"A 65-year-old female is admitted to hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?"
The fracture line is diagonal to the shaft of the bone.
"A six-year-old male presents with fever, pain, swelling and warmth. Tests reveal osteomyelitis and development of an involucrum. Treatment should include:"
surgical debridement and antibiotics;
A 51-year-old male experiences severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?
Trauma, drugs or alcohol.
Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis)?
Admitted to the hospital for hip surgery and has had problems with anaesthesia in the past.
Fibromyalgia is a chronic musculoskeletal disorder characterised by:
"diffuse pain, fatigue and point tenderness;"
An isolated muscle is believed to be a type 1 fibre. Which of the following should be observed upon stimulation?
Slow contraction speed.
An isolated muscle is believed to be a type 2 fibre. Which of the following should be observed upon stimulation?
Fast contraction speed.
A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:
Which of the following structures is the contractile unit of a muscle cell?
The elbow joint is an example of:
freely moveable joint
Slightly moveable joint
Which of these structures are not present in compact bone?
"The internal structure of bone is maintained by remodelling, a three-phase process in which existing bone is resorbed and new bone is laid down to replace it. Resorption is carried out by bone cells called:"
"The internal structure of bone is maintained by remodelling, a three-phase process in which existing bone is resorbed and new bone is laid down to replace it. Bone building is carried out by bone cells called:"
A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:
decreased oestrogen levels.
A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?
Vertebral and sacroiliac
A patient will begin taking hydroxychloroquine for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient?
That an eye exam is necessary at the beginning of therapy with this drug.
A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol and colchicine. The nurse will include which statement when teaching the patient about this drug regimen?
You will take both drugs initially and then stop taking the colchicine.
"Although _____ is similar to osteomalacia, it occurs in growing bones of children."
A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called:
A patient who has developed postmenopausal osteoporosis will begin taking alendronate. The nurse will teach this patient to take the drug:
while sitting upright with plenty of water;
The major effect of aging on the skeletal system is
loss of bone mass.
With normal weight bearing what type of fracture can occur in an abnormal bone.
Myoglobinuria (rhabdomyelosis) can be a serious life threatening complication of
severe muscle trauma.
a chronic musculoskeltal syndrome characterised by diffuse pain and tender points.
Legg-Calve-Perthes disease is
one of the most common osteochondroses.
Legg-Calve-Perthes disease is characterised by
epiphyseal necrosis or degeneration of the head of the femur.
Muscle fibres contain
bundles of myofibrils
Myofibrils are arranged in
parallel along the longnitudinal axis of the muscle fibre.
a metabolic bone disease.
Osteomalacia is characterised by
inadequate bone mineralisation.
Osteoarthritis is a common aged related disorder of
the synovial joints.
Osteoarthritis primary defect is a
loss of articular cartilage.
Rheumatoid arthritis is
an inflammatory joint disorder (Auto immune disease).
Rheumatoid arthritis is characterised by the destruction of
synovial membrane, articular cartilage, joint capsule, ligaments and tendons.
Bisphophonates undergo incorporation into bone by
inhibiting bone resorption by decreasing osteoclast activity.
where damaged muscle fibers break down and release myoglobin.
The most dangerous electrolyte imbalance associated with rhabdomyolysis is
The classic clinical manisfestation of rhabdomyolysis is
profound muscle weakness with pain
The key characteristic of excessive myoglobin is
dark, reddish brown urine.
Treatment for rhabdomyolysis is
IV crystalloid solutions
Sodium bicarbonate affects rhabdomyolysis by
rendering myoglobin insoluble.
Compartment syndrome is
an increase in compartment contents or compression of the compartment increases the pressure.
The most common area that compartment syndrome is found
Most common cause of compartment syndrome is
What is FES
Fat embolism syndrome
Fat embolism syndrome is
due to a long bone fracture where a drop of fat has traveled to lungs or other organs following fracture.
is where there is more bone absorbed by the body than what is being formed. Higher risk in women as menopause accelerates bone loss.
Risk factors for osteoporosis
insufficient calcium intake
lack of weight bearing exercise
low body weight and short in stature.
too much phosphate
use of glucocorticoids and not enough sun exposure.
Drug of choise for osteoporosis
alendronate 5 mg once daily
tear or injury to the tendon
tear or injury to the ligament
Complete separation of a tendon or ligament from its bony attachment site.
bone to muscle
bone to bone
inflammation of the tendon
painful degradation of the collagen fibres
Inflammation of the bursa
inflammation of a tendon where it attaches to the bone
drug that increases bone formation
less than three joints affected
5 or more joints affected
has a severe systemic onset
What are the distinct modes of onset for juvenile arthritis?
Non steroidal anti inflammatory drugs
disease modifying anti rheumatic drugs (methotrexate, sulfasalazine)
chronic inflammatory joint disease characterised by stiffening and fusion of the spine and sacroiliac joints.
DMARD takes 3 - 6 week to take effect can be hepatotoxic, taken once a week.
Anti inflammatory and immunomodulatory actions, slows progression of joint deterioration and has GI side effects.
reduces uric acid production (inhibits uric acid formation)
increases uric acid excretion
anti inflammatory properties does not reduce uric acid formation or excretion.
Group of disorders that cause degeneration of skeletal muscle fibres.
Duchennes muscular dystrophy
caused by mutation in the gene located on the short arm of the x chromosome.
progressive appears by approximately 3 years of age.