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WorksheetsCh. 12 Questions
Total questions: 10
Worksheet time: 5mins
A 72-year-old woman with a history of early menopause presents with a compression fracture of T12 after lifting a light box. Which pathophysiologic sequence best explains this injury?
Decreased osteoblast activity from chronic inactivity causing bone overgrowth and brittleness
Estrogen deficiency increasing osteoclast activity, accelerating bone resorption and decreasing bone density
Chronic vitamin C deficiency reducing collagen cross-linking and bone hardness
Excess parathyroid hormone causing abnormal bone remodeling with sclerotic thickening
A 13-year-old girl is found to have an S-shaped lateral curvature of her spine with asymmetry of her shoulders and rib cage. Which complication is most likely if this condition progresses untreated?
Compression fractures of the thoracic vertebrae from bone weakness
Osteonecrosis of vertebral bodies from vascular compromise
Restrictive lung disease from altered chest wall mechanics and decreased thoracic volume
Increased risk of lumbar lordosis from pelvic tilt compensation
A 60-year-old man presents with joint pain, swelling, and warmth in the first metatarsophalangeal joint. Synovial fluid aspiration shows negatively birefringent, needle-shaped crystals. Which underlying process most likely led to this finding?
Autoimmune destruction of articular cartilage with pannus formation
Supersaturation of uric acid in the blood causing monosodium urate crystal deposition in synovial fluid
Chronic wear and tear causing chondrocyte apoptosis and cartilage thinning
Septic arthritis from bacterial invasion of the joint space
A 45-year-old woman with rheumatoid arthritis presents with worsening fatigue and joint deformities despite NSAID use. Which medication class is indicated to slow joint destruction?
High-dose opioids to reduce pain and inflammation
Disease-modifying antirheumatic drugs (DMARDs) to suppress immune-mediated synovial inflammation
Systemic corticosteroids for short-term symptom control only
Intra-articular hyaluronic acid injections to replace synovial fluid
A 66-year-old man with Paget’s disease of bone presents with hearing loss and increasing head circumference. Which best explains his symptoms?
Osteoclastic overactivity thinning the skull and causing brain herniation
Widespread osteonecrosis impairing cranial nerve function
Disorganized bone remodeling leading to thickened but structurally weak skull bones that compress cranial nerves
Vitamin D toxicity increasing bone mineralization and narrowing foramina
A 24-year-old man develops severe thigh pain and swelling after a fracture repair 2 weeks ago. The skin is tense, and passive stretching of the muscles worsens the pain. Pulses are intact. Which immediate intervention is needed?
High-dose NSAIDs to reduce swelling
Ice and elevation to reduce inflammation
Emergent fasciotomy to relieve compartment pressure and restore perfusion
Immobilization of the limb for an additional 2 weeks
A 42-year-old man presents with persistent hip pain after a fracture repair. MRI shows areas of bone death without infection. Which risk factor most likely contributed to his condition?
Chronic NSAID use
Low dietary calcium
Chronic corticosteroid therapy impairing bone vascular supply
Increased osteoblast activity from testosterone replacement
A 51-year-old woman presents with morning back stiffness that improves with activity. X-ray reveals fusion of the sacroiliac joints and bamboo-spine appearance. Which HLA type is strongly associated with her condition?
HLA-DR3
HLA-DQ2
HLA-B27
HLA-A2
A 34-year-old man develops fever, localized tibial pain, and swelling 1 month after an open fracture. MRI shows cortical bone destruction. Which organism is most commonly implicated?
Streptococcus pyogenes
Pseudomonas aeruginosa
Staphylococcus aureus
Escherichia coli
A 49-year-old woman presents with diffuse musculoskeletal pain, fatigue, and poor sleep. Exam shows multiple bilateral tender points. Labs are normal. Which underlying mechanism best explains her condition?
Autoimmune synovial inflammation causing cartilage destruction
Vitamin D deficiency impairing calcium homeostasis
Central nervous system pain amplification with abnormal neurotransmitter regulation
Peripheral nerve demyelination impairing pain signaling
