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In the diaphysis of a typical long bone which of the following structures is in closest proximity to the trabeculae of cancellous bone?


A) Interstitial lamellae
B) Osteons
C) Sharpey fibers
D) Outer circumferential lamellae
E) Inner circumferential lamellae

F) A) and E)
G) A) and D)

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A 25-year-old man presents with persistent joint pain and a history of recurrent fractures of each humerus. His hematocrit and complete blood count (CBC) are normal, but blood calcium levels are high. Hormone levels are all within normal ranges except PTH that exceeds normal by threefold. Which if the following could be prescribed to offset the effects of the elevated PTH?


A) Vitamin D
B) Vitamin C
C) Recombinant RANK ligand
D) Somatotrophin (growth hormone)
E) Calcitonin

F) A) and D)
G) B) and D)

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E

A 46-year-old woman presents with pain in the left leg that worsens on weight bearing. An x-ray shows demineralization, and a bone biopsy decalcified with EDTA shows reduction in bone quantity. The patient had undergone menopause at age 45 without estrogen replacement. She reports long-standing diarrhea. In addition, laboratory tests show low levels of vitamin D, calcium, and phosphorus, and elevated alkaline phosphatase. A second bone biopsy was taken but not decalcified, which showed extensive deposition of uncalcified osteoid on all the bone surfaces. On the basis of these data, the best diagnosis would be which of the following?


A) Osteoporosis
B) Scurvy
C) Osteomalacia
D) Rickets
E) Hypoparathyroidism

F) B) and E)
G) D) and E)

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C

Which if the following most accurately describes compact bone?


A) Predominant bone type in the epiphyses of adult long bones
B) Also known as cancellous bone
C) Characterized by the presence of osteons
D) Lines the medullary (marrow) cavity
E) Forms the diploë in cranial bones

F) A) and B)
G) B) and E)

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Which "zone" of endochondral ossification in the growing femur of an adolescent is the farthest from that bone's secondary ossification center?


A) Zone of hypertrophy
B) Zone of reserve cartilage
C) Zone of calcified cartilage
D) Zone of ossification
E) Zone of proliferation

F) B) and E)
G) A) and B)

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Which component of bone impedes the distribution of nutrients and oxygen to osteocytes?


A) ECM
B) Canaliculi
C) Periosteum
D) Cell processes
E) Haversian canals

F) A) and C)
G) A) and D)

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Which of the following most accurately describes the endosteum?


A) Composed of two layers: osteogenic and fibrous
B) Continuous with the joint capsule
C) Attached to the bone surface by collagen bundles called Sharpey fibers
D) Lines the medullary cavity
E) Contains mature osteocytes

F) B) and D)
G) A) and B)

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D

In healthy bone canaliculi are likely to contain which one of the following?


A) Capillaries
B) Nerve axons
C) Osteocytic processes
D) Osteoid
E) Osteoclasts in resorption lacunae

F) A) and C)
G) C) and D)

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The major lubricant for diarthrotic joints is synthesized by cells located in which joint structure?


A) Nucleus pulposus
B) Synovial membrane
C) Articular cartilage
D) Annulus fibrosus
E) Fibrous capsule

F) C) and E)
G) A) and B)

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A 42-year-old woman, who has been a type I diabetic for 30 years, falls when she trips over the vacuum cleaner hose. She tried to break her fall by placing her hand out to save herself and in the process her wrist was forced backward, breaking her radius near the wrist. Which of the following is produced in the first step in healing this bone injury?


A) Osteoid
B) Hematoma
C) Bony callus
D) Fibrocartilage
E) Compact bone

F) C) and E)
G) B) and E)

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