A 52-year-old woman comes to the clinic complaining of persistent bone pain in her hips and lower back. She reports feeling weak and tired, and says climbing stairs has become difficult. She recently adopted a strict indoor lifestyle due to remote work and rarely goes outside. Bloodwork shows low vitamin D levels.
What are the 5 symptoms?
- Bone pain (hips and lower back)
- Muscle weakness
- Fatigue
- Difficulty with mobility (climbing stairs)
- Low vitamin D levels
A 52-year-old woman comes to the clinic complaining of persistent bone pain in her hips and lower back. She reports feeling weak and tired, and says climbing stairs has become difficult. She recently adopted a strict indoor lifestyle due to remote work and rarely goes outside. Bloodwork shows low vitamin D levels.
What is the diagnosis?
Osteomalacia
A 4-year-old boy is brought in by his parents because his legs appear bowed and he has been growing more slowly than expected. They mention he is a very picky eater and drinks little milk. On exam, his wrists and knees appear widened and tender.
What are the 4 symptoms?
- Bowed legs
- Slow growth
- Widened, tender joints (wrists and knees)
- Poor dietary intake of calcium/vitamin D
A 4-year-old boy is brought in by his parents because his legs appear bowed and he has been growing more slowly than expected. They mention he is a very picky eater and drinks little milk. On exam, his wrists and knees appear widened and tender.
What is the diagnosis?
Rickets
A 38-year-old woman reports morning stiffness in her hands that lasts over an hour. She says her fingers feel swollen and painful, especially in the knuckles on both hands. She also notes fatigue and occasional low-grade fevers. Symptoms improve slightly with movement but return later in the day.
What are the 5 symptoms?
- Morning stiffness lasting > 1 hour
- Symmetrical joint pain and swelling (hands/knuckles)
- Fatigue
- Low-grade fevers
- Pain that improves with movement
A 38-year-old woman reports morning stiffness in her hands that lasts over an hour. She says her fingers feel swollen and painful, especially in the knuckles on both hands. She also notes fatigue and occasional low-grade fevers. Symptoms improve slightly with movement but return later in the day.
What is the diagnosis?
Rheumatoid Arthritis
A 67-year-old man complains of knee pain that worsens when he walks or stands for long periods. He reports stiffness when getting out of bed, but it improves within minutes. He has a history of working in construction for 35 years. X-rays show narrowing of the joint space.
What are the 4 symptoms?
- Knee pain that worsens with activity
- Brief morning stiffness (< 30 minutes)
- History of heavy joint use
- Joint space narrowing on X-ray
A 67-year-old man complains of knee pain that worsens when he walks or stands for long periods. He reports stiffness when getting out of bed, but it improves within minutes. He has a history of working in construction for 35 years. X-rays show narrowing of the joint space.
What is the diagnosis?
Osteoarthritis
A 72-year-old woman fell while stepping off a curb and sustained a wrist fracture from what she describes as “a very small fall.” She says she has been losing height over the past decade and sometimes experiences back discomfort. She has never had a bone density test.
What are the 5 symptoms?
- Fragility fracture from minor trauma
- Height loss
- Back pain/discomfort
- Older age, female
- No prior bone density screening
A 72-year-old woman fell while stepping off a curb and sustained a wrist fracture from what she describes as “a very small fall.” She says she has been losing height over the past decade and sometimes experiences back discomfort. She has never had a bone density test.
What is the diagnosis?
Osteoporosis
Which type of tissue forms first in endochondral ossification?
A. Bone matrix
B. Hyaline cartilage model
C. Compact bone
D. Mesenchymal membrane
Hyaline cartilage model
What is the correct order of steps in endochondral ossification?
A. Bone collar formation → cartilage model develops → osteoblasts invade → secondary ossification
B. Cartilage model develops → bone collar forms → primary ossification center forms → secondary ossification centers appear
C. Secondary ossification → cartilage model develops → bone collar forms → osteoblast invasion
D. Osteoclast invasion → bone collar forms → cartilage model develops → primary ossification
Cartilage model develops → bone collar forms → primary ossification center forms → secondary ossification centers appear
The primary ossification center forms in which region of a long bone?
A. Epiphysis
B. Diaphysis
C. Articular cartilage
D. Periosteum
Diaphysis
The growth in length of long bones during childhood occurs where?
A. Bone collar
B. Epiphyseal plate
C. Medullary cavity
D. Periosteal membrane
Epiphyseal plate
Which bones are formed by intramembranous ossification?
A. Vertebrae
B. Long bones
C. Skull bones and clavicle
D. Ribs
Skull bones and clavicle
What is the correct order of steps in intramembranous ossification?
A. Osteoid forms → mesenchymal cells cluster → trabeculae form → periosteum develops
B. Mesenchymal cells cluster → osteoblasts secrete osteoid → trabeculae form → periosteum develops
C. Periosteum develops → osteoid forms → mesenchymal cells cluster → trabeculae form
D. Mesenchyme becomes cartilage → osteoblasts invade → bone collar forms
Mesenchymal cells cluster → osteoblasts secrete osteoid → trabeculae form → periosteum develops
Intramembranous ossification begins when mesenchymal cells differentiate into which cells?
A. Osteoclasts
B. Chondrocytes
C. Osteoblasts
D. Fibroblasts
Osteoblasts
During intramembranous ossification, what forms first after osteoid is secreted?
A. Secondary ossification centers
B. Trabeculae (spongy bone)
C. Compact bone plates
D. Articular cartilage
Trabeculae (spongy bone)
What forms last during intramembranous ossification?
A. Mesenchymal membrane
B. Osteoid secretion
C. Trabeculae
D. Compact bone on the outer surfaces
Compact bone on the outer surfaces
Which of the following is a structural classification of joints?
A. Synarthrosis
B. Amphiarthrosis
C. Diarthrosis
D. Fibrous
Fibrous
Which joint classification describes a joint that allows no movement?
A. Synarthrosis
B. Diarthrosis
C. Amphiarthrosis
D. Cartilaginous
Synarthrosis
Which type of joint is held together by dense connective tissue and has no joint cavity?
A. Fibrous
B. Synovial
C. Cartilaginous
D. Ball-and-socket
Fibrous
The epiphyseal plate is an example of which type of joint?
A. Symphysis
B. Synovial
C. Synchondrosis
D. Gomphosis
Synchondrosis
Which type of joint includes a fluid-filled cavity between articulating bones?
A. Cartilaginous
B. Synovial
C. Fibrous
D. Suture
Synovial
