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APEA Orthopedics Pharmacology ACTUAL EXAM
QUESTIONS WITH WELL DETAILED
ANSWERS/GRADE A+ ASSURED/NEWEST UPDATE
2026/2027
Which one of the following is associated with slipped capital femoral
epiphysis in a pediatric patient?
• Osteoporosis
Osteoarthritis
• Osteonecrosis
• Osteopenia ......ANSWER......Osteronecrosis
Slipped capital femoral epiphysis is the displacement of the femoral
head that produces instability of the proximal growth plate. Shear
force placed on the growth plate can cause osteonecrosis as the bone
moves. In children, blood supply to this part of the bone is tenuous.
The most common cause of a septic arthritis is:
O Staphylococcus aureus
Klebsiella pneumoniae
• Group A Streptococcus
pg. 1
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• Corynebacterium ......ANSWER......Staphylococcus aureus
Staphylococcus aureus is the most common cause of a septic arthritis.
Septic arthritis can occur as a result of direct invasion of the joint by
bacteria. Septic arthritis may also occur as a result of septicemia that
develops after joint replacement surgery. During septicemia caused by
an infection at a site near a joint, organisms are deposited in or on the
synovial membrane. When the bacteria grow, the infection can spread
to the joint space and then bone and cartilage.
The agents responsible for bone resorption in the process of bone
remodeling are:
• myeloid stem cells.
• mesenchymal cells.
-osteoclasts.
• osteoblasts. ......ANSWER......osteoclasts
The agents responsible for bone resorption in the process of bone
remodeling are osteoclasts. Bone is continually remodeled in response
to microtrauma. Bone remodeling occurs at discrete sites within the
skeleton and proceeds in an orderly fashion. Bone resorption is always
followed by bone formation, a phenomenon known as coupling.
Osteoclasts, derived from hematopoietic precursors, are responsible
for bone resorption. Osteoblasts, derived from mesenchymal cells, are
responsible for bone formation. Osteoblasts not only secrete and
pg. 2
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mineralize osteoid but also appear to control the bone resorption
carried out by osteoclasts. Osteocytes, which are terminally
differentiated osteoblasts embedded in mineralized bone, direct the
timing and location of bone remodeling. In osteoporosis, the coupling
mechanism between osteoclasts and osteoblasts is thought to be
unable to keep up with the constant microtrauma to trabecular bone.
Osteoclasts require weeks to resorb bone, whereas osteoblasts need
months to resorb bone. Osteoclasts and osteoblasts are dependent on
each other for production and linked in the process of bone
remodeling.
A pathologic alteration in the musculotendinous origins of the extensor
carpi radialis brevis muscle and longus tendons as a result of overuse is:
• lateral epicondylitis.
• synovitis of the elbow.
-O cubital tunnel syndrome.
• bursitis. ......ANSWER......lateral epicondylitis
Lateral epicondylitis, known as "tennis elbow," is a pathologic
alteration in the musculotendinous origins of the extensor carpi
radialis brevis muscle. The alteration (with subsequent pain) occurs on
the lateral epicondylar region of the distal humerus and is a result of
overuse. Lateral epicondylitis is not an inflammatory disease; it is
more properly termed a tendinosis. It specifically involves the origin of
the extensor carpi radialis brevis at the lateral condyle. Any activity
involving wrist extension or supination can be associated with overuse
pg. 3
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of the muscles originating at the lateral epicondyle. The area with the
most tenderness is usually an area just distal to the origin of the
extensor muscles of the forearm at the lateral epicondyle.
A 50-year-old woman reports morning joint stiffness that lasts less than
1 hour and resumes after activity. During physical examination, the NP
detects crepitus. This symptom indicates:
• rheumatoid arthritis.
O bursitis.
• tendonitis.
• osteoarthritis. ......ANSWER......Osteoarthritis
Crepitus is a palpable or audible grating or crunching sensation
produced by motion. It may or may not be accompanied by
discomfort. Crepitus occurs when roughened articular or extra-
articular surfaces are rubbed together by active motion or by manual
compression. Crepitus in a joint can indicate cartilage wear in the joint
space, as in osteoarthritis. Osteoarthritis is a progressive destruction
of the articular cartilage and subchondral bone accompanied by
osteophyte formation and sclerosis. Symptoms include morning
stiffness lasting less than 1 hour and stiffness that resumes at the end
of the day.
The pathologic hallmark of juvenile rheumatoid arthritis is:
pg. 4
APEA Orthopedics Pharmacology ACTUAL EXAM
QUESTIONS WITH WELL DETAILED
ANSWERS/GRADE A+ ASSURED/NEWEST UPDATE
2026/2027
Which one of the following is associated with slipped capital femoral
epiphysis in a pediatric patient?
• Osteoporosis
Osteoarthritis
• Osteonecrosis
• Osteopenia ......ANSWER......Osteronecrosis
Slipped capital femoral epiphysis is the displacement of the femoral
head that produces instability of the proximal growth plate. Shear
force placed on the growth plate can cause osteonecrosis as the bone
moves. In children, blood supply to this part of the bone is tenuous.
The most common cause of a septic arthritis is:
O Staphylococcus aureus
Klebsiella pneumoniae
• Group A Streptococcus
pg. 1
,2|Page
• Corynebacterium ......ANSWER......Staphylococcus aureus
Staphylococcus aureus is the most common cause of a septic arthritis.
Septic arthritis can occur as a result of direct invasion of the joint by
bacteria. Septic arthritis may also occur as a result of septicemia that
develops after joint replacement surgery. During septicemia caused by
an infection at a site near a joint, organisms are deposited in or on the
synovial membrane. When the bacteria grow, the infection can spread
to the joint space and then bone and cartilage.
The agents responsible for bone resorption in the process of bone
remodeling are:
• myeloid stem cells.
• mesenchymal cells.
-osteoclasts.
• osteoblasts. ......ANSWER......osteoclasts
The agents responsible for bone resorption in the process of bone
remodeling are osteoclasts. Bone is continually remodeled in response
to microtrauma. Bone remodeling occurs at discrete sites within the
skeleton and proceeds in an orderly fashion. Bone resorption is always
followed by bone formation, a phenomenon known as coupling.
Osteoclasts, derived from hematopoietic precursors, are responsible
for bone resorption. Osteoblasts, derived from mesenchymal cells, are
responsible for bone formation. Osteoblasts not only secrete and
pg. 2
,3|Page
mineralize osteoid but also appear to control the bone resorption
carried out by osteoclasts. Osteocytes, which are terminally
differentiated osteoblasts embedded in mineralized bone, direct the
timing and location of bone remodeling. In osteoporosis, the coupling
mechanism between osteoclasts and osteoblasts is thought to be
unable to keep up with the constant microtrauma to trabecular bone.
Osteoclasts require weeks to resorb bone, whereas osteoblasts need
months to resorb bone. Osteoclasts and osteoblasts are dependent on
each other for production and linked in the process of bone
remodeling.
A pathologic alteration in the musculotendinous origins of the extensor
carpi radialis brevis muscle and longus tendons as a result of overuse is:
• lateral epicondylitis.
• synovitis of the elbow.
-O cubital tunnel syndrome.
• bursitis. ......ANSWER......lateral epicondylitis
Lateral epicondylitis, known as "tennis elbow," is a pathologic
alteration in the musculotendinous origins of the extensor carpi
radialis brevis muscle. The alteration (with subsequent pain) occurs on
the lateral epicondylar region of the distal humerus and is a result of
overuse. Lateral epicondylitis is not an inflammatory disease; it is
more properly termed a tendinosis. It specifically involves the origin of
the extensor carpi radialis brevis at the lateral condyle. Any activity
involving wrist extension or supination can be associated with overuse
pg. 3
, 4|Page
of the muscles originating at the lateral epicondyle. The area with the
most tenderness is usually an area just distal to the origin of the
extensor muscles of the forearm at the lateral epicondyle.
A 50-year-old woman reports morning joint stiffness that lasts less than
1 hour and resumes after activity. During physical examination, the NP
detects crepitus. This symptom indicates:
• rheumatoid arthritis.
O bursitis.
• tendonitis.
• osteoarthritis. ......ANSWER......Osteoarthritis
Crepitus is a palpable or audible grating or crunching sensation
produced by motion. It may or may not be accompanied by
discomfort. Crepitus occurs when roughened articular or extra-
articular surfaces are rubbed together by active motion or by manual
compression. Crepitus in a joint can indicate cartilage wear in the joint
space, as in osteoarthritis. Osteoarthritis is a progressive destruction
of the articular cartilage and subchondral bone accompanied by
osteophyte formation and sclerosis. Symptoms include morning
stiffness lasting less than 1 hour and stiffness that resumes at the end
of the day.
The pathologic hallmark of juvenile rheumatoid arthritis is:
pg. 4
