NRP511 Advanced Pathophysiology
Week 1 Discussion
Genetic Testing/Counseling
Genetic testing has grown in scope and popularity in recent years. You will likely experience patients inquiring about genetic counseling or potential candidates for consultation.
Address one of the following:
dentify and discuss who might be a good potential candidate for referral to genetic counseling. Referrals must at least have a specific reason why the referral was made.
Identify and discuss potential benefits of genetic testing/counseling at various points in the lifespan (e.g. pre-birth, adolescence, adulthood, etc.)
Identify any potential downsides to undergoing genetic testing/counseling.
NRP511 Advanced Pathophysiology
Week 2 Discussion
Patient Scenario: Review of Thyroid Lab Results
You review lab results with a patient. They are having mild symptoms of fatigue, constipation, and weight gain. The results are:
TSH- 4.8 (0.4-4.0mIU/L)
T4- 6.0 (4.6-12 ug/dl)
Address the following:
What is the possible diagnosis? Would you treat this? Why?
Discuss relevant pathophysiology for this thyroid scenario.
What is the most important education you would provide to the patient?
NRP511 Advanced Pathophysiology
Week 3 Discussion
Patient Scenario: Effects of tobacco use
Your patient presents to the clinic today and you notice in their chart that they continue to smoke after multiple discussions to quit. He is African American, 52 years old and has a history of hypertension and dyslipidemia. His BP is 138/88 on medication. His most recent cholesterol values are Total Cholesterol 250, HDL 38, LDL 160, Triglyceride 200.
Address one or more of the following:
Describe the pathophysiology related to tobacco use on the body and cardiovascular health.
How does tobacco use factor into his overall cardiovascular risk? (Consider utilizing this tool: ACSVD Risk Calculator - you can assume no diabetes).
What education would you provide to this patient? What strategies may you recommend for cessation to better ensure success?
NRP511 Advanced Pathophysiology
Week 4 Discussion
Sexual Dysfunction
Option #1 Sexual dysfunction is an important component in a person’s health that can be taboo and difficult to discuss in the clinic setting.
Address the following:
Review the pathophysiology of erectile dysfunction (ED) and discuss any potential causes of the condition.
Why should you be concerned with cardiovascular health in your patient with ED?
Discuss the education you would provide to the patient, including how you would facilitate a discussion about sexual health, or what referrals you may consider for a patient with ED.
OR (not both)
Option #2 - STD
A 21 year old male reports to your office for std/sti screening. He reports having sex with men (MSM). He has no symptoms.
Questions to consider - you don't have to address them all.
What do you want to ask in the sexual history? There are also lots of resources out there for how to take a sexual history for different groups. Here's one resource: Taking a sexual history
What concerns do you have and why?
What testing should you do? What route of testing will you perform?
Why would you need to test for hepatitis A, B, and/or C?
What does the USPSTF guidelines say about screening this individual?
Is this patient a candidate for PREP?
NRP511 Advanced Pathophysiology
Week 5 Discussion
Antibiotic Resistance
Antibiotic resistance continues to be a serious and legitimate concern in medicine and the community.
Address one of the following, Patient A or Patient B, and respond to the prompt:
Patient A
Patient A is a 14-year-old boy accompanied by his mother to your clinic after several days of sneezing, coughing, and headache. You determine it is likely viral sinusitis. His mother is insistent you prescribe an antibiotic today. What education would you provide to the patient and parent?
Patient B
Patient B is a 34-year-old female, with no prior medical history, who arrives to your clinic today for symptoms of rhinitis, fatigue, sore throat, and occasional cough. She is afebrile and symptoms have been ongoing for 6 days. You determine its likely a viral infection. Discuss the relevant pathophysiology explaining any of the symptoms for this patient. What aspect could treatment modify?
Due Monday
Compare and contrast your responses with one classmate or respond to your faculty member.
NRP511 Advanced Pathophysiology
Week 6 Discussion
Patient Scenarios: Headaches and Chronic Pain Syndrome
Address one of the following, Patient A or Patient B, and respond to the prompt:
Patient A
You have a 42-year-old female patient present to your clinic with a many year history of “headaches”. Identify and discuss at least one question you may ask this patient regarding their chief complaint and the pertinent pathophysiology to support why you’re asking.
Patient B
You are seeing a 68-year-old male with medical history positive for chronic pain and multiple chronic medical comorbidities. You review the depression screen which seems to be positive today. Describe how depression can contribute to his chronic pain syndrome using relevant pathophysiology. How is this related to his other chronic disease and comorbidities?
NRP511 Advanced Pathophysiology
Week 7 Discussion
Fibromyalgia
Fibromyalgia has become a more common diagnosis in recent years and can come with a stigma. It is critical to not only have an accurate diagnosis but a clear understanding as to how this disease process contributes to symptoms. You have a patient present to the clinic today with Fibromyalgia in their past medical history and they describe diffuse pain “all over my body”.
Fibromyalgia can be looked at as a diagnosis of exclusion and often becomes a catch-all when we can’t explain what is happening.
Address the following (cite sources and justify answers):
Explain how you can be certain of the Fibromyalgia diagnosis. Should you always trust it is accurate because it is in their chart or because the patient says they have it?
Identify what questions you may ask this patient regarding this diagnosis and how it is relevant using pathophysiology.
Identify and discuss potential causes and/or contributing factors for this pain pattern. (Hint: inflammation)
NRP511 Advanced Pathophysiology
Week 8 Discussion
Patient Scenario: Crohn’s Disease
You have a patient that presents to the clinic today with a history of Crohn’s disease for many years with occasional flare ups. They follow up as directed with a GI specialist. They have a newer complaint today of bilateral knee pain with no history of injury.
Address the following:
Identify and discuss a potential concern or complication of Crohn’s disease using relevant pathophysiology to support.
Discuss ways Crohn’s disease is different from IBS.
Discuss if the history of Crohn’s disease and the new complaint of joint pain can be related? If yes, how so?
NRP511 Advanced Pathophysiology
Week 2 Assignment
Blood Count (CBC) Reports
Assignment Content
As an FNP, you will be expected to be proficient at interpreting complete blood count (CBC) results so that you can make an accurate diagnosis in identifying anemia, infection, and leukemia.
Review the 3 complete blood count reports below to answer the questions.
CBC Report #1
CBC Report #1
Question 1The above hemogram is most consistent with:
B12 or folate deficiency
Iron deficiency anemia
Anemia of chronic disease
Question 2The above hemogram RBCs are:
Microcytic, hyperchromic
Macrocytic, hypochromic
Microcytic, hypochromic
CBC Report #2
CBC Report #2
Question 3The above hemogram is most consistent with:
Anemia of chronic disease
Pernicious anemia
Iron deficiency anemia
Question 4The above hemogram RBCs are:
Normocytic, normochromic
Macrocytic, normochromic
Microcytic, hyperchromic
CBC Report #3
CBC Report #3
Question 5The above hemogram is most consistent with:
Iron deficiency anemia
Anemia of chronic disease
B12 or folate deficiency
Question 6The above hemogram RBCs are:
Macrocytic, normochromic
Macrocytic, hypochromic
Microcytic, hyperchromic
NRP511 Advanced Pathophysiology
Week 3 Assignment
Signature Assignment: Patient Diagnosis Case Study: Metabolic Syndrome
This week you focused on cardiovascular health. Now it is time to apply your knowledge by completing a case study on metabolic syndrome.
For this assignment, you will use UpToDate from the Nursing Resources page to search for and locate evidence-based guidelines to answer the questions within the case study.
Complete the Patient Diagnosis Case Study: Metabolic Syndrome.
Submit your assignment. Use APA format. Do not type your answers into the attached document. Use in text citation and include a reference list.
Feel free to submit a draft to me via email BEFORE the assignment is due for comments
NRP511 Advanced Pathophysiology
Week 5 Assignment
Patient Diagnosis Case Study: Asthma
Based on the knowledge you have gained up to this point, it is time to apply your skills to complete a case study for a patient presenting with asthma exacerbation.
For this assignment, you will use UpToDate from the Nursing Resources page to search for and locate evidence-based guidelines to answer the questions within the case study.
Complete the Patient Diagnosis Case Study: Asthma. Use APA format. Do not type your answers into the attached document. Use intext citation. Include a reference list.
NRP511 Advanced Pathophysiology
Week 6 Assignment
Patient Diagnosis Case Study: Migraine
Assignment Content
Based on the knowledge you have gained up to this point, it is time to apply your skills to complete a case study for a patient presenting with a migraine.
Read the patient scenario and answer the following questions.
Patient Scenario
A 34-year-old female patient presents to your primary care clinic and complains of a headache.
Note: You have two attempts. You can choose to just do it all on one attempt. However, because it is a case study, go in the first time and copy down the questions and answers work on it, then go back in later on your second attempt and answer the questions. Do not put in any answers on your first attempt. You should receive a 0. This should not be an opportunity to play with the correct or wrong answers. If you put in answers on the first attempt (or get a score other than 0) I will count this as your attempt.
Question 1As you consider potential diagnoses, select all options that are not considered to be possible serious and/or life-threatening etiologies.
Brain Tumor
Meningitis
Giant Cell/Temporal Arteritis
Cerebrovascular Disease (AVM)
Infection
Primary Migraine Dysfunction Disorder (PMDD)
Hemicrania
Question 2What is a possible cause for Cluster type headaches? Choose the best answer.
Occipital and/or Trigeminal Neuralgia
Trigeminal and Hemicrania Neuralgia
Overactivation of the Vagus and Occipital Nerve
Pineal dysfunction
Question 3You realize that you would like to evaluate this patient further for any “Red Flags.” Which of the following questions would not be appropriate to ask in the context of red flags? Select all that apply.
Is this your first/worst headache or is this different than previously?
Have you had any fever or weight loss?
Did it occur suddenly? (thunderclap)
Have you noticed difficulty moving your extremities or difficulty with speech or vision?
Have you had any nausea or vomiting?
Does this occur on both sides of your head?
Have you had recent trauma or injury?
Did your first headache occur before you were 30 years old?
Question 4You have determined that there are no redflags and want to better characterize her chief complaint. She states that her headaches are usually unilateral and can throb. She thinks she gets headaches about 15-18 days a month and they tend to last 1-2 days each episode. She appears to most likely be experiencing:
Atypical tension type headaches
Migraines
Uncomplicated cluster type headache
A slow brain bleed (subarachnoid hemorrhage)
Menstrual headaches with migraine feature
Question 5Before you discuss treatment, you decide you want to explore her symptoms and condition a bit further now that you have an idea about the diagnosis. You would ask all the following relevant questions except:
Do you have associated nausea/vomiting?
Have you missed any work or had limited ability to perform ADL’s due to this?
Do you have photophobia?
What remedies have you tried to make this better?
Do you have low back pain?
Do you notice worsening symptoms during or around menstruation?
Question 6Now that the patient’s condition is evaluated you begin to consider treatment options and recommendations. As a part of this,you will need to provide the patient with the following education during the visit. Which statements should not be included? Select all that apply.
You appear to be suffering from migraine syndrome and this is a chronic disease.
NSAID have been shown to provide benefit in improving attacks, take as much as you need.
There could be multiple triggers which you can try to minimize, such as avoiding certain foods.
Adequate sleep is important.
It may be possible to reduce or prevent your headaches with treatment.
Antidepressants probably won’t help at all.
NRP511 Advanced Pathophysiology
Week 7 Assignment
Patient Diagnosis Case Study: Pain Management
Read the patient scenario and answer the following questions.
Note: You have two attempts. You can choose to just do it all on one attempt. However, because it is a case study, go in the first time and copy down the questions and answers work on it, then go back in later on your second attempt and answer the questions. Do not put in any answers on your first attempt. You should receive a 0. This should not be an opportunity to play with the correct or wrong answers. If you put in answers on the first attempt (or get a score other than 0) I will count this as your attempt.
Patient Scenario
A 41-year-old male patient presents to your primary care clinic and complains of “pain all over my body”. He reports this has been ongoing for many years but now seems to be worsening in the last 3 months. There was no incident that seemed to trigger the symptoms.
Question 1Complaints of generalized body wide pain can be difficult to properly diagnose and likewise treat. From the list provided, which are not possible etiologies that would explain his pain? Select all that apply.
Complex Regional Pain Syndrome (CRPS)
Fibromyalgia
Autoimmune disease (rheumatism)
NSAID overuse disorder
Depression
Myofascial pain syndrome
Thyroid Disease
Peripheral Vascular disease
Question 2In order to narrow down the possible diagnosis you realize you should try to determine whether the pain is more of a central sensitization issue versus neuropathic versus nociceptive. Which of the following is an example of an etiology related to central sensitization?
Fibromyalgia
Degenerative Disc Disease (DDD)
Stroke
Pain secondary to a torn medial meniscus
Question 3Now that you have a short list in your mind of the possibilities, you decide to further explore the complaint of “body wide pain”. Based on the list of questions provided below, which 2 questions would you not ask to better characterize “body wide pain”? You decide you should ask all the following to better characterize the pain except:
Can you pinpoint where you feel your pain?
Do you have pain in your large or small joints or both?
Does the pain get worse with activity or at different times of day?
Do you want some pain medication today?
Do you have any family history of autoimmune disease?
Have you felt sad lately or had trouble sleeping?
Do you take your blood pressure medication as prescribed?
Question 4The patient has responded to your questions with the following:
My joints hurt sometimes but not every day. The pain does not travel, and it is more achy feeling. I seem to sleep fine and I’m not sad. The pain is usually worse with activity. I think my mom may have had Lupus or something.
Which 2 of the following options seem to be the most likely etiology?
Fibromyalgia
Spine etiology
Rheumatism
Osteoarthritis
Lyme Disease
Question 5Before you discuss treatment, you decide you want to explore in more depth the treatments the patient has already tried. You ask all the of following pertinent and appropriate questions except: (select 1)
Have you been to physical therapy in the last 6 months?
Do you use OTC medications to try to alleviate pain?
Have you seen a Chiropractor or tried acupuncture in the last 6 months?
Have you tried any injection-based therapy?
Have you tried ice/heat/stretching?
Are you addicted to opiates?
Question 6The patient responds “Nothing works” but does not seem to have tried anything you asked other than some over the counter (OTC) medication. Now that the patient’s condition is better evaluated, you begin to consider treatment options and recommendations.
Review the following statements which will serve as the patient education you will deliver during the visit. Which 2 statements should not be included as part of your patient education?
You may be suffering from spine pain secondary to degenerative disease. This is a chronic disease…
NSAID have been shown to provide benefit in improving this pain, take as much as you need.
The key to managing this type of disease is to engage in multi-modal treatment with the goal being to make slow steady progress.
Opiates are not indicated in managing this kind of chronic disease.
If you don’t improve after initial attempts at treatment, we may have you undergo further testing.
Medications should be the only thing you need to make your pain go away.
It is also possible you may have pain from rheumatological etiology. Should you fail to improve, we can consider consultation and further testing.
NRP511 Advanced Pathophysiology
Week 1 Quiz
Question 1During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
Bronchial edema caused by the chemotactic factor of anaphylaxis
Bronchial edema caused by binding of the cytotropic antibody
Smooth muscle contraction caused by histamine bound to H1 receptors
Smooth muscle contraction caused by histamine bound to H2 receptors
Question 2Vaccinations are able to provide protection against certain microorganisms because of what?
Strong response from IgM
Level of protection provided by IgG
Memory cells for IgE
Rapid response from IgA
Question 3In the later stages of an inflammatory response, which phagocytic cell is predominant?
Neutrophils
Monocytes
Chemokines
Eosinophils
Question 4The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?
IgE
IgG
IgM
T cells
Question 5What is the inflammatory effect of nitric oxide (NO)?
Increases capillary permeability, and causes pain
Increases neutrophil chemotaxis and platelet aggregation
Causes smooth muscle contraction and fever
Decreases mast cell function, and decreases platelet aggregation
Question 6Where are antibodies produced?
Helper T lymphocytes
Thymus gland
Plasma cells
Bone marrow
Question 7A patient is admitted to the hospital with multiple myeloma (MM). Which diagnostic test should the healthcare professional assess as the priority?
Serum potassium level
Serum calcium level
Bone scan or limb x-rays
Bone marrow biopsy
Question 8Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?
Synergistically
Additively
Antagonistically
Agonistically
NRP511 Advanced Pathophysiology
Week 2 Quiz
Question 1A healthcare professional is reviewing a patient’s laboratory results and sees that the patient has a low reticulocyte count and a high iron level. Which type of anemia does the professional associate these findings with?
Folate deficiency anemia
Iron deficiency anemia
Hemolyticanemia
Anemia of chronic disease
Question 2Most protein hormones are transported in the bloodstream and are what?
Bound to a lipid-soluble carrier
Free in an unbound, water-soluble form
Bound to a water soluble-binding protein
Free because of their lipid-soluble chemistry
Question 3The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include which solute?
Sodium and water retention
Sodium retention and water loss
Sodium dilution and water retention
Sodium dilution and water loss
Question 4What is diabetes insipidus a result of?
Antidiuretic hormone hyposecretion
Antidiuretic hormone hypersecretion
Insulin hyposecretion
Insulin hypersecretion
That's not correct
Question 5A patient has pernicious anemia and asks the healthcare professional to explain the disease. Which statement by the professional is most accurate?
The lack of certain foods in your diet
Your body cannot absorb vitamin B12.
You are not getting enough vitamin C.
Your bone marrow has stopped working.
Question 6Without prior exposure to an antigen, which cells are able to destroy some types of tumor cells and some virus-infected cells?
Lymphocytes
Plasma cells
Megakaryocytes
Natural killer (NK) cells
Question 7Which of these is the role of nitric oxide (NO) in hemostasis?
Stimulates the release of fibrinogen to maintain the platelet plug.
Stimulates the release of clotting factors V and VII.
Causes vasoconstriction and stimulates platelet aggregation.
Controls platelet activation through in concert with prostacyclin.
Question 8Which of these is a lipid-soluble hormone?
Cortisol
Oxytocin
Epinephrine
Growth hormone
NRP511 Advanced Pathophysiology
Week 3 Quiz
Question 1What is the most important negative inotropic agent?
Norepinephrine
Epinephrine
Acetylcholine
Dopamine
Question 2Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
Inflammation and roughening of the endothelium of the artery are present.
Hypertrophy and vasoconstriction of the endothelium of the artery are present.
Excessive clot formation and lipid accumulation in the endothelium of the artery are present.
Evidence of age-related changes that weaken the endothelium of the artery is present.
Question 3
An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?
Atrial septal defect (ASD)
Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
Atrioventricular canal (AVC) defect
Question 4Which laboratory test is an indirect measure of atherosclerotic plaque?
Homocysteine
Low-density lipoprotein (LDL)
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP)
Question 5What is the major determinant of the resistance that blood encounters as it flows through the systemic circulation?
Volume of blood in the systemic circulation
Muscle layer of the metarterioles
Muscle layer of the arterioles
Force of ventricular contraction
Question 6What effect does atherosclerosis have on the development of an aneurysm?
Atherosclerosis causes ischemia of the intima.
It increases nitric oxide.
Atherosclerosis erodes the vessel wall.
It obstructs the vessel.
Question 7What is the initiating event that leads to the development of atherosclerosis?
Release of the inflammatory cytokines
Macrophages adhere to vessel walls.
Injury to the endothelial cells that line the artery walls
Release of the platelet-deprived growth factor
Question 8In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?
Increases preload and decreases afterload
Increases preload and increases afterload
Decreases preload and increases afterload
Decreases preload and decreases afterload
NRP511 Advanced Pathophysiology
Week 5 Quiz
Question 1A patient is having a spirometry measurement done and asks the healthcare professional to explain this test. What response by the professional is best?
To evaluate the cause of hypoxia
To measure the volume and flow rate during forced expiration
To measure the gas diffusion rate at the alveolocapillary membrane
To determine pH and oxygen and carbon dioxide concentrations
Question 2A 7 year-old-child presents to the clinic where parents report signs and symptoms consistent with asthma. What does the healthcare professional do in order to confirm this diagnosis?
Assess for a parental history of asthma
Draw serum levels of immunoglobulin E (IgE) and eosinophil levels
Measure expiratory flow rate with spirometry testing
Give a trial of asthma medication and check for improvement
Question 3Why is nasal congestion a serious threat to young infants?
Infants are obligatory nose breathers.
Their nares are small in diameter.
Infants become dehydrated when mouth breathing.
Their epiglottis is proportionally greater than the epiglottis of an adult’s.
Question 4The core defects of asthma include: (choose the best response)
inflammation/alveolar destruction/bronchoconstriction
mucous production/alveolar destruction/bronchoconstriction
inflammation/mucous production/bronchoconstriction
obstruction/mucous production/bronchoconstriction
Question 5What does the student learn about ventilation?
Hypoventilation causes hypocapnia.
Hypoventilation causes alkalosis.
Hyperventilation causes hypocapnia.
Hyperventilation causes acidosis.
Question 6Fluid in the pleural space characterizes which condition?
Pleural effusion
Atelectasis
Bronchiectasis
Ischemia
Question 7Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?
Respiratory syncytial virus (RSV)
Influenza virus
Adenoviruses
Rhinovirus
Question 8Which statement best describes cystic fibrosis?
Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
NRP511 Advanced Pathophysiology
Week 6 Quiz
Question 1ADD/ADHD involves which of the following neurotransmitters in its pathophysiology? (choose the best answer)
serotonin
acetylcholine
dopamine and norepinephrine
norepinephrine and serotonin
Question 2Clinical manifestations of Parkinson disease are caused by a deficit in which of the brain’s neurotransmitters?
Gamma-aminobutyric acid
Dopamine
Norepinephrine
Acetylcholine
Question 3Which of the meninges closely adheres to the surface of the brain and spinal cord and follows the sulci and fissures?
Dura mater
Arachnoid
Pia mater
Inner dura
Question 4Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with what?
Schizophrenia
Major depression
Mania
Panic disorder
Question 5Where is the neurotransmitter, norepinephrine, secreted?
Somatic nervous system
Parasympathetic preganglion
Sympathetic postganglion
Parasympathetic postganglion
Question 6Which of the following gliomas is considered the highest grade and thus most serious?
Pilocytic astrocytoma
Astrocytoma multiforme
Anaplastic oligodendroglioma
Anaplastic Schwannoma
That's not correct
Question 7Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what?
Result from demyelination by an immune reaction.
Cause permanent destruction of peripheral nerves.
Result from inadequate production of neurotransmitters.
Block acetylcholine receptor sites at the myoneuronal junction.
Question 8What is a common location to find a Schwannoma in the body?
in White Matter
on Cranial Nerve VIII
on the Optic Nerve
rising from the meninges along the spinal cord
NRP511 Advanced Pathophysiology
Week 7 Quiz
Question 1You see a patient with complaints of midline axial neck pain and headaches for 3 months. The pain does not travel into the upper extremities and there are no signs of sensory/motor dysfunction. Which of the following is the most likely core defect?
Fibromyalgia
Cervical spondylosis
Muscle spasm
Neuroforaminal stenosis with impingement of exiting cervical nerve roots
Question 2A patient in the clinic is worried about having fibromyalgia. You would begin your diagnosis by exclusion by assessing for all of the following EXCEPT:
Rheumatism
low-grade systemic inflammation
Thyroid disease
Osteoarthritis
That's not correct
Question 3Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscle fibers to the basement membrane?
Syntrophin
Laminin
Dystrophin
Troponin
Question 4What is the most common malignant bone tumor diagnosed during childhood?
Chondrosarcoma
Fibrosarcoma
Ewing Sarcoma
Osteosarcoma
Question 5What is a primary defect in osteoarthritis?
Stromelysin and acid metalloproteinase breakdown articular cartilage.
Immunoglobulin G (IgG) destroys the synovial membrane.
Synovial membranes become inflamed.
Cartilage-coated osteophytes create bone spurs.
Question 6Which of the following is most consistent with suspicion for rheumatoid arthritis (RA)?
Bilateral large and small joint involvement, pain worse upon wake and with activity
Unilateral or Bilateral large joint involvement, pain worse upon wake and at bedtime
Unilateral or Bilateral small joint involvement, pain worse at bedtime and with activity
Diffuse body wide pain in multiple joints, worse with physical activity
Question 7What does a Ewing sarcoma arise from?
Bone marrow
Bone-producing mesenchymal cells
Metadiaphysis of long bones
Embryonal osteocytes
Question 8Which bone cells are large and multinucleated and contain lysosomes filled with hydrolytic enzymes?
Osteoblasts
Osteoclasts
Osteocytes
Fibrocytes
