*MOVED*Advanced H.M.E.N

Question 1

Which of the following conditions appears to share pathologic, clinical and radiologic features with Hand-Schuller-Christian disease, although it is uncommon disease process and the average patient is much older? A. Rosai-Dorfman disease B. Erdheim-Chester disease C. Burkitt’s lymphoma D. Malignant histiocytosis

Answer 1

B. Erdheim-Chester disease

Question 2

Flattening and sclerosis of the 3rd metatarsal head, with enlargement and irregularity of the base of the phalanx, is an osteonecrosis most commonly seen in A.`Adolescent males B. Adult males C. Adolescent females D. Adult females

Answer 2

C. Adolescent females

Question 3

Which of the following is common finding in children with thalassemia major? A. H-vertebraeB. Irregular vertical striations near the ends of the the long bones C. Multiple rib fractures D. Premature fusion of the epiphyses

Answer 3

D. Premature fusion of the epiphyses

Question 4

What is the most common skeletal abnormality of hypoparathyroidism? A. Dense metaphyseal bands B. Osteoporosis C. Subcutaneous calcification D. Osteosclerosis

Answer 4

D. Osteosclerosis

Question 5

Which bones are most commonly affected by osteomyelitis in sickle cell anemia? A. Facial bones B. Skull C. Long bones D. Vertebrae

Answer 5

C. Long bones

Question 6

In addition to periostitis, what other radiographic findings are most often seen with chronic venous insufficiency? A. Soft tissue edema and ossification B. Lymphedema C. Osteoncrosis D. Osteomyelitis

Answer 6

A. Soft tissue edema and ossification

Question 7

In acromegaly, what radiographic appearance may be created by the formation and approximation of osseous excrescences and enlargement of distal tufts and bases of the distal phalanges? A. Spade-like distal tufts B. Pseudoforamina C. Turret exostoses D. Bizarre parosteal osteochondromatous proliferation

Answer 7

B. Pseudoforamina

Question 8

In myelofibrosis, fibrotic replacement of bone marrow is demonstrated by which of the following changes in signal intensity on standard spin echo magnetic resonance sequences? A. Increased T1 and decreased T2-weighted signal B. Decreased T1 and increased T2-weighted signal C. Increased T1 and T2-weighted signal D. Decreased T1 and T2-weighted signal

Answer 8

D. Decreased T1 and T2-weighted signal

Question 9

Which of the following complications is surprisingly uncommon in Cushing’s disease? A. Vertebral compression fractures B. Renal calculi C. Osteonecrosis D. Excessive callus formation

Answer 9

C. Osteonecrosis

Question 10

Parathyroid hormone may have a direct effect on collagen or promote its enzymatic degradation, thus predisposing patients to capsular laxity and ligamentous instability. Which of the joints below are particularly vulnerable to this? A. PIP and DIP joints B. Glenohumeral joint C. Subtalar joint D. Acromioclavicular and sacroiliac joints

Answer 10

D. Acromioclavicular and sacroiliac joints

Question 11

The “Salt and pepper skull” of hyperparathyroidsm is due to what pathologic process? A. Intracotical bone resorption B. Diploic bone resorption C. Bone marrow hyperplasia D. Trabecular bone resorption

Answer 11

D. Trabecular bone resorption

Question 12

What is the pathologic basis of pseudohypoparathyroidism? A. Deficient secretion of parathyroid hormone B. Surgical removal of the parathyroid glands C. The presence of biologically ineffective parathyroid hormone D. Inability of end organs to respond to parathyroid hormone

Answer 12

D. Inability of end organs to respond to parathyroid hormone

Question 13

Which disorder is described by the following paragraph: “osteolysis of the terminal phalanges of the hands with band-like radiolucencies across the waist of one or more terminal phalanges and tuftal resorption; affecting the thumb more frequently than other digits”. A. post-traumatic acro-osteolysis B. Leprosy C. Multicentric reticulohistiocytosis D. Acro-osteolysis due to polyvinyl chloride toxicity

Answer 13

D. Acro-osteolysis due to polyvinyl chloride toxicity

Question 14

Which facial bone is commonly involved in marrow hyperplasia in sickle cell anemia? A. Maxilla B. Mandible C. Occiput D. Zygoma

Answer 14

B. Mandible

Question 15

The Erlenmeyer-flask deformity may be seen, among others, in Gaucher’s disease, Pyle’s disease, osteopetrosis, and which of the following: A. Hypophosphatasia B. Plumism C. Vitamin E toxicity D. Bismuth toxicity

Answer 15

B. Plumbism

Question 16

Which of the following describes a hemolytic anemia with onset in late childhood or adolescence, featuring anemia, jaundice, and splenomegaly; with normal hemoglobin, but abnormal (inflexible) erythrocytes which get stuck in and are destroyed by the spleen? A. Aplastic anemia B. Fanconi’s anemia C. Sickle cell anemia D. Hereditary spherocytosis

Answer 16

D. Hereditary spherocytosis

Question 17

Which of the following skeletal manifestations may be seen in hypovitaminosis A occurring in infancy? A. Early closure of cranial sutures B. Widening of tubular bones C. Epiphyseal overgrowth D. Widening of cranial sutures due to increased intracranial pressure

Answer 17

D. Widening of cranial sustures due to increased intracranial pressure

Question 18

Of the following articulations, which one is most frequently involved in hemophilia? A. Knee B. Cervical spine C. Hip D. Wrist

Answer 18

A. Knee

Question 19

If adequately performed, hemodialysis generally leads to resolution of the bone changes seen in renal osteodystrophy. If, instead, these bone changes progress, what is now believed to be the primary cause? A. Excessive removal of phosphate during dialysis B. Osteomalacia due to aluminum intoxication C. Phosphate retention during dialysis D. Excessive removal of calcium during dialysis

Answer 19

B. Osteomalacia due to aluminum intoxication

Question 20

In which of the following occupations would would the occurrence of band-like acro-osteolysis be most accurately be considered a form of stress fracture? A. Snake handler B. Polyvinyl chloride worker C. Guitar player D. Electrician

Answer 20

C. Guitar player

Question 21

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

Answer 21

B. Button sequestrum

Question 22

Which of the following processes results in thickening of the long bones in osteomalacia? A. Cortical remodeling B. Subperiosteal deposition of osteoid C. Endosteal thickening D. Appositional bone growth

Answer 22

B. Subperiosteal deposition of osteoid

Question 23

At what age is sickle cell dactylitis or “hand-foot syndrome” most common? A. Adulthood B. Adolescence C. 2 to 10 years D. 6 months to 2 years

Answer 23

D. 6 months to 2 years

Question 24

What skull abnormalities are commonly found in hypophosphatasia? A. Widened diploe B. Sclerotic skull base C. Craniosynostosis D. Basilar impression

Answer 24

C. Craniosynostosis

Question 25

Bismuth toxicity in adults may demonstrate which of the following radiographic abnormalities? A. Dense transverse metaphyseal bands B. Erlenmeyer flask deformity C. Osteonecrosis D. Cortical hyperostosis

Answer 25

C. OSteonecrosis

Question 26

Magnetic resonance imaging of the lumbar spine of a 15-year old female with sickle-cell anemia demonstrate a widespread decrease in signal intensity of vertebral bone marrow, on both T1, T2 and fat-suppressed sequences. This raises the concern for? A. Bone marrow ischemia/infarction B. Iron overload C. Osteomyelities D. Normal reconversion of bone marrow

Answer 26

B. Iron overload

Question 27

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

Answer 27

C. Apophyses or epiphyses

Question 28

Which of the following arthritic conditions may be seen in 18-40% of patients with primary hyperparathyroidism? A. Calcium pyrophosphate crystal deposition disease B. Oseoarthritis C. Ochronosis D. Gout

Answer 28

A. Calcium Pyrophosphate crystal deposition disease

Question 29

Which of the following is a frequent extra-osseous complication of hemodialysis, which may be severe, and, according to a study quoted in Resnick, may affect up to 80% of patients? A. Carpal tunnel syndrome B. Septicemia C. Osteonecrosis D. Soft tissue and vascular calcification

Answer 29

D. Soft tissue and vascular calcification

Question 30

The radiographic finding of increased radiolucency of bone is best termed? A. Osteoporosis B. Osteopenia C. Osteomalacia D. Osteoclastoma

Answer 30

B. Osteopenia

Question 31

Subchondral bone loss may be seen within joints in osteoporosis. Which disease is mimicked by magical subchondral bone resorption? A. Septic arthritis B. Tuberculous arthritis C. Rheumatoid arthritis D. Psoriatic arthritis

Answer 31

C. Rheumatoid arthritis

Question 32

Which of the following disorders represents a high-turnover osteoporosis characterized by urinary loss of calcium and phosphorus without a compensatory increase in intestinal calcium absorption? A. Hyperparathyroidism B. Osteoporosis of immobilization or disuse C. Paget's disease D. Idiopathic juvenile osteoporosis

Answer 32

B. Osteoporosis of immobilization or disuse

Question 33

Which of the following compression neuropathies is particularly characteristic in acromegaly, occurring in 30% of patients, frequently bilaterally? A. Carpal tunnel syndrome B. Compartment syndrome C. Raynaud's syndrome D. Neural foraminal encroachment

Answer 33

A. Carpal tunnel syndrome

Question 34

A radiodense or chalky appearance of bones throughout the thorax, vertebral column, and pelvis with relative sparing of the skull and appendicular skeleton suggest which of the following: A. Osteopetrosis B. Fluorosis C. Hypervitaminosis D D. Hypervitaminosis A

Answer 34

B. Fluorosis

Question 35

Which of the following must be included in the differential diagnosis of gas within a vertebral body? A. Dissected air from pneumothorax B. Spinal infection C. Chemical fixer artifact D. Degenerative disc disease

Answer 35

B. Spinal infection

Question 36

Which of the following spinal syndromes may represent a form of reflex sympathetic dystrophy? A. Kummel's disease B. Scheuermann's disease C. Idiopathic juvenile osteoprosis D. Idiopathic juvenile kyphosis

Answer 36

A. Kummel's disease

Question 37

Ward's triangle in the neck of the femur is an area of comparative radiolucency bordered by four anatomic groups of trabeculae. With early trabecular resorption due to osteoporosis, which anatomic group of trabeculae becomes more accentuated? A. The principal compressive group B. The principal tensile group C. Both principal compressive and principal tensile groups D. The principal ad secondary compressive groups

Answer 37

C. Both principal compressive and principal tensile groups

Question 38

Gradually developing biconcave deformities of the vertebral bodies are characteristic of disorders with diffuse weakening of bone, such as osteoporosis, osteomalacia, Paget's disease and hyperparathyroidism. These deformities are known as... A. H-vertebrae B. FIsh vertebrae C. Cartilaginous nodes D. Cupid's bow contour

Answer 38

B. Fish vertebrae

Question 39

What is the most common radiographic finding in the skull in hypoparathyroidism? A. Calvarial thickening B. Enlargement of the frontal sinuses C. Osteosclerosis of the skull base D. Enlargement of the sella turcica

Answer 39

A. Calvarial thickening

Question 40

What does the Hawkins sign represent? A. Osteosclerosis of the entire talus, signifying talar osteonecrosis B. Osteopenia of the entire talus, representing adequate blood supply to the talus after injury C. A subchondral radiolucency in the talar dome, representing adequate vascularity in the area D. Patchy radiolucency of the talar dome, signifying osteonecrosis

Answer 40

C. A subchondral radiolucency in the talar dome, representing adequate vascularity in the area

Question 41

A frontal pelvis radiograph of an 18-year-old black male who complains of hip pain and limping demonstrates bilateral osteosclerosis and early subchondral collapse of the femoral epiphyses. A reasonable differential diagnosis includes which of the following? A. Legg-Calve-Perthes disease B. steroid-induced osteonecrosis C. Gaucher's disease D. sickle-cell anemia

Answer 41

D. Sickle-cell anemia

Question 42

What is the term for the appearance of the skull in Hand-Schuller-Christian disease, where confluent areas of destruction may isolate islands of bone? A. Floating skull B. Osteoporosis eosinophilica C. Geographic skull D. Beveled skull

Answer 42

C. Geographic skull

Question 43

Which of the following is a complication of osteonecrosis which may occur many years after, and may possibly be a result of the repair process? A. Pathologic fracture B. Sarcomatous degeneration C. Repeat infarction D. Septic arthritis

Answer 43

B. Sarcomatous degeneration

Question 44

What percentage of Langerhans Cell Histiocytosis is made up by eosinophilic granuloma? A. 5% B. 20% C. 50 % D. 70%

Answer 44

D. 70%

Question 45

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

Answer 45

C. proximal femur

Question 46

Of the following magnetic resonance imaging methods used in the diagnosis of transient osteoporosis of the hip, which is incompatible with the effective use of gadolinium-based contrast agent? A. chemical shift B. fat suppression C. STIR D. spin-echo

Answer 46

C. STIR

Question 47

Which bone in the skull remains unaffected by the changes due to marrow hyperplasia in thalassemia? A. Frontal B. Parietal C. Temporal D. Occipital

Answer 47

D. Occipital

Question 48

The development of osteoporosis eventually occurs due to an imbalance between bone resorption and bone formation. In which of the following conditions is there an increase in both bone resorption and bone formation, leading to osteoporosis? A. Hyperparathyroidism B. Osteoporosis due to steroid administration C. Osteoporosis due to alcoholism D. Osteoporosis due to heparin administration

Answer 48

A. Hyperparathyroidism

Question 49

Which of the following conditions most resembles chronic hypervitaminosis A? A. Diffuse idiopathic skeletal hyperostosis B. Infantile cortical hyperostosis C. Diaphyseal dysplasia D. Metaphyseal chondrodysplasia

Answer 49

B. Infantile cortical hyperostosis

Question 50

Which condition may be noted in manufacturers of illicit alcohol ("moonshine"), in which renal tubular injury leads to uric acid retention? A. Hemarthrosis, most prominently in the knees B. Blindness C. Saturnine gout D. Renal tubular acidosis

Answer 50

C. Saturnine gout

Question 51

Which feature of thalassemia may also be seen in hereditary spherocytosis, although milder and much more rarely? A. Hair-on-end skull B. Rodent facies C. Diaphyseal infarction D. H-vertebrae

Answer 51

A. Hair-on-end skull

Question 52

In the radiologic staging of osteonecrosis of the femoral head, which stage demonstrates the crescent sign? A. Stage 1 B. Stage II C. Stage III D. Stage IV

Answer 52

C. Stage III

Question 53

Which of the following allows differentiation 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 of RSD C. Absence of intra-articular erosions in rheumatoid arthritis D. Preservation of joint space in RSD

Answer 53

D. Preservation of joint space in RSD

Question 54

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

Answer 54

C. Beveled edges

Question 55

In a patient with hemolytic anemia, a paraspinal mass of low signal intensity on T1-weighted images, with a rim of higher signal intensity similar to fat, is consistent with? A. A paraspinal abscess due to Salmonella infection B. Superimposed diffuse idiopathic skeletal hyperostosis C. Extramedullary hematopoiesis D. Paraspinal hematoma due to pathologic vertebral fracture

Answer 55

C. Extramedullary hematopoiesis

Question 56

What causes the coarsened trabecular pattern in osteomalacia? A. Loss of secondary trabeculae in spongy bone, leading to greater prominence of the remaining trabeculae B. The deposition of unmineralized osteoid which coats the trabeculae and lines haversian canals C. An overabundance of osteoid seams in the cortex D. This pattern is created by radiographic summation of multiple Looser's lines

Answer 56

A. Loss of secondary trabeculae in spongy bone, leading to greater prominence of the remaining trabeculae

Question 57

On magnetic resonance imaging of osteochondritis dissecans, which of the following is an indicator of instability of the osteochondral fragment? A. High signal intensity on T2-weighted images, surrounding the fragment B. On T2-weighted images, low signal intensity interface between the fragment and parent bone C. With gadolinium, lack of enhancement of the interface between the fragment and the parent bone D. High signal intensity on T1-weighted images, surrounding the fragment

Answer 57

A. High signal intensity on T2-weighted images, surrounding the fragment

Question 58

Which of the following crystal deposition diseases might be expected to occur in a patient with severe thalassemia? A. Hemochromatosis B. Wilson's disease C. Calcium hydroxyapatite crystal deposition disease D. Multicentric reticulohistiocytosis

Answer 58

A. Hemochromatosis

Question 59

What substance is found in abnormal amounts in the blood and urine of patients with hypophosphatasia? A. Phosphoethanolamine B. Mike's Hard Lemonade C. Glucose D. Urinary hydroxyproline

Answer 59

A. Phosphoethanolamine

Question 60

Which of the following is a synonym for familial idiopathic hyperphosphatasia, a rare disorder of bone occurring in children, which shares some of its skeletal characteristics with a common disorder of bone affecting older individuals? A. Juvenile rheumatoid arthritis B. Juvenile Paget's disease C. Hyperostosis frontalis interna D. Familial expansile osteolysis

Answer 60

B. Juvenile Paget's disease

Question 61

In the metaphyses of growing long bones, bismuth toxicity may share which of the following radiographic manifestations with lead toxicity? A. Dense transverse metaphyseal bands B. Erlenmeyer flask deformity C. Osteonecrosis D. Cortical hyperostosis

Answer 61

A. Dense transverse metaphyseal bands

Question 62

The major skeletal abnormality in hyperthyroidism is ? A. Osteomalacia B. Generalized osteoporosis C. Subperiosteal resorption D. Hypertrophic osteoarthropathy

Answer 62

B. Generalized osteoporosis

Question 63

Vascular occlusion in sickle cell anemia may lead to extensive osteosclerosis and coarsening of the trabecular pattern in the pelvis, spine and long bones. Which of the following processes could safely be excluded in the differential diagnosis of this appearance? A. Paget's disease B. Gaucher's disease C. Myelofibrosis D. Blastic metastasis

Answer 63

B. Gaucher's disease

Question 64

You are asked to evaluate radiographs of a child with a known autosomal-recessive congenital disorder. The history includes multiple fractures with resulting deformities and shortening of the extremities. There are significant blood enzyme abnormalities. The radiographs demonstrate general deossification with a coarsened trabecular pattern, bowing deformities and old fractures. The most striking radiographic abnormalities are noted at the growth plates, which exhibit rickets-like changes, but there are also irregular, quite prominent radiolucencies which extend deeply into the metaphysis. These findings suggest... A. Fanconi's syndrome B. Hypophosphatasia C. Hereditary vitamin D-dependent rickets D. Familial vitamin D-resistant rickets

Answer 64

B. Hypophosphatasia

Question 65

Which of the following is commonly associated with polyvinyl chloride toxicity acro-osteolysis? A. Multiple sclerosis B. Chronic fatigue syndrome C. A disorder similar to Raynaud's phenomenon D. Aplastic anemia

Answer 65

C. A disorder similar to Raynaud's phenomenon

Question 66

What is the pathologic basis, and generally the cause of death, in Letterer-Siwe disease? A. Marrow infiltration and replacement by histiocytes B. Cerebral invasion by histiocytes C. Histiocytic proliferation of multiple organ systems, leading to progressive anemia D. Histiocytic infiltration of the myocardium leading to heart failure

Answer 66

C. Histiocytic proliferation of multiple organ systems, leading to progressive anemia

Question 67

What distinguishes Hand-Schuller-Christian disease from eosinophilic granuloma? A. Ethnicity of affected patients B. Multiplicity of lesions and organ involvement C. Lack of progression D. Presence of "floating teeth"

Answer 67

B. Multiplicity of lesions and organ involvement

Question 68

Which of the following radiographic findings in bone is interpreted as a favorable prognostic sign in patients with histiocytosis? A. Enlargement of osseous lesions B. Patchy, diffuse, or ring-like sclerosis of or around bone lesions C. Cortical thickening D. Periosteal reaction

Answer 68

B. Patchy, diffuse, or ring-like sclerosis of or around bone lesions

Question 69

What is responsible for enlargement of the thoracic cage in acromegaly? A. This is only seen when patients have coexisting emphysema B. Enlargement of the pulmonary parenchyma C. Elongation of the ribs D. The common coexistence of pectus carinatum and acromegaly

Answer 69

C. Elongation of the ribs

Question 70

What best differentiates the radiographic findings in myelofibrosis from those seen in fluorosis? A. Absence of spinal osteophytosis and ligamentous calcification in myelofibrosis B. Sparing of the appendicular skeleton in myelofibrosis C. Absence of periosteal new bone formation in fluorosis D. The two disorders are indistinguishable without bone marrow biopsy

Answer 70

A. Absence of spinal osteophytosis and ligamentous calcification in myelofibrosis

Question 71

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

Answer 71

C. Leukemia

Question 72

Fanconi's anemia and the TAR syndrome can resemble each other very closely. Which of the following best differentiates between the two? A. The osseous abnormalities in Fanconi's anemia are consistently the same and are bilateral B. In the TAR syndrome, the radius may be hypoplastic, dysplastic or absent C. There are always five digits present in the hand in the TAR syndrome D. The two syndromes are radiographically indistinguishable

Answer 72

C. There are always five digits present in the hand in the TAR syndrome

Question 73

Which of the following is typical of osteochondritis dissecans of the knee (OCD), as opposed to spontaneous osteonecrosis of the knee (SONK)? A. OCD generally occurs in older patients B. OCD occurs in the non-weight-bearing portion of the knee C. OCD is more painful at night D. OCD can occur due to a multitude of causes

Answer 73

B. OCD occurs in the non-weight-bearing portion of the knee

Question 74

What distinguishes pseudopseudohypoparathyroidism from pseudohypoparathyroidism? A. Normocalcemia B. Hypercalcemia C. Hyperphosphatemia D. Hypocalcemia

Answer 74

A. Normocalcemia

Question 75

What is the most common intrathoracic cause of hypertrophic osteoarthropathy? A. Cyanotic congenital heart disease B. Bronchogenic carcinoma C. Hodgkin's disease D. Metastatic disease

Answer 75

B. Bronchogenic carcinoma

Question 76

What is the most common estimated frequency of post-traumatic osteonecrosis of the scaphoid? A. 1 - 5% B. 10 - 15% C. 25% D. over 50%

Answer 76

B. 10 - 15%

Question 77

At what age is Letterer-Siwe disease most common? A. Under 3 years B. Between 5 and 10 years C. Adolescence D. Early adulthood

Answer 77

A. Under 3 years

Question 78

What is the most common cause of hypoparathyroidism? A. Accidental radiation damage to the parathyroid glands B. Congenital absence or atrophy of the parathyroid glands C. Excision of or damage to the parathyroid glands during thyroid surgery D. Damage to the parathyroid glands due to chemotherapy

Answer 78

C. Excision of or damage to the parathyroid glands during thyroid surgery

Question 79

Where is the most typical and classic location of osteochondritis dissecans? A. Medial facet of the patella B. Capitulum of the humerus C. Medial aspect, lateral femoral condyle D. Lateral aspect, medial femoral condyle

Answer 79

D. Lateral aspect, medial femoral condyle

Question 80

Which of the following is not part of the "classic triad" of Hand-Schuller-Christian disease? A. Diabetes insipidus B. Exophthalmos C. Destructive bone lesions D. Hepatosplenomegaly

Answer 80

D. Hepatosplenomegaly

Question 81

In quantitative bone mineral 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 of trabecular bone makes it more responsive to metabolic stimuli C. The skeleton is mainly composed of trabecular bone, which makes analysis more accurate D. Quantitative bone mineral analysis is performed on cortical bone, not trabecular bone

Answer 81

B. The high rate of metabolic turnover of trabecular bone makes it more responsive to metabolic stimuli

Question 82

What is the major skeletal abnormality in hypopituitarism? A. Osteoporosis B. Slipped capital femoral epiphysis C. Periostitis deformans D. Delayed skeletal maturation

Answer 82

D. Delayed skeletal maturation

Question 83

In which of the following rare types of osteomalacia is the central skeleton of otherwise healthy males exclusively affected? A. Dialysis-related osteomalacia B. Hepatic osteodystrophy C. Osteomalacia related to vitamin D deficiency D. Atypical axial osteomalacia

Answer 83

D. Atypical axial osteomalacia

Question 84

Which of the following conditions complicates myelofibrosis in 5 to 20% of cases? A. Hemarthrosis B. Gout C. Multiple myeloma D. Amyloidosis

Answer 84

B. Gout

Question 85

What is the predominant radiographic feature of pachydermoperiostosis? A. Medullary sclerosis B. Coarsened trabecular pattern C. Cortical thinning D. Periostitis

Answer 85

D. Periostitis

Question 86

In which of the following hematopoeitic bone marrow disorders are the facial bones involved in marrow hyperplasia, to the extent that the paranasal sinuses are obliterated and a very characteristic facial appearance results? A. Sickle cell anemia B. Iron deficiency anemia C. Hereditary spherocytosis D. Thalassemia

Answer 86

D. Thalassemia

Question 87

Periostitis deformans is seen in toxicity of which of the following substances? A. Lead B. Bismuth C. Phosphorus D. Fluorine

Answer 87

D. Fluorine

Question 88

Which of the following is not a cause of post-traumatic osteonecrosis of the femoral head? A. Femoral neck fracture B. Hip dislocation C. Slipped capital femoral epiphysis D. Femoral shaft fracture

Answer 88

D. Femoral shaft fracture

Question 89

Subchondral bone resorption at the discovertebral junction may allow formation of which of the following radiographic findings? A. Limbus bones B. Schmorl's nodes C. Narrowing of the disc space D. Rugger-jersey spine

Answer 89

B. Schmorl's nodes

Question 90

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

Answer 90

D. Dense metaphyseal lines at the proximal fibula