Until the skeleton matures and adult stature is reached, where does growth in the length of bone occur?
Epiphyseal line
Physeal plate
Epiphyseal cartilage
Metaphyseal plate
A healthcare professional is educating an expectant parent class. Which skeletal deformity does the professional tell them is normal at birth but generally disappears by years of age?
Genu varum (bowleg)
Genu valgum (knock knee)
Equinovarus (clubfoot)
Pes planus (flat feet)
A healthcare professional wants to estimate the total mass of muscle in a patient’s body. What serum laboratory test should the professional evaluate?
Albumin
Blood urea nitrogen
Creatinine
Creatine
A healthcare professional working with children learns that which is the most common congenital skeletal defect of the upper extremity?
Vestigial tabs
Paget disease
Rickets
Syndactyly
What diagnosis is given to parents when their infant’s hip maintains contact with the acetabulum but is not well seated within the hip joint?
Dislocatable hip
Subluxated hip
Dislocated hip
Subluxable hip
Which sign or symptom is a very late indication of developmental dysplasia of the hip?
Asymmetry of the gluteal or thigh folds
. Leg-length discrepancy
Waddling gait
Pain
To assess for osteogenesis imperfecta, which laboratory result would the healthcare professional expect to find?
Increased phosphorus
Decreased calcium
Increased alkaline phosphatase
Decreased total protein
A child has a disorder that resulted in the failure of bones to ossify, resulting in soft bones and skeletal deformity. What treatment plan does the healthcare professional discuss with the parents?
Extremely careful handling
Increasing vitamin D intake
Revascularization
Containment and motion therapy
An insufficient dietary intake of which vitamin can lead to rickets in children?
C
B12
B6
D
A child has scoliosis with a 40-degree curvature of the spine, and the parent is worried about pulmonary involvement. What statement by the healthcare professional is most appropriate?
“Scoliosis is a bone disorder and does not affect the lungs.”
“Yes, we should obtain pulmonary function studies soon.”
“Scoliosis severe enough to involve the lungs would be fatal.”
“The lungs aren’t affected until the curvature is over 80 degrees.”
In osteomyelitis, bacteria gain access to the subperiosteal space in the metaphysis. What factor makes this route the easiest for bacteria to gain access to this area?
Cortex of the bone in this area is porous or mazelike.
Blood supply to the metaphysis is easily compromised
Macrophages and lymphocytes have limited access to the subperiosteal space.
Bacteria usually spread down the medullary cavity of the bone.
The student wants to know how the clinical manifestations and onset of juvenile idiopathic arthritis (JIA) differ from those of rheumatoid arthritis (RA) in adults. What answer by the healthcare professional is best?
JIA begins insidiously with systemic signs of inflammation.
JIA predominantly affects large joints.
JIA has more severe joint pain than adult RA.
JIA has a rapid onset of generalized aches as the first symptom.
An adolescent has been diagnosed with osteochondrosis. How does the healthcare professional describe the pathophysiology to the teen?
Imbalance between calcitonin and parathyroid hormone
Nutritional deficiency of calcium and phosphorus
Bacterial infection of the bone
Vascular impairment and trauma to bone
Which bones are affected in Legg-Calvé-Perthes disease?
Heads of the femur
Distal femurs
Heads of the humerus
Distal tibias
What does the student learn about the pain experienced with Legg-Calvé-Perthes disease?
Elbow and upper and lower arm pain is aggravated by activity and relieved by rest.
Knee, inner thigh, and groin pain is described as a continuous ache and relieved by antiinflammatory drugs.
Knee, inner thigh, and groin pain is aggravated by activity and relieved by rest.
Elbow and upper and lower arm pain is described as a continuous ache and relieved by antiinflammatory drugs.
The healthcare professional directs a student to assess a teen who has Osgood-Schlatter disease. What assessment finding does the student anticipate for this disorder?
Lateral epicondylitis of the elbow
Inflammation of the anterior cruciate ligament
Bursitis of the subscapular bursa in the glenohumeral joint
Tendinitis of the anterior patellar tendon
At birth, the diagnosis of cerebral palsy (CP) may be made based on what factor?
Brain trauma
Prematurity
Major brain malformation
Genetic defect
A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate?
X-linked recessive inheritance
Common SMN1 gene abnormality
Autosomal dominant inheritance
Inheritance is not well defined
Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscle fibers to the basement membrane?
Syntrophin
Laminin
Dystrophin
Troponin
A child has Duchenne muscular dystrophy. What complication does the healthcare professional teach the parents is most important to control?
Respiratory infection
Joint contractures
Urinary tract infection
Fractures from falling
Generally, what is the first symptom of facioscapulohumeral muscular dystrophy?
Inability to open the eyes completely
Difficulty standing
Drooping shoulders
Facial pain
What is the most common malignant bone tumor diagnosed during childhood?
Chondrosarcoma
Fibrosarcoma
Ewing Sarcoma
Osteosarcoma
Molecular analysis has demonstrated that osteosarcoma is associated with which gene?
TP53
src
myc
TSC2
A child has osteosarcoma and the healthcare team is assessing for metastases. What diagnostic study would be the priority?
Pancreatic enzyme analysis
Liver biopsy
Chest x-ray or CT scan
Brain MRI
What does a Ewing sarcoma arise from?
Bone marrow
Bone-producing mesenchymal cells
Metadiaphysis of long bones
Embryonal osteocytes
Rhabdomyosarcoma can develop in which type of muscle?
Cardiac
Smooth
Involuntary
Striated
A newborn is diagnosed with osteomyelitis. What organism does the healthcare professional prepare to treat?
Staphylococcus aureus
Escherichia coli
Group B streptococcus
Bacillus anthracis
A student asks what the cause of structural scoliosis is. What explanation by the professor is accurate?
Poor posture
Vertebral rotation
Poor calcium absorption
Intrauterine trauma
What does the student learn about bone growth before adulthood? (Select all that apply.)
Growth in the length of bone occurs at the physeal plate.
Growth occurs through endochondral ossification.
Bone growth takes place under hormonal control.
Cartilage cells at the epiphyseal side of the physeal plate multiply and enlarge.
Cartilage cells at the metaphyseal side of the plate are replaced by bone.
The anatomic makeup of which bone structures make them susceptible locations for osteomyelitis in children? (Select all that apply.)
Hip joint
Distal femur
Proximal humerus
Distal radius
Lateral ankle
