Hip Diseases, Injuries and Treatments - Part 2 (Msq Drill 189)

1. Is renal osteodystrophy one disease or a spectrum of diseases?

One bone disease

A spectrum of diseases

2. Renal osteodystrophy is a spectrum of disorders of bone mineral metabolism associated with:

Acute liver disease

Acute kidney disease

Chronic liver disease

Chronic kidney disease

3. X-rays of an osteoarthritic hip will show which of the following?

Spurring

Joint space narrowing

Subchondral sclerosis

Subchondral cysts

Submit

4. Physical examination of the patient with osteoarthritis will show:

Decreased ROM

Increased ROM

Crepitus

Submit

5. Can leg length problems also cause back pain?

Yes

No

6. Do hip fractures occur more commonly in men or in women?

Men

Women

7.

Is this a hip fracture or dislocation?

Fracture

Dislocation

8. If patients fall on the ___________ contusions are very common.

Sacrum

Ischial tuberosity

Iliac crest

9. Avulsion injuries can occur at any point where muscles attach to the pelvis region. True or false?

True

False

10. Can patients with legg calve perthe disease also present with c/o knee pain?

Yes

No

11. Developmental dysplasia was formerly called congenital hip dislocation. True or false?

True

False

12. What are the two tests that are used to test for developmental dysplasia in which a patient has a dislocated hip?

Ortolani's test

Routing test

Barlows test

Submit

13. Is it absolutely necessary to excise an osteoid osteomas?

Yes, they should always be exscised

No, they are rarely excised

14.

Osteoid osteoma

Avulsion fx of the proximal femur

Bennet's fx

Osteoporotic bone

15. Is referred pain also a common cause of hip pain?

Yes

No

16. Which of the following are causes of referred pain to the hip?

Spinal disease

Knee disease

Discomfort from a baker's cyst

Ligamental or bursal pain

Trochanteric bursitis

Submit

17. Which of the following metabolic bone disease is age related, and leads to a decrease in bone mass. It is responsible for over a million fractures per year and is usually associated with low estrogen in post menopausal women?

Osteosclerosis

Osteomalacia

Renal osteodystrophy

Osteoporosis

18.

What is this metabolic bone disease in which elevation of bone density is observed?

Osteoarthritis

Osteoporosis

Osteosclerosis

Renal osteodystrophy

19. Do you treat the osteomalacia or the cuase of the malabsorption of vitamin D in a patient with osteomalacia?

You treat the osteomalacia

You treat the cause of the malabsorption of vitamin D

20. What metabolic bone disease is caused by abnormal collagen synthesis. It causes fragility, short stature, scoliosis, tooth defects, hearing loss and ligamentous laxity. It is also a frequent cause of fractures with little trauma. It is an autosomal dominant genetic disorder?

Osteoarthritis

Osteogenesis imperfecta

Ehler danlos

Acondroplasia

21. These patients may have what bone disease?

Osteomalacia

Osteogeneis imperfecta

Raynaud's

22. What disease occurs as a result of abnormal bone remodeling? The bone is enlarged, less dense , brittle and prone to fractures. Its cause is unknown?

Rickets

Paget's disease

Osteoarthritis

23.
What injury ensues after this type of fall?

Avulsion

Contusion

Fracture

24.

Heterotopic ossification of muscle
Trauma related
Conservative treatment

What is the diagnosis?

Avulsion fracture of the proximal femur

Myositis ossificans

Avulsion fracture of the less trochanter

Renal osteodystrophy

25.

Inflammation of the pubic symphisis is known as :

Osteitis pubis

Avulsion fracture of the pubes

Pubic symphysis inflammation

26. Crepitus is the hallmark of arthritis. True or false?

True

False

27. An athletic patient pesents with groin pain and a cliking, locking or catcing sound in the hip. You are able to diagnose this using either an MRI or Arthroscopy. What is the diagnosis?

Osteocondritis dessicans

Humeral condylar teat

Medial meniscal tear

Acetabular labrum tear

28. Surgery is ALWAYS indicated for a slipped capital epiphysis. True or false?

True

False

29. Avascular necrosis of the proximal femoral head epiphysis is known as:

Legg-calve-perthes disease

Osteochondritis dessicans

Transient synovitis

30. Between Ortolani and Barlow's which one is a reductive test?

Ortolani

Barlow

Barlow is provocative

Explanation

Barlow is provocative

31. Will you be able to see DDH on x-ray?

Yes, they have ossified femoral head

No, their femoral head is not yet ossified, ultrasound is better

32. Osteonecrosis usually occurs in adults or children?

Adults

Children

33. Which of the following can lead to osteonecrosis and a possible crumbled femoral head?

Alcohol abuse

Chronic steroid use

Trauma

Metastatic disease

Preganancy

Submit

34. Can a patient with rheumatoid arthritis undergo a total hip replacement as a form of treatment?

Yes

No

35. What is higher, the sensitivity or specificity of MRI in the diagnoiss of inflammatory causes of hip pain?

Higher sensitivity

Higher specificity

36. Is an osteoid osteoma, a tumor of the hip, malignant or benign?

Malignant

Benign

37. Which part of the hip is affected by an osteoid osteoma?

Distal femur

Fovea

Proximal femur

Distal femur

38. You observe a small radiolucent nidus witha white dense reactive zone on x-ray and diagnose an osteoid osteoma. Is this usually less than 1.5cm in diameter or more than 1.5 cm in diameter?

Less than 1.5 cm in diameter

More than 1.5 cm in diameter

39. Whatis the most common malignant tumor of the skeletal system?

Metastatic cancer

Primary bone tumors

Melanoma

Lymphoma

40. *********** 85% of metastasis to the bone comes from which areas?

Breast

Lung

Thyroid

Kidney

Prostrate

Submit

41. Osteoporosis
osteosclerosis
osteomalcia
osteogenesis imperfects
pagets
rickets & renal osteodystrophy are all __________ that can also cause hip pain.

Inflammatory connective tissue diseases

Autoimmune bone diseases

Metabolic bone diseases

42. Which of the following are treatments for osteoporosis?

Exercise

Calcium supplementation

Estrogen

Biphosphonates

Submit

43. What metabolic bone disease is caused by a decreased intake of Vitamin D leading to a deficiency in the mineralization of the protein structures of the bone. It causes softening of the bone and in children it is called Rickets.

Osteomalacia

Renal osteodystrophy

Osteopenia

44.

What is this condition?

Leg calf perthe disease

Osteogenesis imperfecta

Rickets

45. A damaged kidney causes decreased excretion of phosphate causing:

Hypoparathyroidism

Hyperparathyroidism

Hypothyroidism

Thypoerthyroidism

46. What is the most common form of arthritis?

Osteoarthritis

Osteoporosis

Rheumatoid arthritis

Ankylosing spondylitis

47. Which of the following are used to treat osteoarthritis?

NSAIDS

Weight loss

Assistive devices

Intrarticualar cortisone injections

Hip replacement

Submit

48.
Black females have been reported to be twice as likely to fracture their hips than white and hispanic females. True or false?

True

False

white women have been reported to be twice as likely to fracture their hips than black and hispanic females.

Explanation

white women have been reported to be twice as likely to fracture their hips than black and hispanic females.

49. What is the main treatment for Hip fractures?

Hip replacement

NSAIDS

Avoid falls

Immobilization of the hip

50. What is the most common bacteria in osteomyelitis?

Staph aureaus

H influenza

Pseudomonas aureginosa

Strep aureus

51. Is this a hip dislocation or fracture?

Dislocation

Fracture

52. Patients presenting with pain around the outer portion of their hip should have what diagnosis in their differential?

Avascular necrosis

Trochanteric bursitis

Osteochondritis dessicans

53. An obese 15 year old present with knee pain. What is the one x-ray you want to order and why?

Knee xray ossgood slaughter

Hip-xray slipped capital epiphysis

Lower foot - liss franc

54. What is the most common cause of painful hips in childhood

Osgood slaughter

Slipped capital epiphysis

Transient synovitis

diagnosis is by exclusion, you want to work them up for in infectious process

Explanation

diagnosis is by exclusion, you want to work them up for in infectious process

55. What is the median age for the occurence of legg-calve perthes disease?

5

6

7

8

9

56. A first born female is born breech resulting in hip subluxation-dislocation. She also has torticollis and metatarsus adductus. She has capsular laxity. What is the most likely diagnosis of her disease?

Developmental dysplasia

Lesh nyhan disease

Ehlers danlos

57.

This patient has rheumatoid arthritis. "Which of the following is visible on this x-ray?"

Narrowing of joint spaces

Periarticular osteopenia

Juxtaarticular erosions (non-cartillage portected bone)

Subluxation and gross deformity

Perioarticular soft tissue swelling

Submit

58. In children ____________________ can cause inflammatory hip pain?

Pseudomonas aueriginosa

Clostridium difficile

H influenza

Staph aureus

59. Are osteoid osteoma's benign tumors of the proximal femur more common in adults or children?

Adults

Children

60.

What is this condition known as in children?

Costochondritis

Osteomalacia

Rickets

Osteosclerosis

61. Which type of collagen is abnormal in patients with osteogenesis imperfecta?

Type 1 collagen

Type II collagen

Type III collagen

Type IV collagen

62. Which of the following are the broad categories of rickets?

Nutritional

Hereditary Vit D dependant

Familial hypophosphatemic rickets

Non vitamin D dependant

Submit

63. Of the three broad catergories of rickets which one is the most common?

Nutritional

Hereditary vitamin D dependant

Familial hypophosphatemic rickets

64. Paget's disease is also known as:

Osteitis deformans

Osteochondritis dessicans

Legg calve perthes disease

65. Metastatic tumors of the skeletal system are ________ times more common than primary bone tumors

5

10

15

20

25

66. What are the two forms of renal osteodystrophy?

High turnover

Proliferative

Non proliferative

Low turnover

Submit

67. In which metabolic bone disease do bones appear sclerotic with widened growth plates and varus deformities of the proximal femur?

Legg clave perthes disease

Osteocondritis dessicans

Osteoporosis

Renal osteodystrophy

68. There are an estimated __________ hip fractures that occur each year.

50 000

75 000

150 000

340 000

1 million

69. Most studies show that _____ or more patients will die within one year following injury.

10%

20%

27%

35%

50%

70.
Should you immediately excise a myositis ossificans?

Yes

No

You never ever take them out unless you are 100% certain that it hs stoppped growing.

Explanation

You never ever take them out unless you are 100% certain that it hs stoppped growing.

71. Which of the following are other inflammatory causes of hip pain?

Osteomyelitis - infection of the bone

Septic arthritis - infection of a joint

Bacteria & viruses

Mycobacterium and fungi

Osteoarthritis

osteoarthritis is not an inflammatory process.

Explanation

osteoarthritis is not an inflammatory process.

Submit

72. Which of the following are ways that you can diagnose other inflammatory causes of hip pain?

Aspiration

X-ray

Bone scan

MRI

CT scan

Submit

73. Which of the following are some of the most common bacteria that you may find causing inflammation in the hip joint?

Staph aureaus

H influenza

Neissseria Gonorhea

C- difficile

E coli

Submit

74. What would you prescribe for your patient with newly diagnosed osteomalacia?

10 000 IU weekly of vitamin D for 4-6 weeks

500 IU VITAMIN D BID

1000 Iu vitamin D every month

75. Which of the following is very typical in patients with osteogenesis imperfecta?

Short stature

Increased laxicity of the joints with frequent stress ractures

Accompanying autoimmune mediated connective tissue disease

Discoloration of sclera causing a blue-gray color (thinner sclera showing the choroidal veins of the retina.)

76. Which of the following are part of the treatment regimen for patients with osteogenesis imperfecta?

Bisphonophates

Exercise

Physical therapy

Calcium

Prevention of fractures

Submit

77. What are the two types of osteogenesis imperfecta?

Congenita

Acquired

Tarda

Submit

78. How do you treat Paget's disease?

Bisphonates such as fosamax

Calcium supplementation

Calcitonin

Submit

79. Which of the following are common causes of osteitis pubis?

Soccer

Hockey

Running

Walking

Swimming

Repetitive trauma

Explanation

Repetitive trauma

Submit

80. Which of the following are sites of fractures in the hip area?

Femoral neck and head

Intertrochanteric and subtrochnateric

Lesser trochanter & greater trochanter

Foveal fractures

Stress fracture

Submit

81. _____ out of 10 hip fractures occur in patients over 65 years old.

2

4

6

7

9

82. Abnormal contact between femoral head and acetabulum is known as a femoroacetabular impingment., What are the two classifications?

Avulsine

Pincer type

Unmixed

Mixed

Submit

83. Which of the following drugs is very effective for Osteoid osteomas?

Hydrocodone

NSAIDS

Steroids

Chemotherapy

Aspirin

84. Rickets causes failure of mineralization. Which of the following changes will be observed in the bones of these patients?

Wide disoriented physis

Thinning and bowing of the diaphyseal bone

Narrowed joint spaces

Diaphyseal bone thickening

Comes fro the old english term wriccken to twist.

Explanation

Comes fro the old english term wriccken to twist.

Submit

85. Which of the following are other causes of groin pain?

Adductor strains

Hernia

Nerve entrapement

Stress fracture of the femoral neck

Hip dislocations

Submit

Hip Diseases, Injuries and Treatments - Part 2 (Msq Drill 189)

1. Is renal osteodystrophy one disease or a spectrum of diseases?

2.

What first name or nickname would you like us to use?

2. Renal osteodystrophy is a spectrum of disorders of bone mineral metabolism associated with:

3. X-rays of an osteoarthritic hip will show which of the following?

4. Physical examination of the patient with osteoarthritis will show:

5. Can leg length problems also cause back pain?

6. Do hip fractures occur more commonly in men or in women?

7. Is this a hip fracture or dislocation?

8. If patients fall on the ___________ contusions are very common.

9. Avulsion injuries can occur at any point where muscles attach to the pelvis region. True or false?

10. Can patients with legg calve perthe disease also present with c/o knee pain?

11. Developmental dysplasia was formerly called congenital hip dislocation. True or false?

12. What are the two tests that are used to test for developmental dysplasia in which a patient has a dislocated hip?

13. Is it absolutely necessary to excise an osteoid osteomas?

14.

15. Is referred pain also a common cause of hip pain?

16. Which of the following are causes of referred pain to the hip?

17. Which of the following metabolic bone disease is age related, and leads to a decrease in bone mass. It is responsible for over a million fractures per year and is usually associated with low estrogen in post menopausal women?

18. What is this metabolic bone disease in which elevation of bone density is observed?

19. Do you treat the osteomalacia or the cuase of the malabsorption of vitamin D in a patient with osteomalacia?

20. What metabolic bone disease is caused by abnormal collagen synthesis. It causes fragility, short stature, scoliosis, tooth defects, hearing loss and ligamentous laxity. It is also a frequent cause of fractures with little trauma. It is an autosomal dominant genetic disorder?

21. These patients may have what bone disease?

22. What disease occurs as a result of abnormal bone remodeling? The bone is enlarged, less dense , brittle and prone to fractures. Its cause is unknown?

23. What injury ensues after this type of fall?

24. Heterotopic ossification of muscleTrauma relatedConservative treatmentWhat is the diagnosis?

25. Inflammation of the pubic symphisis is known as :

26. Crepitus is the hallmark of arthritis. True or false?

27. An athletic patient pesents with groin pain and a cliking, locking or catcing sound in the hip. You are able to diagnose this using either an MRI or Arthroscopy. What is the diagnosis?

28. Surgery is ALWAYS indicated for a slipped capital epiphysis. True or false?

29. Avascular necrosis of the proximal femoral head epiphysis is known as:

30. Between Ortolani and Barlow's which one is a reductive test?

31. Will you be able to see DDH on x-ray?

32. Osteonecrosis usually occurs in adults or children?

33. Which of the following can lead to osteonecrosis and a possible crumbled femoral head?

34. Can a patient with rheumatoid arthritis undergo a total hip replacement as a form of treatment?

35. What is higher, the sensitivity or specificity of MRI in the diagnoiss of inflammatory causes of hip pain?

36. Is an osteoid osteoma, a tumor of the hip, malignant or benign?

37. Which part of the hip is affected by an osteoid osteoma?

38. You observe a small radiolucent nidus witha white dense reactive zone on x-ray and diagnose an osteoid osteoma. Is this usually less than 1.5cm in diameter or more than 1.5 cm in diameter?

39. Whatis the most common malignant tumor of the skeletal system?

40. *********** 85% of metastasis to the bone comes from which areas?

41. Osteoporosisosteosclerosisosteomalciaosteogenesis imperfectspagetsrickets & renal osteodystrophy are all __________ that can also cause hip pain.

42. Which of the following are treatments for osteoporosis?

43. What metabolic bone disease is caused by a decreased intake of Vitamin D leading to a deficiency in the mineralization of the protein structures of the bone. It causes softening of the bone and in children it is called Rickets.

44. What is this condition?

45. A damaged kidney causes decreased excretion of phosphate causing:

46. What is the most common form of arthritis?

47. Which of the following are used to treat osteoarthritis?

48. Black females have been reported to be twice as likely to fracture their hips than white and hispanic females. True or false?

49. What is the main treatment for Hip fractures?

50. What is the most common bacteria in osteomyelitis?

51. Is this a hip dislocation or fracture?

52. Patients presenting with pain around the outer portion of their hip should have what diagnosis in their differential?

53. An obese 15 year old present with knee pain. What is the one x-ray you want to order and why?

54. What is the most common cause of painful hips in childhood

55. What is the median age for the occurence of legg-calve perthes disease?

56. A first born female is born breech resulting in hip subluxation-dislocation. She also has torticollis and metatarsus adductus. She has capsular laxity. What is the most likely diagnosis of her disease?

57. This patient has rheumatoid arthritis. "Which of the following is visible on this x-ray?"

58. In children ____________________ can cause inflammatory hip pain?

59. Are osteoid osteoma's benign tumors of the proximal femur more common in adults or children?

60. What is this condition known as in children?

61. Which type of collagen is abnormal in patients with osteogenesis imperfecta?

62. Which of the following are the broad categories of rickets?

63. Of the three broad catergories of rickets which one is the most common?

64. Paget's disease is also known as:

65. Metastatic tumors of the skeletal system are ________ times more common than primary bone tumors

66. What are the two forms of renal osteodystrophy?

67. In which metabolic bone disease do bones appear sclerotic with widened growth plates and varus deformities of the proximal femur?

68. There are an estimated __________ hip fractures that occur each year.

69. Most studies show that _____ or more patients will die within one year following injury.

70. Should you immediately excise a myositis ossificans?

71. Which of the following are other inflammatory causes of hip pain?

72. Which of the following are ways that you can diagnose other inflammatory causes of hip pain?

73. Which of the following are some of the most common bacteria that you may find causing inflammation in the hip joint?

74. What would you prescribe for your patient with newly diagnosed osteomalacia?

75. Which of the following is very typical in patients with osteogenesis imperfecta?

76. Which of the following are part of the treatment regimen for patients with osteogenesis imperfecta?

77. What are the two types of osteogenesis imperfecta?

7.

Is this a hip fracture or dislocation?

18.

What is this metabolic bone disease in which elevation of bone density is observed?

23.
What injury ensues after this type of fall?

24.

Heterotopic ossification of muscle
Trauma related
Conservative treatment

What is the diagnosis?

25.

Inflammation of the pubic symphisis is known as :

41. Osteoporosis
osteosclerosis
osteomalcia
osteogenesis imperfects
pagets
rickets & renal osteodystrophy are all __________ that can also cause hip pain.

44.

What is this condition?

48.
Black females have been reported to be twice as likely to fracture their hips than white and hispanic females. True or false?

57.

This patient has rheumatoid arthritis. "Which of the following is visible on this x-ray?"

60.

What is this condition known as in children?

70.
Should you immediately excise a myositis ossificans?