Exam Corner

Basic Science & Anatomy

Prepared by Mohamed Sukeik
SICOT Associate Member & SICOT Newsletter Associate Editor – London, United Kingdom

 

Questions

  1. All of the below have an autosomal dominant inheritance pattern except:

    1. Haemophilia

    2. Osteochondromatosis

    3. Ehlers Danlos syndrome

    4. Kniest dysplasia

    5. Metaphyseal epiphyseal dysplasia
       

  2. The inheritance pattern for all of the following is correct except: 

    1. Hypophosphatemic rickets: X-linked dominant

    2. Hunter syndrome: X-linked recessive

    3. McCune Albright syndrome: Sporadic mutation

    4. Marfan syndrome: Autosomal recessive

    5. Hypophosphatasia: Autosomal recessive
       

  3. The associated gene for all of the following is correct except:

    1. Apert syndrome: FGF2R

    2. McCune Albright syndrome: Gs alpha subunit of the receptor/adenylyl cyclase-coupling G proteins

    3. Ehlers Danlos syndrome: COL 1A2 and COL 3A1

    4. Synovial sarcoma: (X;19) (p11;q11)

    5. Kniest dysplasia: COL 2A1
       

  4. Accumulation of sphingomyelin in reticuloendothelial system cells occurs in which of the following?

    1. Hunter syndrome

    2. Hurler syndrome

    3. Morquio syndrome

    4. Gaucher disease

    5. Niemann-Pick disease
       

  5. Which of the following micro-organisms is associated with osteomyelitis in HIV patients?

    1. Streptococcus viridans

    2. Bacteroides species

    3. Serratia marcescens

    4. Eikenella species

    5. Corynebacterium species
       

  6. Which of the following growth plate zones is affected in Osteopetrosis?

    1. Reserve zone

    2. Proliferative zone

    3. Hypertrophic zone

    4. Primary spongiosa

    5. Secondary spongiosa
       

  7. Which of the following growth plate zones is affected in Osteogenesis imperfecta?

    1. Reserve zone

    2. Proliferative zone

    3. Hypertrophic zone

    4. Primary spongiosa zone

    5. Secondary spongiosa zone
       

  8. Which of the following does not occur in osteoarthritis?

    1. Increased water content

    2. Increased chondroitin levels

    3. Increased keratin sulfate levels

    4. Articular cartilage degradation

    5. Genetic predisposition
       

  9. Which of the following antibiotics inhibit cross-linking of polysaccharides in the cell wall by blocking transpeptidase enzyme?

    1. B-lactam antibiotics

    2. Aminoglycosides

    3. Macrolides

    4. Quinolones

    5. Clindamycin
       

  10. Which of the following intervals is bordered by teres minor superiorly and contains the axillary nerve?

    1. Medial triangular space

    2. Triangular interval

    3. Quadrangular space

    4. Lateral triangular space

    5. None of the above
       

  11. Which of the following nerve injuries is associated with medial winging of the scapula?

    1. Suprascapular nerve

    2. Spinal accessory nerve

    3. Long thoracic nerve

    4. Dorsal scapular nerve

    5. Axillary nerve
       

  12. The clavicle fuses at the age of:

    1. 5 weeks

    2. 12 weeks

    3. 1 year

    4. 5 years

    5. 25 years
       

  13. The Thompson’s approach utilises the interval between which of the following?

    1. Extensor carpi radialis brevis and extensor carpi radialis longus

    2. Extensor carpi radialis brevis and anconeus

    3. Extensor and flexor carpi ulnaris

    4. Extensor carpi radialis brevis and extensor digitorum

    5. Brachioradialis and flexor carpi radialis
       

  14. Matti’s approach utilizes the interval between which of the following?

    1. First and second extensor compartments

    2. First and third extensor compartments

    3. Second and third extensor compartments

    4. Second and fourth extensor compartments

    5. Third and fourth extensor compartments
       

  15. Which of the following is related to an abnormality in osteoclasts function?

    1. Vitamin-D deficiency rickets

    2. Vitamin-D dependent rickets

    3. Hypophosphatasia

    4. Paget’s disease

    5. Renal osteodystrophy
       

  16. Which of the following is associated with reduced alkaline phosphatase levels?

    1. Vitamin-D deficiency rickets

    2. Vitamin-D dependent rickets

    3. Hypophosphatasia

    4. Paget’s disease

    5. Renal osteodystrophy
       

  17. Which of the following disorders is an osteochondrosis affecting the ischiopubic region?

    1. Van Neck’s disease

    2. Scheuermann’s disease

    3. Panner’s disease

    4. Kocher’s disease

    5. Thiemann’s disease
       

  18. Which of the following disorders is an osteochondrosis affecting the phalanges of the hand?

    1. Van Neck’s disease

    2. Scheuermann’s disease

    3. Panner’s disease

    4. Kocher’s disease

    5. Thiemann’s disease
       

  19. Which of the following disorders is an osteochondrosis affecting the capitellum?

    1. Van Neck’s disease

    2. Scheuermann’s disease

    3. Panner’s disease

    4. Kocher’s disease

    5. Thiemann’s disease
       

  20. Which of the following collagen types is usually seen in hypertrophic cartilage?

    1. Type I

    2. Type III

    3. Type IV

    4. Type X

    5. Type XI

Answers

  1. a
    Haemophilia follows an X-linked recessive inheritance pattern.
    Reference: Review of Orthopaedics, Miller

  2. d
    Marfan syndrome follows an autosomal dominant inheritance pattern.
    Reference: Review of Orthopaedics, Miller

  3. d
    Synovial sarcoma: Associated gene includes (X;18) (p11;q11)£
    Reference: Review of Orthopaedics, Miller

  4. e
    Accumulation of sphingomyelin in reticuloendothelial system cells occurs in Niemann-Pick disease which follows an autosomal recessive inheritance pattern.
    Reference: Review of Orthopaedics, Miller

  5. c
    Serratia marcescens is associated with osteomyelitis in IV drug abusers.
    Reference: Review of Orthopaedics, Miller

  6. e
    The secondary spongiosa zone is affected in Osteopetrosis and the defect is related to CLCN7 gene.
    Reference: Review of Orthopaedics, Miller

  7. e
    The secondary spongiosa zone is affected in Osteogenesis imperfecta and the defect is related to COL 1A1 and COL1A2 genes.
    Reference: Review of Orthopaedics, Miller

  8. c
    Reduced keratin sulfate levels is seen in osteoarthritis. All other options are related to osteoarthritis.
    Reference: Review of Orthopaedics, Miller

  9. a
    B-lactams inhibit cross-linking of polysaccharides in the cell wall by blocking transpeptidase enzyme.
    Aminoglycosides inhibit protein synthesis through binding to cytoplasmic 30S-ribosomal subunit.
    Clindamycin and macrolides inhibit the dissociation of peptidyl-transfer RNA from ribosomes during translocation by binding to 50S-ribosomal subunit. 
    Quinolones inhibit DNA gyrase.
    Reference: Review of Orthopaedics, Miller

  10. c
    The quadrangular space is bordered by teres minor superiorly, teres major inferiorly, long head of triceps medially and humerus laterally. It transmits the axillary nerve and posterior circumflex humeral artery. The triangular interval also known as lateral triangular space contains the profunda brachii artery and radial nerve. The triangular space also known as medial triangular space transmits the circumflex scapular artery.
    Reference: Surgical Exposures in Orthopaedics, Hoppenfeld

  11. c
    Long thoracic nerve supplies serratus anterior and is associated with medial winging of the scapula when injured. Spinal accessory nerve supplies trapezius and is associated with lateral winging of the scapula when injured. Dorsal scapular nerve injury is associated with rhomboideus palsy. Osseous origins for winging include osteochondromas and fractures malunion.
    Reference: Review of Orthopaedics, Miller

  12. e
    The clavicle is the first bone to appear at 5 weeks (fetal) and last to fuse at 25 years of age.
    Reference: Review of Orthopaedics, Miller

  13. d
    The Thompson’s approach utilises the interval between extensor carpi radialis brevis (radial nerve) and extensor digitorum and extensor pollicus longus (PIN).
    Reference: Surgical Exposures in Orthopaedics, Hoppenfeld

  14. b
    Matti’s approach utilizes the interval between first and third extensor compartments both innervated by PIN.
    Reference: Review of Orthopaedics, Miller

  15. d
    Paget’s disease is caused by osteoclastic abnormality with increased bone turnover. Clinical findings include deformities, pain, congestive heart failure and fractures. Radiographic findings include coarse trabeculae and ‘picture frame vertebrae’.
    Reference: Review of Orthopaedics, Miller

  16. c
    Hypophosphatasia is caused by a reduced alkaline phosphatase level. Clinical findings include bone deformities and hypotonia. Radiographic findings include poor mineralization.
    Reference: Review of Orthopaedics, Miller

  17. a
    Van Neck’s disease is an ischiopubic synchondrosis.
    Reference: Review of Orthopaedics, Miller

  18. e
    Thiemann’s disease is an osteochondrosis affecting the phalanges of the hand.
    Reference: Review of Orthopaedics, Miller

  19. c
    Panner’s disease is an osteochondrosis affecting the capitellum.
    Reference: Review of Orthopaedics, Miller

  20. d
    Type X collagen is associated with calcification of cartilage and is usually seen in hypertrophic cartilage.
    Reference: Review of Orthopaedics, Miller