Pathophysiology final

Pain and inflammation associated with gout are caused by crystallization of _______ in the tissues.

Uric acid Pain and inflammation associated with gout are caused by crystallization of uric acid in the tissues.

Ankylosing spondylitis results in:

Vertebral joint fusion Ankylosing spondylitis results in joint fibrosis, ossification, and fusion. Joints most commonly affected include the intervertebral and sacroiliac joints.

The best screening test for osteoporosis is:

a dual energy x-ray absorptiometry (DEXA) scan A DEXA scan is the most useful test for evaluating bone density if osteoporosis is suspected.

An avulsion occurs when:

a tendon is torn off its bony attachment An avulsion occurs when a tendon or ligament is completely separated form its bony attachment.

Episodes of gout are often triggered by all of the following factors except:

high-fat diet Episodes of gout can be triggered by excessive alcohol intake, use of certain drugs, and trauma.

Which of the following substances prevent proper bone healing?

Alcohol and nicotine Alcohol and nicotine can delay proper bone healing.

The pathophysiology of osteomalacia involves:

Abnormal calcium crystallization Osteomalacia is a metabolic disease characterized by inadequate or delayed mineralization in the osteoid.

All of the following events occur following a bone fracture except:

An increase in the number of osteoclasts at the fracture site. Osteoblasts migrate to the site of injury to repair the fractured bone tissue.

Rheumatoid arthritis results from joint inflammation caused by:

Autoimmune injury Rheumatoid arthritis is caused by autoimmune injury to synovial joints.

The cause(s) of most cases of endogenous osteomyelitis is (are):

Blood-borne bacteria Endogenous osteomyelitis is caused by blood-borne infections. The specific causative organisms differ among age and population groups.

Patients with osteoporosis are at risk for which of the following problems?

Pathologic bone fractures Osteoporosis weakens the bone structure and increases the risk of fracture.

A bone breaks in a place where there was pre-existing disease. What type of fracture is being described?

Pathological A pathologic fracture occurs in a place where there was pre-existing disease that weakened the area.

A fracture in which the bone breaks into two or more fragments is termed a(n):

Comminuted fracture A fracture in which the bone breaks into two or more fragments is called a comminuted fracture.

Pain in fibromyalgia is associated with:

Decrease in pain threshold Individuals with fibromyalgia have lowered mechanical and thermal pain thresholds, high pain ratings for provoking stimuli, and altered temporal summation of pain stimuli.

Factors contributing to the development of osteoporosis in older women include:

Decreased estrogen levels The hormone estrogen helps maintain bone strength and integrity in women. In menopause, decreased estrogen production increases a woman's risk of developing osteoporosis.

The chief pathologic feature of degenerative joint disease is:

Degeneration of articular cartilage The hallmark of degenerative joint disease is degeneration of articular cartilage in synovial joints.

Complications that can occur as a fractured bone heals include all of the following except:

Disunion Disunion is not a type of complication.

Inflammation of a tendon where it attaches to the bone at its origin is called:

Epicondylitis Inflammation of a tendon where it attaches to the bone is called epicondylitis and is caused by repetitive movements.

Which of the following adult populations are at high risk for developing osteomyelitis?

Intravenous drug users, orthopedic surgery patients, and diabetics Orthopedic surgery patients are at risk for developing osteomyelitis from exogenous infections that enter surgical wound sites. Individuals with diabetes are also at risk because of higher frequencies of skin infections. Intravenous drug users can develop bacteremia and endogenous osteomyelitis from infected needles.

The primary manifestation of osteoarthritis is:

Joint pain Joint degeneration in osteoarthritis almost always causes pain in affected joints.

Treatment priorities in myoglobinuria (rhabdomyolysis) focus on preventing failure of which of the following organs?

Kidneys Priorities in treatment of myoglobinuria include identifying and treating the underlying disorder and preventing life-threatening renal failure.

Known causes of osteoporosis include all of the following except:

Late menopause Early menopause and late menarche are risk factors for the development of osteoporosis.

Risk factors for osteoarthritis include all of the following except:

Low calcium intake Low calcium intake is a risk factor in the development of osteoporosis.

In addition to joint pain, rheumatoid arthritis often manifests with which of the following systemic symptoms?

Malaise, fever and lymphadenopathy Systemic manifestations of rheumatoid arthritis include fever, malaise, and lymphadenopathy.

Which of the following cancers involves the proliferation of plasma cells in the bone marrow, causing skeletal pain?

Myeloma Myeloma is caused by the neoplastic proliferation of plasma cells that eventually penetrate into the bone marrow, resulting in significant bone destruction. The most common early symptom of myeloma is aching skeletal pain that increases in severity as the disease progresses.

Which of the following diseases is characterized by osteomalacia in the growing bones of children?

Rickets Rickets is a form of osteomalacia caused by a vitamin D deficiency which results in soft, deformable bones.

Synovial joint problems in rheumatoid arthritis are due to which of the following pathologies?

Neutrophils and inflammatory cytokines cause damage to articular cartilage Enzymatic destruction of cartilage occurs in osteoarthritis. In rheumatoid arthritis, neutrophils and inflammatory cytokines (IL-1 and TNF-alpha) cause damage to articular cartilage and the nearby synovium.

Which of the following disorders presents with significant bone demineralization from a vitamin D deficiency and usually results in skeletal pain?

Osteomalacia Osteomalacia is a rare metabolic disease characterized by inadequate mineralization of bone tissue in compact and spongy bone. The most common cause of osteomalacia is vitamin D deficiency.

Which of the following musculoskeletal tumors usually forms in the bone marrow?

Osteosarcoma Osteosarcomas are bone cancers that usually originate in the red bone marrow.

Which of the following disorders is characterized by enlargement and softening of the bones?

Paget disease Paget disease (osteitis deformans) is characterized by excessive bone resorption and formation, resulting in chronic enlargement and softening of certain bones.

Which of the following pairs of symptoms is likely to manifest following a femoral fracture?

Pain and swelling in the thigh Because of inflammation, a fracture generally manifests with pain and swelling at the site of injury.

Individuals with gout are much more likely to develop which of the following problems?

Renal stones An excessive uric acid level in the blood in gout promotes the development of uric acid calculi (stones) in the kidneys.

Severe muscle trauma from crush injuries can result in which of the following complications?

Rhabdomyolysis Severe trauma can result in the release of myoglobin from skeletal muscle cells, causing a life-threatening condition called rhabdomyolysis.

A partial tear of a ligament is called a:

Second-degree sprain A strain is a tendon injury.

In osteomyelitis, the area of necrotic bone at the site of the infection is called the:

Sequestrum The area of devitalized bone tissue at the site of the infection is called the sequestrum.

A tear in a tendon is commonly known as a:

Strain A strain is a tear in a tendon. A sprain is a tear in a ligament.

The displacement of two bones in which the articular surfaces partially lose contact with each other is called:

Subluxation The displacement of two bones in which the articular surfaces partially lose contact with each other is called subluxation. Subluxation results in joint deformity, immobility, and pain.

A torus fracture occurs when:

The cortex of the bone buckles A torus fracture occurs when the cortex of the bone buckles, but does not break.

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:

Tophaceous gout The third and chronic stage of gout is called tophaceous gout. Progressive hyperuricemia leadsd to urate crystal deposits called tophi in cartilage, synovial membranes, tendons, and soft tissues.

Which of the following fractures involves fragmentation of the articular cartilage and generally occurs in adolescents?

Transchondral Transchondral fractures (chondral=cartilage) involve the separation of the articular cartilage from the bone and typically occur in adolescents.

A characteristic feature of fibromyalgia is:

Trigger point pain Fibromyalgia specifically manifests with trigger point pain or tenderness.