Cartilage, Crystals, and Bone Metabolism
Rheumatology
Infections and Tumors
Pediatrics
Ischemia, Pressure, and Bone Death
Spine and Nerve Compression
100
Identify the underlying patho: degeneration of articular cartilage characterized by loss of proteoglycans, cartilage fibrillation, and subchondral bone scelerosis.
What is osteoarthritis?
100
Symmetric polyarthritis with progressive joint deformity and synovial proliferation.
What is pannus formation?
100
The most common cause of bone infection involves bacterial invasion leading to inflammation and destruction of bone tissue.
What is Staphylococcus aureus infection?
100
Chronic synovial inflammation in children leading to joint damage and potential systemic involvement.
What is juvenile idiopathic arthritis (JIA)?
100
Increased pressure within a closed fascial compartment leads to decreased perfusion, tissue ischemia, and potential muscle and nerve death.
What is compartment syndrome?
100
A condition in which the nucleus pulposus protrudes through the annulus fibrosus and compresses a nerve root.
What is disc herniation?
200
Identify the diagnosis: A metabolic bone disorder caused by defective bone mineralization due to vitamin D deficiency, leading to accumulation of unmineralized osteoid.
What is osteomalacia?
200
Autoantibodies against nuclear antigens leading to complement deposition and multi-organ involvement.
What is systemic lupus erythematous (SLE)?
200
A joint infection presenting with acute pain, swelling, fever, and purulent synovial fluid with a high neutrophil count.
What is septic arthritis?
200
A pediatric vasculitis characterized by prolonged fever, conjunctivitis, strawberry tongue, rash, and cervical lymphadenopathy.
What is Kawasaki disease?
200
A condition caused by interruption of blood supply to bone, leading to bone death and eventual structural collapse.
What is avascular necrosis?
200
A condition characterized by narrowing of the spinal canal leading to nerve compression and symptoms that improve with flexion.
What is spinal stenosis?
300
A condition caused by deposition of monosodium urate crystals that activate neutrophils and trigger an acute inflammatory response within the joint.
What is gout?
300
An inflammatory arthritis characterized by axial involvement and enthesitis is strongly associated with HLA-B27. The underlying primarily targets tendon and ligament insertion sites rather than the synovium.
What is enthesitis-driven inflammation (seronegative spondyloarthropathy mechanism)?
300
Identify the underlying patho: A child presents with fever and localized bone pain. Infection develops after bacteria seed the metaphysis, where sluggish blood flow allows bacterial proliferation. Increasing pressure within the bone compromises blood supply and leads to tissue death.
What is hematogenous spread leading to osteomyelitis with bone necrosis?
300
Identify the underlying patho: A disorder in adolescents in which repetitive traction at a tendon insertion site causes inflammation at an apophysis during periods of rapid growth.
What is traction apophysitis?
300
Identify the underlying patho: Repetitive traction on a ligament in a young child causes it to slip over a bony structure and become trapped, leading to limited arm use without significant swelling.
What is annular ligament displacement?
300
Identify the underlying patho: Chronic compression of neurovascular structures as they pass between the neck and shoulder leads to upper extremity pain, numbness, and weakness, often after trauma or repetitive use.
What is compression of the brachial plexus (thoracic outlet syndrome)?
400
A 2-year-old child presents with bowed legs and delayed growth. Pathophysiology involves impaired mineralization of the growth plate due to vitamin D deficiency, leading to defective endochondral ossification.
What is rickets?
400
Identify the underlying patho: A patient presents with progressive difficulty swallowing and decreased esophageal motility. Examination also reveals thickened, tight skin over the fingers.
What is collagen deposition?
400
A bone lesion shows well-defined borders with a narrow zone of transition, indicating slow growth and limited invasion of surrounding tissue.
What is benign bone tumor growth?
400
Identify the underlying patho: A child presents with a painless limp and limited hip motion. The condition results from temporary loss of blood supply to the femoral head, leading to bone necrosis and later remodeling.
What is avascular necrosis of the femoral head?
400
Identify the underlying patho: A patient sustains a midshaft humerus fracture and develops wrist drop with decreased sensation over the dorsum of the hand.
What is radial nerve injury due to compression or disruption along the humeral shaft?
400
Identify the underlying patho: A patient presents with low back pain that progresses to radiating leg pain. Symptoms worsen with coughing and straining. The pain is caused not only by compression but also by inflammatory mediators irritating the nerve.
What is combined mechanical compression and chemical inflammation of a nerve root?
500
An older adult presents with bone pain and deformity. The underlying pathophysiology involves excessive osteoclastic bone resorption followed by disorganized osteoblastic activity, resulting in structurally weak, enlarged bone.
What is Paget disease of bone?
500
Identify the underlying patho: A 52-year-old woman presents with dry eyes and difficulty swallowing dry foods. She has normal inflammatory markers but reports persistent fatigue. Examination shows dry mucous membranes and dental caries.
What is cytotoxic T-cell-mediated destruction of exocrine glands?
500
Identify underlying patho: A 16-year-old boy presents with persistent bone pain that worsens at night. Imaging shows a poorly defined lesion with aggressive bone destruction. The process involves rapid cellular proliferation and destruction of normal bone architecture.
What is malignant bone tumor formation?
500
Identify the underlying patho: An overweight adolescent presents with hip and knee pain. The condition occurs when mechanical stress causes displacement at the proximal femoral growth plate during rapid growth.
What is growth plate weakening with epiphyseal slippage?
500
Identify the underlying patho: A patient presents with lateral elbow pain that worsens with repetitive wrist extension. The condition results from microtearing and degeneration of a tendon rather than acute inflammation.
What is degenerative tendinopathy of the extensor carpi radialis brevis?
500
Identify the underlying patho: A patient presents with severe low back pain, bilateral leg weakness, saddle anesthesia, and loss of bladder control. The condition results from compression of multiple nerve roots in the lower spinal canal.
What is cauda equina syndrome due to nerve root compression?