Quiz On Bone Pathology

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  • 1/28 Questions

    A patient presents with hypermobile joints, easy bruising, hyperextensible skin  and kyphoscoliosis. He is also seen with a blue sclera. The diseases that could cause some of the same symptoms listed above are:

    • SIADH secretion and Hoshimotos
    • Osteogenesis imperfecta and Cushing's syndrome
    • Adenoma of the adrenal gland and pheochromocytoma
    • Subdural hematoma and Epidural Hematoma
    • Conn's syndrome and Cushing's syndrome
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About This Quiz

Many diseases that affect the whole body affect the bones in our bodies. Over the past few days in our classes we have been able to cover some of this topic. Take up the quiz below on bone pathology and see how much you understand about the features and diagnosis for the said diseases.

Quiz On Bone Pathology - Quiz

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  • 2. 

    A 56 year old post-menopausal woman complains of bone fractures. A gross image of her bones shows decreased size of the trebculae and loss of apposition. What molecule is increased in her disease?

    • RANK

    • OPG

    • Monocytes

    • Antibodies

    • IFNg

    Correct Answer
    A. RANK
    Explanation
    In this scenario, the correct answer is RANK. RANK stands for Receptor Activator of Nuclear Factor Kappa-B, which is a molecule involved in the regulation of bone remodeling. Increased levels of RANK can lead to increased bone resorption, which can result in decreased size of the trabeculae and loss of apposition, as seen in the gross image of the patient's bones. This suggests that the patient may be suffering from a condition characterized by increased bone resorption, such as osteoporosis or Paget's disease.

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  • 3. 

    A patient presents with multiple fractures and blue sclera of the eye. The same disease in infants would result in:

    • Death

    • Tumor of the bone

    • Fractures

    • Blue sclera

    • A C and D

    Correct Answer
    A. A C and D
    Explanation
    The patient presents with multiple fractures and blue sclera of the eye, which are characteristic features of osteogenesis imperfecta (OI). OI is a genetic disorder that affects the production of collagen, leading to fragile bones that are prone to fractures. Blue sclera is also a common feature in OI due to the translucency of the connective tissue in the eye. In infants with OI, the same disease would result in death, as the condition is often severe and life-threatening in early infancy. Therefore, the correct answer is A, C, and D.

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  • 4. 

    Upon performing a radiological examination of a patient's bone, there appears to be increased density and mineralization of the bone due to dysfunction in osteoclasts. The disease is also known as brittle bone disease. The enzyme that is not functioning properly in this disease is:

    • Carbonic anhydrase

    • Phosphatase

    • Creatine kinase

    • Phosphorylase

    • None of the above

    Correct Answer
    A. Carbonic anhydrase
    Explanation
    Carbonic anhydrase is an enzyme that plays a crucial role in bone resorption by osteoclasts. It helps in the breakdown of bone tissue by maintaining the acidic environment necessary for osteoclast activity. Dysfunction in carbonic anhydrase can lead to increased bone density and mineralization, which is a characteristic feature of brittle bone disease. Therefore, the correct answer is carbonic anhydrase.

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  • 5. 

    A patient presents with a benign tumor of the mature bone in the face. There appears to be bone islands. What is associated with this tumor?

    • Maffuci' syndrome

    • Gardner's syndrome

    • Ollier's disease

    • Rheumatoid arthritis

    • None of the above are associated

    Correct Answer
    A. Gardner's syndrome
    Explanation
    Gardner's syndrome is associated with a benign tumor of the mature bone in the face with bone islands. This syndrome is a rare genetic disorder that causes the growth of multiple polyps in the colon and other parts of the body. It is also associated with other abnormalities, including benign bone tumors such as osteomas. Therefore, Gardner's syndrome is the correct answer as it is specifically linked to the described tumor and bone islands in the patient.

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  • 6. 

    A blood sample of a patient is taken and there appears to be high levels of uric acid. A feature/s commonly associated with this patient is:

    • Tophi

    • Calcium pyrophosphate

    • Heberden's node

    • Pannus

    • A and D

    Correct Answer
    A. Tophi
    Explanation
    High levels of uric acid in the blood can lead to the formation of tophi, which are deposits of uric acid crystals that can accumulate in joints, tendons, and other tissues. Tophi are often seen in patients with gout, a condition characterized by elevated levels of uric acid. Therefore, the presence of tophi is commonly associated with a patient with high levels of uric acid. Calcium pyrophosphate, Heberden's node, and pannus are not directly related to high levels of uric acid.

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  • 7. 

    A 70 year old with long standing hypertension and increasing shoe size and cap size comes into your office. Her condition has progressed a tumor. Radiological examination reveals sunburst effect and Codman's triangle. What is the most common location of her tumor?

    • Metaphysis

    • Diaphysis

    • Epiphysis

    • Metaphysis and Diaphysis

    • Diaphysis and Epiphysis

    Correct Answer
    A. Metaphysis
    Explanation
    The most common location of the tumor in this case is the metaphysis. This can be inferred from the presence of the sunburst effect and Codman's triangle on radiological examination. These findings are typically associated with osteosarcoma, a type of bone tumor that commonly occurs in the metaphysis of long bones, such as the femur or tibia.

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  • 8. 

    A woman presents with fever, headache and malaise, symptoms of an infection. She received catheterization recently. Bone radiology studies reveals laying down of new bone. The disease she has can also be cause by a viral agent. Which of the following disease has a viral etiology?

    • Chondrocytoma

    • Progressive multifocal leukoencephalopathy

    • Osteogenesis imperfecta

    • Subdural hematoma

    • None of the above

    Correct Answer
    A. Progressive multifocal leukoencephalopathy
    Explanation
    Progressive multifocal leukoencephalopathy (PML) is a rare viral infection that affects the central nervous system. It is caused by the JC virus, which is a type of polyomavirus. The symptoms described in the question, such as fever, headache, and malaise, are consistent with an infection. Additionally, the laying down of new bone seen on the radiology studies is not characteristic of any of the other conditions listed. Therefore, PML is the only disease among the options that has a viral etiology.

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  • 9. 

    A 15 year old boy has shortened limbs and ribs, frontal bossing of the forehead, bowing of the limbs, his IQ however is normal. The cells that are affected in his disorder are:

    • Osteoclasts

    • Chondrocytes

    • Osteoblasts

    • Macrophages

    • Osteocytes

    Correct Answer
    A. Chondrocytes
    Explanation
    Chondrocytes are the cells responsible for the formation and maintenance of cartilage in the body. In this case, the 15-year-old boy has shortened limbs and ribs, which suggests a disorder affecting his skeletal system. Chondrocytes play a crucial role in the development and growth of bones, as they are responsible for the production and maintenance of cartilage, which serves as a template for bone formation. Therefore, if chondrocytes are affected in his disorder, it can lead to abnormal bone growth and development, resulting in the observed symptoms.

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  • 10. 

    A 25 year old man presents with benign tumor of the bone. The tumor is associated with macrophages and upon radiological examination of the bone, there appears to be a soap bubble like lesion. What is main location of the tumor?

    • Metaphysis

    • Diaphysis

    • Epiphysis

    • Humerus

    • Pelvis

    Correct Answer
    A. Epiphysis
    Explanation
    The correct answer is Epiphysis. Epiphysis refers to the end part of a long bone, which is separated from the shaft by a growth plate. Benign tumors of the bone associated with macrophages and a soap bubble-like lesion are often seen in the epiphysis. This location is common for tumors such as giant cell tumor of bone, which typically occur in the epiphysis of long bones like the femur or tibia.

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  • 11. 

    A young male of the age 24 presents with a benign tumor of the appendicular skeleton. Which of the following tumors has a similar prognosis?

    • Chondrosarcoma

    • Osteosarcoma

    • Osteoma

    • Ewing's sarcoma

    • None of the above

    Correct Answer
    A. Osteoma
    Explanation
    Osteoma is a benign tumor of the bone, which means it is not cancerous and does not spread to other parts of the body. Therefore, it has a similar prognosis as the benign tumor presented by the young male patient. Chondrosarcoma and osteosarcoma are malignant tumors, meaning they are cancerous and have the potential to spread. Ewing's sarcoma is also a malignant tumor, but it typically occurs in children and young adults and has a different prognosis compared to the benign tumor presented by the patient.

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  • 12. 

    A 5 year old child has a GI tract problem that causes malabsorption of a certain substance. The same disease seen is adults is known as osteomalacia. What condition is also associated with the deficiency?

    • Osteoporosis

    • Osteopetrosis

    • Scurvy

    • Cushing's syndrome

    • Pneumonia of the Lung

    Correct Answer
    A. Osteoporosis
    Explanation
    Osteoporosis is associated with the deficiency caused by malabsorption of a certain substance in both children and adults with GI tract problems. Osteoporosis is a condition characterized by weak and brittle bones, which can lead to an increased risk of fractures. The malabsorption of the substance in the GI tract affects the body's ability to properly absorb and utilize calcium, leading to a decrease in bone density and strength. Therefore, osteoporosis is the correct condition associated with the deficiency in this case.

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  • 13. 

    A 40 year old white male from Germany complains of pain in certain areas of the body. He is also discovered to be hypertensive. It is said that he has a problem wearing shoes and hats since they don't fit him properly anymore, he has outgrown them. What is the most common etiologic factor of his disease?

    • HIV

    • Smoking

    • It's hereditary

    • Polyoma virus

    • Paramyxovirus

    Correct Answer
    A. Paramyxovirus
    Explanation
    The most common etiologic factor of the patient's disease is believed to be the Paramyxovirus. This virus is known to cause various symptoms and complications, including pain in certain areas of the body and hypertensive problems. The fact that the patient is also experiencing difficulties with wearing shoes and hats due to outgrowing them suggests that there may be a growth-related issue caused by the virus. HIV, smoking, and hereditary factors are not mentioned in the given information and therefore cannot be considered as the most common etiologic factor.

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  • 14. 

    A 16 year old boy presents with a tumor of the long bones. Upon histological examination, there appears to be small blue cells. What is the prime location of the tumor?

    • Epiphysis

    • Metaphysis

    • Diaphysis

    • Epiphysis and diaphysis

    • None of the above.

    Correct Answer
    A. Diaphysis
    Explanation
    The prime location of the tumor is the diaphysis. The diaphysis is the shaft or middle part of a long bone, and the presence of small blue cells upon histological examination suggests that the tumor is located in this region. The epiphysis refers to the ends of the long bones, while the metaphysis is the area between the diaphysis and the epiphysis. Therefore, neither the epiphysis nor the metaphysis is the prime location for the tumor in this case.

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  • 15. 

    A blood test is performed on a patient with chronic renal failure and it seem that the levels of phosphate and calcium are lowered. There also appears to be iron and aluminum deposition in the bones. What is a common complication of his condition?

    • Osteopetrosis

    • Osteoporosis

    • Scurvy

    • Osteomalacia

    • Diabetes Mellitus

    Correct Answer
    A. Osteomalacia
    Explanation
    A common complication of chronic renal failure, given the described symptoms of lowered phosphate and calcium levels as well as iron and aluminum deposition in the bones, is Osteomalacia. Osteomalacia involves the softening of the bones due to impaired bone metabolism primarily caused by inadequate levels of available phosphate, calcium, and Vitamin D, which are often observed in patients with chronic kidney disease.

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  • 16. 

    A patient presents with fever, night sweats, and bloody sputum. There appear to be abscesses with calcification in his spine. The most likely outcome of his disease is:

    • Good prognosis

    • Malignancy

    • Spread to IV disc

    • Endocarditis

    • Pneumonia

    Correct Answer
    A. Spread to IV disc
    Explanation
    The most likely outcome of the patient's disease is spread to the IV (intervertebral) disc. This can be inferred from the presence of abscesses with calcification in the spine, along with symptoms such as fever, night sweats, and bloody sputum. These findings suggest an infectious process, possibly tuberculosis, which can spread to the adjacent IV disc. This can lead to spinal instability and neurological complications if not properly treated. Therefore, spread to the IV disc is the most likely outcome based on the given information.

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  • 17. 

    The most common tumor of the bone occurs via _

    Correct Answer
    metastasis
    direct innoculation
    Explanation
    Metastasis is the most common way in which tumors spread to the bone. It occurs when cancer cells from another part of the body travel through the bloodstream or lymphatic system and settle in the bone, forming a secondary tumor. Direct inoculation, on the other hand, refers to the introduction of cancer cells into the bone through direct contact, such as during a surgical procedure. However, metastasis is more common and accounts for the majority of bone tumors.

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  • 18. 

    A patient presents with a benign tumor of cartilagenous origin. It is known to arise from displaced fragments of growth plate. What is the main site of this tumor?

    • Metaphysis

    • Diaphysis

    • Epiphysis

    • Proximal femur

    • Humerus pelvis and femur

    Correct Answer
    A. Metaphysis
    Explanation
    The main site of the benign tumor of cartilagenous origin described in the question is the metaphysis. The metaphysis is the region of the long bone where the growth plate is located. This tumor arises from displaced fragments of the growth plate, which is consistent with its location in the metaphysis. The diaphysis is the shaft of the long bone, while the epiphysis is the end of the bone. The proximal femur and humerus pelvis and femur are specific locations within the bone, but they do not represent the main site of this particular tumor.

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  • 19. 

    A patient presents with bleeding in the gums and microfractures. There also appears to be increased parathyroid hormone levels due to a decrease in calcium. The pathogenesis association with this disease is:

    • Defective crosslinking of collagen

    • Failed hydroxylation

    • Gene deletion

    • Failure to cleave

    • None of the above

    Correct Answer
    A. Failed hydroxylation
    Explanation
    Failed hydroxylation is the most likely explanation for the patient's symptoms. Hydroxylation is a process that adds a hydroxyl group to collagen, which is necessary for its proper formation and function. Without hydroxylation, collagen becomes weak and prone to microfractures, leading to bleeding in the gums. Increased parathyroid hormone levels and decreased calcium can also be seen in conditions associated with failed hydroxylation, such as vitamin C deficiency (scurvy). Defective crosslinking of collagen, gene deletion, and failure to cleave are not directly related to the symptoms described.

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  • 20. 

    A patient presents with severe joint disease and symptoms that mimic rheumatoid arthritis and osteoarthritis. There appears to be calcium pyrophosphate crystals in his joint. Which of the following gene is affected in the hereditary version of the disease?

    • HNPCC

    • ANKH

    • Gene for collage Type1

    • Gene for collagen Type 2

    • None of the above

    Correct Answer
    A. ANKH
    Explanation
    ANKH is the correct answer because it is the gene affected in the hereditary version of the disease described in the question. This disease is known as calcium pyrophosphate deposition disease (CPPD) or pseudogout. The presence of calcium pyrophosphate crystals in the joint is a characteristic feature of CPPD. ANKH is responsible for encoding a protein involved in the regulation of pyrophosphate levels, and mutations in this gene can lead to an accumulation of calcium pyrophosphate crystals in the joints, causing the symptoms seen in the patient.

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  • 21. 

    A patient presents to be the office with extremely long extremities, long tapering fingers, hyperflexible joints and pigeon chested. The pathogenesis of his disease is_ and the tissue involved is also observed in _ disease:

    • Mutation of elastin gene, Ehlers-Danlos Syndrome

    • Mutation of fibrillin gene, Osteogenesis Imperfecta

    • Mutation of fibrillin gene, Ehlers-Danlos Syndrome

    • Mutation of collagen type 1, Osteogenesis Imperfecta

    • None of the above.

    Correct Answer
    A. Mutation of fibrillin gene, Ehlers-Danlos Syndrome
    Explanation
    The patient's presentation of extremely long extremities, long tapering fingers, hyperflexible joints, and pigeon chested is consistent with Ehlers-Danlos Syndrome. This syndrome is caused by a mutation in the fibrillin gene, which leads to abnormalities in the connective tissue. The tissue involved in Ehlers-Danlos Syndrome is similar to that observed in Osteogenesis Imperfecta, but Osteogenesis Imperfecta is caused by a mutation in the collagen type 1 gene, not the fibrillin gene. Therefore, the correct answer is mutation of the fibrillin gene, Ehlers-Danlos Syndrome.

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  • 22. 

    A 70 year old man presents with a tumor that has metastasized to different parts of the body. The tumor associated is known to sometimes recur and dedifferentiate. It arises from cartilage producing cells. What is/are a common site of this tumor?

    • Pelvis and proximal femur

    • Distal femur

    • Pelvis and humerus

    • Epiphysis

    • A and C

    Correct Answer
    A. A and C
    Explanation
    The correct answer is "A and C" because the tumor described in the question is likely to be a chondrosarcoma, which is a malignant tumor that arises from cartilage-producing cells. Chondrosarcomas have a tendency to metastasize to different parts of the body, and commonly recur and dedifferentiate. The pelvis and proximal femur, as well as the pelvis and humerus, are common sites for chondrosarcomas to occur. Therefore, options A and C are both correct.

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  • 23. 

    A patient presents with pain in the joints of the hands and feet, morning stiffness that gets better with movement, subcutaneous nodules on the ulnar aspect of the hand. Which of the following is also has a similar pathogenesis as his disease?

    • Myasthenia gravis

    • Osteomyelitis

    • Osteogenesis Imperfecta

    • Osteosarcoma

    • Hashimoto's Thyroiditis

    Correct Answer
    A. Myasthenia gravis
  • 24. 

    _ also has a similar location.

    Correct Answer
    Osteosarcoma
    Enchondroma
    Chondrosarcoma
    Giant cell tumor of the bone
    Explanation
    All of the given options (Osteosarcoma, Enchondroma, Chondrosarcoma, and Giant cell tumor of the bone) have a similar location.

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  • 25. 

    A patient presents with a disease that is associated with HLA-B27 haplotype, that is immune mediated, and presents with fibrosing ankylosis. Which of the the following is not associated with this disease?

    • Rheumatoid arthritis

    • Reiter's syndrome

    • Psoriatic arthritis

    • Enteropathy associated arthritis

    • All of the above are associated

    Correct Answer
    A. All of the above are associated
    Explanation
    All of the diseases listed (Rheumatoid arthritis, Reiter's syndrome, Psoriatic arthritis, and Enteropathy associated arthritis) are associated with the HLA-B27 haplotype and are immune mediated. Additionally, they can all present with fibrosing ankylosis. Therefore, the correct answer is that all of the above diseases are associated with this disease.

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  • 26. 

    A patient presents to your office with pathological fractures. It is determined that the patient has a tumor with hyaline cartilage. There also appears to be vascular tumors. What is a common feature of this disease?

    • Possible osteosarcoma

    • Possible Ewing's disease

    • Possible Breast Cancer

    • Possible Osteomyelitis

    • Possible pneumonia

    Correct Answer
    A. Possible Breast Cancer
    Explanation
    A common feature of breast cancer is the presence of tumors with hyaline cartilage and vascular tumors. Pathological fractures can occur in advanced stages of breast cancer due to the weakening of the bone by the tumor. Therefore, breast cancer is a possible explanation for the patient's presentation with pathological fractures and the presence of tumors with hyaline cartilage.

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  • 27. 

    A 70 year old obese male complains of pain in the joints, and morning stiffness that worsens with movement. He presents with bumps on his hand. Upon taking a radiological image of his bones, there appears to bone growth known as osteophytes and subchondral cysts. Which of the following disease is also associated with a decreased amount of substance associated with this patients disease:

    • Osteogenesis Imperfecta

    • Osteopetrosis

    • Osteoporosis

    • Rheumatoid arthritis

    • Rickets

    Correct Answer
    A. Osteogenesis Imperfecta
    Explanation
    Osteogenesis Imperfecta is a genetic disorder characterized by brittle bones that are prone to fractures. It is not associated with a decreased amount of substance. The patient in the question is presenting with joint pain, morning stiffness, bumps on the hand, and radiological findings of osteophytes and subchondral cysts. These symptoms and findings are consistent with osteoarthritis, which is associated with a decreased amount of cartilage in the joints. Therefore, the correct answer is Rheumatoid arthritis, as it is also associated with a decreased amount of cartilage.

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  • 28. 

    Tibia is the most common site of _

    Correct Answer
    Multiple Myeloma
    Metastatic tumor of the bone
    Ewing's sarcoma
    Giant cell tumor of the bone
    Explanation
    Tibia is the most common site of Multiple Myeloma, Metastatic tumor of the bone, Ewing's sarcoma, and Giant cell tumor of the bone.

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