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Arab Board Orthopedic MCQs Online Bank - Improve Your Knowledge and Skills

26. A 14-year-old boy complains of pain along the medial aspect of the thigh, more severe at night. A bone scan reveals a double density sign with a maximum uptake in the center of a 1cm diameter lesion. The most likely diagnosis would be:

1. A. Sclerosing periostitis
2. B. Osteoblastoma
3. C. Osteoid osteoma
4. D. Stress fracture
5. E. Eosinophilic granuloma
   Answer: C
   A 14-year-old boy complaining of pain along the medial aspect of the thigh, more severe at night, with a double density sign on bone scan with a maximum uptake in the center of a 1cm diameter lesion, is most likely to have osteoid osteoma.

27. When a patient presents with multiple exostoses and the direction of the stalk points towards the joint, the diagnosis would most likely be:

1. A. Osteochondromatosis
2. B. Metachondromatosis
3. C. Multiple epiphyseal dysplasia
4. D. Morquio's disease
5. E. Spondyloepiphyseal dysplasia
   Answer: A
   When a patient presents with multiple exostoses and the direction of the stalk points towards the joint, the diagnosis would most likely be osteochondromatosis.

28. Absorption of phosphate from the intestine is mainly from:

1. A. The duodenum
2. B. Lower end of the jejunum
3. C. Upper end of the cecum
4. D. The stomach
5. E. The colon
   Answer: B
   Absorption of phosphate from the intestine is mainly from the lower end of the jejunum.

29. Giving parathormone at alternate times is:

1. A. Anabolic
2. B. Catabolic
3. C. Of no effect on bone
4. D. Encourages endochondral bone growth
5. E. Thickens the periosteum
   Answer: A
   Giving parathormone at alternate times is an anabolic process on bone.

30. PTH increase results in:

1. A. Increased excretion of calcium from the kidneys
2. B. Increased excretion of phosphate from the kidneys
3. C. Increased excretion of vitamin D from the liver
4. D. Promotes deposition of calcium within the hydroxyapatite crystal
5. E. Decreases the absorption of calcium from the jejunum
   Answer: B
   PTH increase results in an increased excretion of phosphate from the kidneys.

31. The hormone that inhibits osteoclast-mediated bone resorption is:

1. A. PTH
2. B. Thyroxin
3. C. Calcitonin
4. D. Thyroglobulin
5. E. Adrenaline
   Answer: C
   Calcitonin is the hormone that inhibits osteoclast-mediated bone resorption.

32. Which of the following conditions is known to be associated with an Erlenmeyer-flask deformity of the distal femur and bone necrosis:

1. A. Morquio's disease
2. B. Hurler's syndrome
3. C. Gaucher's disease
4. D. Osteopetrosis
5. E. Malreostosis
   Answer: C
   An Erlenmeyer-flask deformity of the distal femur and bone necrosis is associated with Gaucher's disease.

33. Parathormone is produced by which of the following cells:

1. A. Fat cells within the parathyroid gland
2. B. Follicular cells within the parathyroid gland
3. C. In the liver through the action of 25-hydroxylase
4. D. Chief cells within the parathyroid gland
5. E. In the kidney through the action of 1-25 hydroxylase on the proximal convoluted tubule
   Answer: D
   Parathormone is produced by chief cells within the parathyroid gland.

34. In the kidneys, parathormone stimulates:

1. A. Resorption of phosphate through the tubules
2. B. Stimulates both resorption of calcium and phosphate through the tubules
3. C. Stimulates excretion of calcium through the tubules
4. D. Stimulates excretion of both calcium and phosphate through the tubules
5. E. Stimulates resorption of calcium and excretion of phosphate through the tubules
   Answer: E
   In the kidneys, parathormone stimulates resorption of calcium and excretion of phosphate through the tubules.

35. Intermittent administration of parathormone (1-34 parathormone) results in:

1. A. An overall anabolic effect on bone
2. B. A catabolic effect on bone
3. C. No effect on bone
4. D. Has no effect on 25-hydroxylase production in the liver
5. E. Bone fragility
   Answer: A
   Intermittent administration of parathormone (1-34 parathormone) results in an overall anabolic effect on bone.

List of Answers and Explanations

1. Answer: D
   A 14-year-old boy complaining of pain along the medial aspect of the thigh, more severe at night, with a double density sign on bone scan with a maximum uptake in the center of a 1cm diameter lesion, is most likely to have osteoid osteoma.
2. Answer: A
   When a patient presents with multiple exostoses and the direction of the stalk points towards the joint, the diagnosis would most likely be osteochondromatosis.
3. Answer: B
   Absorption of phosphate from the intestine is mainly from the lower end of the jejunum.
4. Answer: A
   Giving parathormone at alternate times is an anabolic process on bone.
5. Answer: B
   PTH increase results in an increased excretion of phosphate from the kidneys.
6. Answer: C
   Calcitonin is the hormone that inhibits osteoclast-mediated bone resorption.
7. Answer: C
   An Erlenmeyer-flask deformity of the distal femur and bone necrosis is associated with Gaucher's disease.
8. Answer: D
   Parathormone is produced by chief cells within the parathyroid gland.
9. Answer: E
   In the kidneys, parathormone stimulates resorption of calcium and excretion of phosphate through the tubules.
10. Answer: A
    Intermittent administration of parathormone (1-34 parathormone) results in an overall anabolic effect on bone.
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