

Question 4

An idiopathic congenital fusion of any 2 (or more) cervical vertebrae

Answer 4

Klippel-Feil syndrome
(dysostosis)
-also commonly associated with Sprengel’s deformity

Question 5

Most common congenital malformation of the limbs

Answer 5

Syndactyly

Question 6

Osteogenesis imperfecta is an autosomal dominant disorder which affects Type _ collagen fibers

Answer 6

Type 1

Question 7

Autosomal dominant, congenital disorder that can lead to a bluish tint in the sclera

Answer 7

Osteogenesis imperfecta

-abnormal collagen of the choroid

Question 8

Type 1 or 2 Osteogenesis imperfecta is lethal

Answer 8

Type 2 (in utero) is lethal 
-cerebral hemorrhage, respiratory failure

Question 9

Most common form of dwarfism, generally characterized by short proximal extremities, bullet vertebrae, trident hand

Answer 9

Achondroplasia

Question 10

Congenital disorder involving a mutation to the FGFR3 gene, what does this mutation inhibit?

Answer 10

Achondroplasia

• Inhibits epiphyseal plate chondrocytes
• dwarfism

Question 11

More severe form of achondroplasia involving a severely underdeveloped thorax

Answer 11

Thanatophoric dwarfism

Question 12

Bullet vertebrae and a trident hand are commonly associated with what congenital disorder

Answer 12

Achondroplasia

Question 13

Congenital disorder in which the medullary cavity fills because of decreased osteoclast activity

Answer 13

Osteopetrosis

Question 14

Erlenmyer flask deformity is associated with Gaucher disease and what other disorder

Answer 14

Osteopetrosis

Question 15

Osteoporosis most commonly impacts what type of bone

Answer 15

Trabecular bone

-cancellous, spongy

Question 16

3 areas tested with a Dexa scan

Answer 16

vertebral body, calcaneus, femoral neck

Question 17

An increase in serum alkaline phosphatase is diagnostic for what acquired disease

Answer 17

Paget disease

-byproduct of osteoblast activity

Question 18

T/F Paget disease is most commonly asymptomatic

Answer 18

True 70-90%

-relatively benign

Question 19

80% of cases of Paget disease involve what specific ares of the skeleton

Answer 19

Axial skeleton (pelvis, sacrum, skull)
Femur

Question 20

While viewing an x-ray of the pelvis the bones have a “shaggy” appearance and increased bone mass, likely diagnosis?

Answer 20

Paget disease

-most common mid to late adult (70 years)

Question 21

Male patient, 73 years old complains that his favorite hat of 6 years all of a sudden is too small for his head, likely diagnosis?

Answer 21

Paget disease

• More common in males
• Most common around 70 years of age
• Skull commonly affected

Question 22

Most common pediatric soft tissue sarcoma

Answer 22

Rhabdomyosarcoma

• malignant
• aggressive
• 2/3 cured, poor prognosis for adults

Question 23

Leiomyosarcoma is more common in males or females

Answer 23

females

• malignant
• painless mass

Question 24

Virtually all skeletal muscle tumors are benign or malignant

Answer 24

malignant

Question 25

Depuytren contracture is an example of superficial or deep fibromatosis

Answer 25

superficial fibromatosis

Question 26

a benign tumor of adipocytes

Answer 26

lipoma | -MC soft tissue tumor of adults

Question 27

Soft tissue tumors are more common in the upper or lower extremities

Answer 27

lower extremities | -benign almost 100x more often than malignant

Question 28

Pain is involved with diffuse or localized tenosynovial giant cell tumor (TGCT)

Answer 28

diffuse tgct - MC in knee - locking, pain, decreased ROM - macrophages accumulate

Question 29

Most common soft tissue tumor of the hand

Answer 29

Localized tenosynovial giant cell tumor (TGCT) | -painless mass

Question 30

macrophages accumulate with diffuse or localized TGCT

Answer 30

diffuse TGCT

Question 31

location of a baker cyst

Answer 31

popliteal region - type of synovial cyst - benign

Question 32

organism responsible for lyme disease

Answer 32

Borrelia burgdorferi - spirochete infection - bulls eye rash

Question 33

60-80% of untreated lyme disease will lead to what condition

Answer 33

lyme arthritis | -joint destruction

Question 34

suppurative arthritis is most common in what joint

Answer 34

knee | -pus forming

Question 35

type of arthritis following a subacute course

Answer 35

gonococcal arthritis - neisseria gonorrhoeae - polyarticular - MC females

Question 36

80% of paget disease cases involve which areas of the body

Answer 36

axial skeleton or femur

Question 37

MC age of diagnosis for paget disease

Answer 37

70 years old

Question 38

Osteomalacia is involved with a vitamin __ deficiency, also associated with (hyper/hypo) parathyroidism?

Answer 38

vitamin D deficiency hypERparathyroidism -remodeled bone is under mineralized

Question 39

Parathyroid glands secrete PTH functioning to maintain serum ___ levels

Answer 39

Calcium

Question 40

most common cause of excessive PTH

Answer 40

adenoma (benign gland tumor)

Question 41

most common nonmalignant cause of hypercalcemia

Answer 41

hyperparathyroidism

Question 42

If cortical and trabecular bone is replaced with loose connective tissue known as a "brown tumor" what is the most likely diagnosis

Answer 42

Hyperparathyroidism

Question 43

Numerous small erosions of the skull creating the appearance of a "salt and pepper skull" on X-ray is associated with what condition

Answer 43

Hyperparathyroidism

Question 44

iatrogenic

Answer 44

caused by Dr.

Question 45

acute or chronic osteomyelitis is more common

Answer 45

acute osteomyelitis - "bone-marrow-inflammation" - marrow infection - leukocytes destroy bone

Question 46

Patient suffering from pyogenic osteomyelitis and sickle cell disease, what would be the most likely causative organism for their osteomyelitis

Answer 46

salmonella

Question 47

overall most common causative bacteria of pyogenic osteomyelitis

Answer 47

staph. aureus

Question 48

2 subtypes of osteomyelitis

Answer 48

Pyogenic | Tuberculosis

Question 49

which of the following is not associated with pyogenic osteomyelitis - involucrum - caseous granuloma - sequestrum - draining sinus

Answer 49

caseous granuloma | -assoc. with tuberculosis osteomyelitis

Question 50

Dead bone at the site of pyogenic osteomyelitis

Answer 50

Sequestrum

Question 51

When tuberculosis spreads to the spine it is known as:

Answer 51

Pott disease | -can have neurologic deficits

Question 52

Primary or Secondary bone tumors are more common

Answer 52

Secondary metastisis to bone

Question 53

benign or malignant bone tumors are more common

Answer 53

benign

Question 54

Osteomas are benign, superficial, hard masses most commonly found where

Answer 54

head, facial bones | -40-50 years

Question 55

Differentiate between an osteoid osteoma and an osteoblastoma

Answer 55

``` osteoma is smaller, localized nocturnal pain, aspirin relieves symptoms, MC at proximal femur and tibia (osteoblastoma MC vertebra) ```

Question 56

15 year old male patient presents with localized pain at the proximal femur region only at night and when he takes aspirin the pain goes away. What is a likely diagnosis

Answer 56

Osteoid osteoma - MC 10-20yr old (males 2x MC) - aspirin relieves pain***

Question 57

T/F Codman's is a radiographic finding associated with a benign bone tumor

Answer 57

False, assoc. with Osteosarcoma - AGGRESSIVE malignant tumor - MC primary bone cancer

Question 58

T/F in older patients osteosarcoma is usually secondary to conditions such as Paget disease or AVN

Answer 58

True | >40 years old

Question 59

Most common age for Typical (primary) Osteosarcoma | What is the prognosis?

Answer 59

10-20 years | -60-70% survival- amputation, chemo

Question 60

Which is more fatal, Primary or Secondary Osteosarcoma

Answer 60

Co-morbid (secondary) osteosarcoma | -poor response to therapy

Question 61

Chondroma involving multiple lesions is also known as _____ disease

Answer 61

Ollier disease | -MC unilateral

Question 62

MC location for multiple hereditary osteochondroma

Answer 62

Knee - genetic - MC in males

Question 63

Solitary enchondromas (chondroma) are more likely to be found where

Answer 63

tubular bones of the hands (proximal phalanges, metacarpals)

Question 64

Low or High grade chondrosarcoma involves cortical erosion

Answer 64

High grade - poor prognosis - 70% mets-->MC to lung

Question 65

Shepherd's crook deformity of the femur is commonly assoc. with what condition

Answer 65

Polyostotic Fibrous Dysplasia - severe deformity - 50% of cases involve craniofacial bones

Question 66

condition characterized by involving polyostotic fibrous dysplasia, endocrinopathy involvement, and cafe au lait spots

Answer 66

McCune-Albright syndrome - endocrine hyper functioning - skin lesions usually unilateral