Emily Doyle
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Pathophysiology: The Biologic Basis of Disease in Adults and Children 8th Edition

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Emily Doyle
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Chapter 46: Alterations of Musculoskeletal Function in Children

Question 1 of 30

1

Until the skeleton matures and adult stature is reached, where does growth in the length of bone occur?

Select one of the following:

  • Epiphyseal line

  • Physeal plate

  • Epiphyseal cartilage

  • Metaphyseal plate

Explanation

Question 2 of 30

1

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?

Select one of the following:

  • Genu varum (bowleg)

  • Genu valgum (knock knee)

  • Equinovarus (clubfoot)

  • Pes planus (flat feet)

Explanation

Question 3 of 30

1

A healthcare professional wants to estimate the total mass of muscle in a patient’s body. What serum laboratory test should the professional evaluate?

Select one of the following:

  • Albumin

  • Blood urea nitrogen

  • Creatinine

  • Creatine

Explanation

Question 4 of 30

1

A healthcare professional working with children learns that which is the most common congenital skeletal defect of the upper extremity?

Select one of the following:

  • Vestigial tabs

  • Paget disease

  • Rickets

  • Syndactyly

Explanation

Question 5 of 30

1

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?

Select one of the following:

  • Dislocatable hip

  • Subluxated hip

  • Dislocated hip

  • Subluxable hip

Explanation

Question 6 of 30

1

Which sign or symptom is a very late indication of developmental dysplasia of the hip?

Select one of the following:

  • Asymmetry of the gluteal or thigh folds

  • . Leg-length discrepancy

  • Waddling gait

  • Pain

Explanation

Question 7 of 30

1

To assess for osteogenesis imperfecta, which laboratory result would the healthcare
professional expect to find?

Select one of the following:

  • Increased phosphorus

  • Decreased calcium

  • Increased alkaline phosphatase

  • Decreased total protein

Explanation

Question 8 of 30

1

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?

Select one of the following:

  • Extremely careful handling

  • Increasing vitamin D intake

  • Revascularization

  • Containment and motion therapy

Explanation

Question 9 of 30

1

An insufficient dietary intake of which vitamin can lead to rickets in children?

Select one of the following:

  • C

  • B12

  • B6

  • D

Explanation

Question 10 of 30

1

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?

Select one of the following:

  • “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.”

Explanation

Question 11 of 30

1

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?

Select one of the following:

  • 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.

Explanation

Question 12 of 30

1

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?

Select one of the following:

  • 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.

Explanation

Question 13 of 30

1

An adolescent has been diagnosed with osteochondrosis. How does the healthcare
professional describe the pathophysiology to the teen?

Select one of the following:

  • Imbalance between calcitonin and parathyroid hormone

  • Nutritional deficiency of calcium and phosphorus

  • Bacterial infection of the bone

  • Vascular impairment and trauma to bone

Explanation

Question 14 of 30

1

Which bones are affected in Legg-Calvé-Perthes disease?

Select one of the following:

  • Heads of the femur

  • Distal femurs

  • Heads of the humerus

  • Distal tibias

Explanation

Question 15 of 30

1

What does the student learn about the pain experienced with Legg-Calvé-Perthes disease?

Select one of the following:

  • 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.

Explanation

Question 16 of 30

1

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?

Select one of the following:

  • 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

Explanation

Question 17 of 30

1

At birth, the diagnosis of cerebral palsy (CP) may be made based on what factor?

Select one of the following:

  • Brain trauma

  • Prematurity

  • Major brain malformation

  • Genetic defect

Explanation

Question 18 of 30

1

A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate?

Select one of the following:

  • X-linked recessive inheritance

  • Common SMN1 gene abnormality

  • Autosomal dominant inheritance

  • Inheritance is not well defined

Explanation

Question 19 of 30

1

Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscle fibers to the basement membrane?

Select one of the following:

  • Syntrophin

  • Laminin

  • Dystrophin

  • Troponin

Explanation

Question 20 of 30

1

A child has Duchenne muscular dystrophy. What complication does the healthcare
professional teach the parents is most important to control?

Select one of the following:

  • Respiratory infection

  • Joint contractures

  • Urinary tract infection

  • Fractures from falling

Explanation

Question 21 of 30

1

Generally, what is the first symptom of facioscapulohumeral muscular dystrophy?

Select one of the following:

  • Inability to open the eyes completely

  • Difficulty standing

  • Drooping shoulders

  • Facial pain

Explanation

Question 22 of 30

1

What is the most common malignant bone tumor diagnosed during childhood?

Select one of the following:

  • Chondrosarcoma

  • Fibrosarcoma

  • Ewing Sarcoma

  • Osteosarcoma

Explanation

Question 23 of 30

1

Molecular analysis has demonstrated that osteosarcoma is associated with which gene?

Select one of the following:

  • TP53

  • src

  • myc

  • TSC2

Explanation

Question 24 of 30

1

A child has osteosarcoma and the healthcare team is assessing for metastases. What diagnostic study would be the priority?

Select one of the following:

  • Pancreatic enzyme analysis

  • Liver biopsy

  • Chest x-ray or CT scan

  • Brain MRI

Explanation

Question 25 of 30

1

What does a Ewing sarcoma arise from?

Select one of the following:

  • Bone marrow

  • Bone-producing mesenchymal cells

  • Metadiaphysis of long bones

  • Embryonal osteocytes

Explanation

Question 26 of 30

1

Rhabdomyosarcoma can develop in which type of muscle?

Select one of the following:

  • Cardiac

  • Smooth

  • Involuntary

  • Striated

Explanation

Question 27 of 30

1

A newborn is diagnosed with osteomyelitis. What organism does the healthcare professional prepare to treat?

Select one of the following:

  • Staphylococcus aureus

  • Escherichia coli

  • Group B streptococcus

  • Bacillus anthracis

Explanation

Question 28 of 30

1

A student asks what the cause of structural scoliosis is. What explanation by the professor is accurate?

Select one of the following:

  • Poor posture

  • Vertebral rotation

  • Poor calcium absorption

  • Intrauterine trauma

Explanation

Question 29 of 30

1

What does the student learn about bone growth before adulthood? (Select all that apply.)

Select one or more of the following:

  • 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.

Explanation

Question 30 of 30

1

The anatomic makeup of which bone structures make them susceptible locations for osteomyelitis in children? (Select all that apply.)

Select one or more of the following:

  • Hip joint

  • Distal femur

  • Proximal humerus

  • Distal radius

  • Lateral ankle

Explanation

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