H.E.M.A.N. (Hematopoietic, Endocrine, Metabolic, and Nutritional Disorders) Flashcards Preview

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Flashcards in H.E.M.A.N. (Hematopoietic, Endocrine, Metabolic, and Nutritional Disorders) Deck (65):
1

In a patient with eosinophilic granuloma, what does a radiodense focus within a lytic cranial lesion represent?

a. target lesion
b. button sequestrum
c. rain-drop skull
d. geographic skull

b. button sequestrum

2

Periosteal new bone formation in thyroid acropachy is most commonly seen in which bones?

a. radius and ulna
b. tibia and fibula
c. metacarpals and metatarsals
d. femur and humerus

c. metacarpals and metatarsals

3

A middle-aged man on long-term hemodialysis complains of moderate low-back pain, which began insidiously several months ago. Lumbar spine radiographs taken four weeks ago were essentially unremarkable, but a new set of radiographs demonstrates loss of the L2/3 and L3/4 disc spaces, with endplate destruction, reactive subchrondral sclerosis, and bony spurring and fragmentation. The patient's white blood cell count and erythocyte sedimentation rate are within normal limits. These findings are consistent with?

a. infectious spondylitis due to hemodialysis
b. destructive spondyloarthropathy of hemodialysis
c. amyloidosis
d. Metastatic disease from an unknown primary tumor

b. destructive spondyloarthropathy of hemodialy

4

Although a certain degree of subperiosteal resorption may be seen with disease causing high bone turnover, when extensive, it is pathognomonic for which disorder?

a. osteoporosis
b. osteopenia
c. osteomalacia
d. osteoclastoma

b. osteopenia

5

Which of the following disorders has a pathogensis similar to Osgood-Schlatter's disease and may coexist with it?

a. Blount's disease
b. osteoochodritis dissecans
c. Sinding-Larsen-Johnansson disease
d. spontaneous osteone of the knee (SONK)

c. Sinding-Larsen-Johnansson disease

6

The radiographic finding of increased radiolucency of bone is best termed?

a. osteoporosis
b. osteopenia
c. osteomalacia
d. osteoclastoma

b. osteopenia

7

Although a certain degree of subperiosteal resorption may be seen with disease causing high bone turnover, when extensive, it is pathognomonic for which disorder?

a. osteoporosis
b. hyperparathyroidism
c. reflex sympathetic dystrophy syndrome
d. osteogenesis imperfecta

b. hyperparathyroidism

8

Which of the following best describes the distribution in individual bones of periosetal new bone formation in thyroid acropachy?

a. generally symmetric
b. diaphyses are most involved
c. more prominent on the ulnar aspect
d. the distribution is completely unpredictable

b. diaphyses are most involved

9

Which of the following is a common finding in the spine in patients with acromegaly?

a. posterior osteophyte formation
b. disc calcification
c. marginal syndesmophytes, similar to those seen in ankylosing sponylitis
d. posterior scalloping

d. posterior scalloping

10

The most common causes of generalized osteoporosis are senescent osteoporosis and...

a. hyperparathryoidism
b. osteogenesis imperfecta
c. postmenopausal osteoporosis
d. multiple myeloma

c. postmenopausal osteoporosis

11

In osteomalacia, radiolucent areas oriented at right angles to the cortex, which incompletely span the diameter of the bone, represent what?

a. Fatigue fractures
b. Losers lines
c. Greenstick injuries
d. Harris lines

b. Losers lines

12

In which location within bone is conversion of bone marrow from fatty to red marrow considered unusual, at any age after the first few months of life?

a. femoral neck
b. base of the skull
c. apophyses or epiphyses
d. vertebral bodies

c. apophyses or epiphyses

13

Where is Thiemann's osteochondrosis found?

a. fifth metatarsal base
b. ischiopubic sychondrosis
c. tarsal navicular
d. phalangeal bases

d. phalangeal bases

14

In magnetic resonance imaging of osteonecrosis of the femoral head, which of the following is a specific indicator of ischemic necrosis of the femoral head?

a. double-line sign
b. snowcap appearance
c. cresent sign
d. sagging-rope sign

a. double-line sign

15

Flattening and sclerosis of the 3rd metatasal head, with enlargement and irregularity of the base of the proximal phalanx, is an osteonecrosis most commonly seen in?

a. adolescent males
b. adult males
c. adolescent females
d. adult females

c. adolescent females

16

What is the fundamental morphologic abnormality that leads to arthritic compliants in patients with acromegaly?

a. increased tendency of the subchondral bone to fracture

b. capsular laxity leading to joint instability

c. overgrowth of cartilage with a more fragile ground substance matrix

d. a marked tendency to calcuim pyrophosphate dihydrate crystal deposition (CPPD)

c. overgrowth of cartilage with a more fragile ground substance matrix

17

In addition to vertebra plana, how may eosinophilic granuloma present in the spine?

a. ivory vertebra
b. band-like radiolucencies
c. soap-bubbly
d. diffuse osteopenia

c. soap-bubbly

18

Which of the following neoplasms is most frequently found to lead to oncogenic osteomalacia, as determined by histological analysis?

a. non-ossifying fibroma
b. hemangiopericytoma
c. giant cell tumor
d. hemangioendothelioma

b. hemangiopericytoma

19

Although any area of the skelton can be used when evaluating cortical bone loss in metabolic bone disease, which bones are usually investigated?

a. the proximal femur
b. the tubular bones of the hand
c. the lumbar spine
d. the calcaneus

b. the tubular bones of the hand

20

What is the cause of Legg-Calve-Perthes disease?

a. osteonecrosis
b. epiphysis
c. dysplasia
d. physeal osteochondritis

a. osteonecrosis

21

The ______ is a thin layer of connective tissue that lines the inside of the cortex and the surface of the medullary cavity.

a. Periosteum
b. Endosteum
c. Parenchyma
d. Mesenchyme

b. Endosteum

22

Which type of thalassemia affects the fetus?

a. alpha-thalassemia
b. beta-thalassemia
c. thalassemia minor
d. thalassemia intermedia

a. alpha-thalassemia

23

Which of the following findings hypervitaminosis D is characteristic of adults rather than children?

a. alternating dense and lucent metaphyseal bands
b. cortical thickening due to periosteal apposition
c. widespread osteosclerosis
d. massive soft tissue calcification

d. massive soft tissue calcification

24

The radiographic finding of transverse radiolucent metaphyseal line ("scurvy line") seen in scurvy corresponds to which of the following pathologic/structural abnormalities of the affected bone:

a. thickened zone of provisional calcification
b. Trummerfield zone
c. a fracture through the metaphyseal area
d. a region of osteoclast proliferation

b. Trummerfield zone

25

Which of the following nuclear machine findings serves to rule out, or at least decrease the profitability of, post-traumatic osteonecrosis of the scapnoid?

a. decreased radiotracker uptake at the distal scaphoid pole
b. increased radiotracker uptake at the distal scaphoid pole
c. decreased radiotracker uptake at the proximal scaphoid pole
d. increased radiotracker uptake at the proximal scaphoid pole

d. increased radiotracker uptake at the proximal scaphoid pole

26

What is the pathologic basis for secondary hyperparathyroidism?

a. parathyroid adenoma
b. long-standing hypocalcemia leading to parathyroid hyperplasia
c. autonomously hyperfunctioning parathyroid glands
d. parathyroid carcinoma

b. long-standing hypocalcemia leading to parathyroid hyperplasia

27

What is the name of the radiographic sign given to the appearance created by enlargement and elongation of the mandible in acromegaly?

a. rodent facies
b. overbite
c. leonine facies
d. lantern jaw

d. lantern jaw

28

When a child presents with unexplained diffuse osteopenia and bilateral metaphyseal radiolucent bands, your primary diagnosis should be ________ until proven otherwise?

a. Osteoporosis
b. Multiple myeloma
c. Leukemia
d.Lymphoma

c. Leukemia

29

Which of the following allows differientiation between reflex sympathetic dystrophy and a primary articular disorder such as rheumatoid arthritis?

a. absence of periarticular osteopenia in RSD
b. the bilateral and symmetric nature in RSD
c. absence of intra-articular erosions in rheumatoid arthritis
d. preservation of joint space in RSD

d. preservation of joint space in RSD

30

What is the eponym for post-traumatic osteonecrosis of the vertebral bodies, leading to delayed collaspe and a painful kyposis?

a. Scheuermann's disease
b. Schmorl's disease
c. Junghann's disease
d. Kummel's disease

d. Kummel's disease

31

In addition to many other complications, patients with small bowel malabsorptive states such as sprue or regional enteritis, are at risk for which of the following deficiencies?

a. scurvy
b. hypovitaminosis D
c. hypovitaminosis A
d. iron deficiency anemia

b. hypovitaminosis D

32

In rickets, there is deficient mineralization of the zone of provisional calcification, which eventually becomes radiolucent and irregular with progression of the disease. This leads to which of the following radiographic findings?

a. widening of the growth plate
b. fraying of the metaphysis
c. cupping of the metaphysis
d. increased radiodensity of the metaphysis

b. fraying of the metaphysis

33

Subperiosteal resorption of cortical bone at the medial aspect of the proximal may be seen in hyperparathyroidism, as well as in another disease process, in which it is known as what sign?

a. Frostberg's sign
b. Waldenstrom's sign
c. Wimberger's sign
d. Hawken's sign

c. Wimberger's sign

34

Which of the following radiographic findings is suggestive ischemic necrosis of the vertebral body?

a. patchy osteosclerosis
b. a central depression at the vertebral linear endplates
c. an irregular intravertebral linear radiolucency
d. a completely flat compression of the vertebral body (vertebra plana)

c. an irregular intravertebral linear radiolucency

35

After what age does the gender difference in the frequency of osteoporosis disappear?

a. after the female menopause
b. after the male mid-life crisis
c. after 50 years of age
d. after 80 years of age

d. after 80 years of age

36

What distinguishes stress fractures seen with overuse of normal bone from pseudofractures of osteomalacia?

a. bilateral and symmetric distribution
b. presence of callus formation
c. location within bone (perpendicular to cortex)
d. parallel margins showing mild to moderate sclerosis

b. presence of callus formation

37

Which of the following is commonly associated with negative ulnar variance?

a. Preiser's disease
b. Panner's disease
c. Keinbock's disease
d. Iselin's disease

c. Keinbock's disease

38

The cortical thickening seen in hypervitaminosis A occur in which region of tubular bones?

a. epiphysis
b. metaphysis
c. diaphysis
d. apophyses

c. diaphysis

39

Which of the following classes of drugs are particularly known to lead to osteomalacia?

a. non-steroidal anti-inflammatories
b. hormone-replacement therapy
c. anticonvulsants
d. intravenous contrast agents

c. anticonvulsants

40

Which of the following disorders was first noted in women during the first trimester of pregnancy is now known to occur in either gender and all ages groups causes spontaneous and sometimes severe hip pain without history of trauma or inflection and generally resolves within 3 months to one year?

a. regional migatory osteoporosis
b. reflex sympathetic dystrophy
c. transient osteoporosis of the hip
d. partial transient osteoporosis

c. transient osteoporosis of the hip

41

What is the name of the radiographic sign in scurvy, created by an epiphyseal shell of increased density with a central lucency?

a. Pelken's sign
b. Waldenstrom's sign
c. Wimberger's ring epiphysis
d. Trummerfeld sign

c. Wimberger's ring epiphysis

42

In quantitative bone material analysis, why is trabecular (cancellous) bone preferred to cortical (compact) bone for accurate analysis?

a. trabecular bone is more easily accessible for analysis
b. the high rate of metabolic turnover trabecular bone makes it more responsive to metabolic stimuli
c. the skeleton is mainly composed of tracecular bone which makes analysis more accurate
d. quantitative bone mineral analysis is performed on cortical bone, not trabecular bone

b. the high rate of metabolic turnover trabecular bone makes it more responsive to metabolic stimuli

43

In which physeal layer does the cartilaginous column became calcified?

a. zone of undifferentiated cartilage cells
b. zone of proliferating cartilage
c. zone of hypertrophic cells (maturation zone)
d. zone of provisional calcification

d. zone of provisional calcification

44

How is the alignment alteration seen in Blout's disease best described?

a. acute varus angulation of the femur with respect to the tibia
b. acute inward angulation of the tabia just below
c. acute valgus angulation of the tabia respect to the femur
d. acute posterior angulation of the tabia just below the knee

b. acute inward angulation of the tabia just below

45

Which of the following terms best describes the condition that occurs when a decrease in bone mass is greater than that expected for a person of a given age, sex, and race, and which results in structural bone failure manifested by fractures?

a. osteoporosis
b. osteopenia
c. osteomalacia
d. osteoclastoma

a. osteoporosis

46

Where is the most frequent site of bone infarction in sickle cell anemia?

a. proximal humerus
b. distal femur
c. proximal femur
d. proximal tibia

c. proximal femur

47

Which of the following is the most common cause of endogenous Cushing's disease?

a. adrenal adenoma
b. anterior pituitary neoplasm
c. adrenal hyperplasia
d. ectopic adrenal tissue

c. adrenal hyperplasia

48

Name the best radiographic projection to identify scaphoid fractures.

a. PA Wrist
b. PA Hand
c. Medial Oblique Wrist
d. PA Wrist with ulnar deviation

d. PA Wrist with ulnar deviation

49

The squared configuration of the skull due to accumulation of osteoid in the frontal and parietal regions of the skull in rickets is known as...

a. triphyllocephaly
b. craniostenosis
c. caput succedaneum
d. craniotabes

d. craniotabes

50

Which of the following is a typical feature of Gaucher's disease?

a. Arachnodactyly
b. Scoliosis
c. Aortic dissection
d. Erienmeyer flask deformity

d. Erienmeyer flask deformity

51

The osteoporosis seen in Cushing's disease resembles which other form of osteoporosis?

a. osteoporosis of immobilization
b. postmenopausal or senile osteoporosis
c. regional migratory osteoporosis
d. reflex sympathetic distrophy

b. postmenopausal or senile osteoporosis

52

The "rachitic rosary" is most commonly seen at the costochondrial junctions of which ribs?

a. the upper ribs
b. the middle ribs
c. the lower ribs
d. at all costochondrial junctions

b. the middle ribs

53

Osteonecrosis due to pancreatitis most commonly involves the femoral head and which other area?

a. small bones of the hands and feet
b. humeral head
c. talus
d. vertebral bodies

b. humeral head

54

Wrist radiographs of a 20 year old male patient with hyperparathyroidism reveal a large lucent lesion with well-defined margins and internal septations, eccentrically located near the subarticular region of the distal radius. The most likely diagnosis is?

a. giant cell tumor
b. aneurysmal bone cyst
c. osteoclastoma
d. fibrous cortical defect

c. osteoclastoma

55

Patients with sickle cell anemia demonstrate an unusual propensity which of the following infections?

a. Meningococcemia
b. Brucella
c. Klebsiella
d. Salmonella

d. Salmonella

56

Which of the following findings is the less commonly seen in thalassemia?

a. "hair-on-end" skull
b. rodent facies
c. H-vertebrae
d. Erlenmeyer flask deformity

c. H-vertebrae

57

Which of the following radiographic manifestations is particularly helpful in the diagnosis of lead poisoning in children?

a. multiple dense metaphyseal lines in a single bone
b. vertical striations within the metaphysis
c. overtubulation of the femora (long, gracile-appearing bones)
d. dense metaphyseal lines at the proximal fibula

d. dense metaphyseal lines at the proximal fibula

58

What is a common feature of skull lesions in eosinophilic granuloma due to non-uniform growth of the lesion?

a. surrounding sclerosis
b. soft tissue mass
c. beveled edges
d. extension across sutures

c. beveled edges

59

Of the following articulations, which one is most frequently involved in hemophilia?

a. knee
b. cervical spine
c. hip
d. wrist

a. knee

60

Which of the following are common associated imaging findings in transient osteoporosis of the hip?

a. loss of joint space
b. joint effusions
c. abnormal signal intensity in the acetabulum
d. abnormal signal intensity in the ipsilateral knew

b. joint effusions

61

How is the general osseous pathology of thalassemia represented on radiographs?

a. widespread osteosclerosis and obliteration of the marrow spaces
b. osteoporosis, widened medullary spaces and coarsened trabecular pattern
c. severe osteopenia and multiple fractures in various stages of healing
d. short, bowed tubulkar bones and multiple vetrebral abnormalities

b. osteoporosis, widened medullary spaces and coarsened trabecular pattern

62

On magnetic resonance imaging, what is the appearance of post-traumatic osteonecrosis of the scaphoid?

a. decreased signal intensity on T1, proton, and T2-weighted imaging sequences
b. increased signal intensity on T1 and proton-density weighted sequences, decreased signal intensity on T2
c. increased signal intensity on T1 , proton, and T2-weighted imaging sequences
d. decreased signal intensity on T1 and proton-density weighted sequences, decreased signal intensity on T2

d. decreased signal intensity on T1 and proton-density weighted sequences, decreased signal intensity on T2

63

Which of the following radiographic abnormalities is not an integral part but rather an associated finding in Scheuermann's disease?

a. anterior vetrebral body wedging leading to kyphosis
b. cartilaginous node formation
c. loss of intervertebral disc height
d. scoliotic curvature at the same level as the kyphosis

d. scoliotic curvature at the same level as the kyphosis

64

At which of the following joints is subchondral bone resorption seen most commonly with hyperparathyroidism?

a. sacroiliac
b. sternoclavicular
c. acromioclavicular
d. symphysis pubs

a. sacroiliac

65

What percentage of Langerhans Cell Histiocytosis is made up eosinophilic granuloma?

a. 5%
b. 20%
c. 50%
d. 70%

d. 70%