1Which mineral is the primary inorganic component of bone?
bone structure & composition
Easy
A.Calcium carbonate
B.Sodium chloride
C.Hydroxyapatite
D.Magnesium sulphate
Correct Answer: Hydroxyapatite
Explanation:
The inorganic phase of bone is mainly hydroxyapatite, a crystalline calcium phosphate, which gives bone its stiffness and compressive strength.
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2Which protein makes up the majority of the organic matrix of bone?
bone structure & composition
Easy
A.Albumin
B.Elastin
C.Keratin
D.Type I collagen
Correct Answer: Type I collagen
Explanation:
The organic matrix of bone is dominated by type I collagen, which provides tensile strength and flexibility.
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3The dense outer layer of bone is known as:
bone structure & composition
Easy
A.Spongy bone
B.Cortical (compact) bone
C.Cancellous bone
D.Trabecular bone
Correct Answer: Cortical (compact) bone
Explanation:
Cortical (compact) bone forms the dense outer shell, while cancellous/trabecular (spongy) bone forms the porous interior.
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4The basic structural unit of compact bone is the:
bone structure & composition
Easy
A.Alveolus
B.Nephron
C.Osteon (Haversian system)
D.Sarcomere
Correct Answer: Osteon (Haversian system)
Explanation:
The osteon, or Haversian system, is the cylindrical structural unit of compact bone, containing a central canal surrounded by concentric lamellae.
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5Which canals in compact bone run longitudinally and carry blood vessels?
blood circulation in bone
Easy
A.Haversian canals
B.Volkmann's canals
C.Semicircular canals
D.Root canals
Correct Answer: Haversian canals
Explanation:
Haversian canals run along the long axis of bone and house blood vessels and nerves at the centre of each osteon.
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6Volkmann's canals in bone primarily serve to:
blood circulation in bone
Easy
A.Secrete synovial fluid
B.Store calcium ions
C.Connect Haversian canals to each other and the periosteum
D.Produce red blood cells
Correct Answer: Connect Haversian canals to each other and the periosteum
Explanation:
Volkmann's canals run transversely, linking adjacent Haversian canals and connecting them to the periosteal blood supply.
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7The main artery supplying blood to the shaft of a long bone is the:
blood circulation in bone
Easy
A.Coronary artery
B.Renal artery
C.Pulmonary artery
D.Nutrient artery
Correct Answer: Nutrient artery
Explanation:
The nutrient artery enters through the nutrient foramen and is the principal blood supply to the diaphysis of a long bone.
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8Bone is generally strongest when loaded in which mode?
mechanical properties of bone
Easy
A.Torsion
B.Tension
C.Shear
D.Compression
Correct Answer: Compression
Explanation:
Bone withstands compressive loads better than tensile or shear loads, largely due to its mineral (hydroxyapatite) content.
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9On a stress–strain curve, the slope of the initial linear region represents the:
mechanical properties of bone
Easy
A.Poisson's ratio
B.Ultimate strength
C.Yield stress
D.Young's modulus (stiffness)
Correct Answer: Young's modulus (stiffness)
Explanation:
The slope of the elastic (linear) region equals Young's modulus, a measure of material stiffness: .
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10Stress is defined as:
mechanical properties of bone
Easy
A.Change in length per original length
B.Force times distance
C.Force per unit area
D.Mass times acceleration
Correct Answer: Force per unit area
Explanation:
Stress is force per unit area, , while strain is the relative change in length.
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11A viscoelastic material such as bone exhibits behaviour that depends on:
viscoelastic properties of bone
Easy
A.The rate of loading
B.Only the final load
C.Only its colour
D.Only temperature
Correct Answer: The rate of loading
Explanation:
Viscoelastic materials show rate-dependent behaviour: bone appears stiffer and stronger when loaded rapidly than when loaded slowly.
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12The gradual increase in deformation of bone under a constant sustained load is called:
viscoelastic properties of bone
Easy
A.Creep
B.Stress relaxation
C.Hysteresis
D.Fatigue
Correct Answer: Creep
Explanation:
Creep is the progressive increase in strain over time under a constant applied stress, a hallmark of viscoelastic materials.
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13The gradual decrease in stress under a constant applied strain is known as:
viscoelastic properties of bone
Easy
A.Stress relaxation
B.Plastic yielding
C.Elastic recoil
D.Creep
Correct Answer: Stress relaxation
Explanation:
Stress relaxation occurs when a viscoelastic material held at constant deformation shows a decreasing internal stress over time.
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14The Maxwell model of viscoelasticity consists of a spring and a dashpot arranged:
Maxwell & Voight models
Easy
A.In a triangle
B.In a loop
C.In parallel
D.In series
Correct Answer: In series
Explanation:
The Maxwell model places a spring and dashpot in series, and it is well suited to describing stress relaxation.
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15In viscoelastic models, the spring element represents the:
Maxwell & Voight models
Easy
A.Thermal expansion
B.Plastic deformation
C.Viscous (fluid-like) behaviour
D.Elastic (solid-like) behaviour
Correct Answer: Elastic (solid-like) behaviour
Explanation:
The spring models purely elastic response (obeying Hooke's law), while the dashpot models the viscous, time-dependent response.
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16The Voight (Kelvin–Voigt) model arranges a spring and a dashpot:
Maxwell & Voight models
Easy
A.Diagonally
B.In series
C.In parallel
D.Randomly
Correct Answer: In parallel
Explanation:
The Kelvin–Voigt (Voight) model connects the spring and dashpot in parallel and is good for representing creep behaviour.
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17Which component gives articular cartilage its ability to resist compression by attracting water?
viscoelastic properties of articular cartilage
Easy
A.Proteoglycans
B.Fibrin
C.Myosin
D.Hydroxyapatite
Correct Answer: Proteoglycans
Explanation:
Proteoglycans carry negative charges that attract water, creating a swelling pressure that helps cartilage resist compressive loads.
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18The time-dependent response of articular cartilage to loading is mainly due to:
viscoelastic properties of articular cartilage
Easy
A.Muscle contraction
B.Fluid (water) flow through the matrix
C.Bone remodelling
D.Nerve conduction
Correct Answer: Fluid (water) flow through the matrix
Explanation:
Cartilage is biphasic; its viscoelastic behaviour arises largely from interstitial fluid flow through the porous solid matrix.
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19Describing bone as anisotropic means that its mechanical properties:
anisotropy and composite models for bone
Easy
A.Vary with the direction of loading
B.Are the same in all directions
C.Do not depend on load
D.Change only with colour
Correct Answer: Vary with the direction of loading
Explanation:
Anisotropy means properties depend on direction; bone is stiffer and stronger along its longitudinal axis than across it.
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20Bone is often modelled as a composite material because it combines:
anisotropy and composite models for bone
Easy
A.A stiff mineral phase with a flexible collagen phase
B.Pure ceramic only
C.Two identical metals
D.Only water and air
Correct Answer: A stiff mineral phase with a flexible collagen phase
Explanation:
Bone behaves like a composite: brittle, stiff hydroxyapatite reinforces tough, flexible collagen, giving both strength and toughness.
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21Bone is a composite material. The mineral phase (hydroxyapatite) primarily contributes which mechanical property, while the collagen phase contributes another?
Correct Answer: Mineral provides stiffness/compressive strength; collagen provides tensile toughness/flexibility
Explanation:
Hydroxyapatite crystals give bone its rigidity and resistance to compression, while collagen fibers provide ductility and tensile toughness, preventing brittle failure.
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22A bone sample is decalcified (mineral removed), leaving only the organic matrix. What behavior would you expect from this sample?
bone structure & composition
Medium
A.It becomes stiffer and stronger in compression
B.It becomes brittle and shatters under low load
C.It becomes flexible and rubbery, bending easily without breaking
D.It remains mechanically unchanged
Correct Answer: It becomes flexible and rubbery, bending easily without breaking
Explanation:
Removing mineral leaves collagen, which is flexible. Decalcified bone can be bent or tied in a knot, demonstrating collagen's role in ductility.
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23In a long bone, blood generally flows in which predominant direction through the cortical bone during normal circulation?
blood circulation in bone
Medium
A.Only longitudinally along the diaphysis with no radial flow
B.Randomly, with no consistent direction
C.Centripetally, from the periosteum inward to the marrow
D.Centrifugally, from the medullary cavity outward toward the periosteum
Correct Answer: Centrifugally, from the medullary cavity outward toward the periosteum
Explanation:
The nutrient artery supplies the medullary cavity, and blood normally flows centrifugally (inner to outer) through cortical bone before draining at the periosteal surface.
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24The nutrient artery enters a long bone through the diaphysis. Which structure serves as the main channel for its passage into the cortex?
blood circulation in bone
Medium
A.The nutrient foramen
B.The Volkmann's periosteal pore only
C.The epiphyseal plate
D.The articular cartilage
Correct Answer: The nutrient foramen
Explanation:
The nutrient artery passes through the nutrient foramen in the diaphysis, then branches into the medullary cavity and Haversian/Volkmann's canals to supply the cortex.
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25Cortical bone typically has an ultimate tensile strength lower than its compressive strength. Given a compressive strength of about and tensile strength of about , this indicates bone is:
mechanical properties of bone
Medium
A.Stronger in tension than compression
B.Stronger in compression than tension (asymmetric strength)
C.Equally strong in tension and compression
D.Incapable of bearing compressive loads
Correct Answer: Stronger in compression than tension (asymmetric strength)
Explanation:
Bone's compressive strength exceeds its tensile strength, so it fails more easily under tension. This asymmetry reflects the mineral phase resisting compression well.
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26The elastic modulus (Young's modulus) of cortical bone is approximately longitudinally. If a long specimen with cross-section is loaded with , the approximate strain is:
mechanical properties of bone
Medium
A. (10%)
B. (0.1%)
C. (0.01%)
D. (1%)
Correct Answer: (1%)
Explanation:
Stress . Strain , i.e. 1%.
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27Bone is viscoelastic, meaning its mechanical response is rate-dependent. At higher strain rates (rapid loading), bone tends to become:
viscoelastic properties of bone
Medium
A.Weaker and softer
B.Stiffer and stronger, but more brittle
C.More compliant and ductile
D.Completely rate-independent
Correct Answer: Stiffer and stronger, but more brittle
Explanation:
As a viscoelastic material, bone's modulus and strength increase with loading rate, but it also absorbs less energy before fracturing, behaving more brittle.
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28Under a constant applied stress, a viscoelastic bone specimen slowly continues to deform over time. This time-dependent behavior is called:
viscoelastic properties of bone
Medium
A.Creep
B.Hysteresis
C.Stress relaxation
D.Yielding
Correct Answer: Creep
Explanation:
Creep is progressive strain under constant stress. (Stress relaxation is decreasing stress under constant strain; hysteresis is energy loss during load/unload cycles.)
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29The Maxwell model consists of a spring and dashpot in series. Which viscoelastic phenomenon does it best represent?
Maxwell & Voight models
Medium
A.Purely elastic instantaneous response
B.Stress relaxation under constant strain
C.Constant stress with zero strain
D.Ideal creep recovery with no permanent deformation
Correct Answer: Stress relaxation under constant strain
Explanation:
The Maxwell (series spring–dashpot) model captures stress relaxation well: at constant strain, stress decays exponentially over time. It poorly models creep.
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30In the Voigt (Kelvin–Voigt) model, a spring and dashpot are arranged in parallel. What is a key limitation of this model?
Maxwell & Voight models
Medium
A.It predicts infinite strain immediately
B.It shows no time dependence
C.It cannot represent instantaneous elastic deformation upon loading
D.It cannot represent creep at all
Correct Answer: It cannot represent instantaneous elastic deformation upon loading
Explanation:
In the parallel Voigt model, the dashpot prevents any instantaneous strain, so it fails to capture the immediate elastic jump seen in real materials, though it does model creep.
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31For a Maxwell model with spring constant and viscosity , the characteristic relaxation time is given by:
Maxwell & Voight models
Medium
A.
B.
C.
D.
Correct Answer:
Explanation:
The relaxation time of the Maxwell model is , governing the exponential decay of stress under constant strain.
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32The time-dependent creep and stress relaxation of articular cartilage is dominated by which physical mechanism?
viscoelastic properties of articular cartilage
Medium
A.Purely elastic deformation of collagen fibers
B.Frictional drag of interstitial fluid flowing through the porous matrix (biphasic behavior)
C.Thermal expansion of proteoglycans
D.Crystalline slip of mineral phase
Correct Answer: Frictional drag of interstitial fluid flowing through the porous matrix (biphasic behavior)
Explanation:
Cartilage is biphasic: its viscoelasticity arises mainly from fluid exuding through the solid porous matrix under load, creating flow-dependent creep and relaxation.
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33When articular cartilage is loaded and held, fluid is squeezed out and creep occurs until equilibrium. Which component provides the swelling pressure that helps resist compression?
viscoelastic properties of articular cartilage
Medium
A.Osteocytes in lacunae
B.Hydroxyapatite crystals
C.Negatively charged proteoglycans (aggrecan) drawing in water osmotically
D.Type I collagen fibers in tension
Correct Answer: Negatively charged proteoglycans (aggrecan) drawing in water osmotically
Explanation:
Proteoglycans carry fixed negative charges (Donnan effect) that osmotically attract water, generating swelling pressure that resists compressive loading.
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34Cortical bone is described as anisotropic. What does this mean for its mechanical testing?
anisotropy and composite models for bone
Medium
A.It behaves as a perfect fluid
B.It has zero Poisson's ratio in all directions
C.Its properties are identical in all directions
D.Its stiffness and strength differ depending on loading direction relative to the osteon axis
Correct Answer: Its stiffness and strength differ depending on loading direction relative to the osteon axis
Explanation:
Anisotropy means direction-dependent properties. Bone is stiffer and stronger along the longitudinal (osteon) axis than in the transverse direction.
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35Cortical bone is often modeled as transversely isotropic. How many independent elastic constants does a transversely isotropic material require?
anisotropy and composite models for bone
Medium
A.21
B.9
C.2
D.5
Correct Answer: 5
Explanation:
A transversely isotropic material (isotropic in one plane, different along the axis) needs 5 independent elastic constants, versus 2 for isotropic and 9 for orthotropic materials.
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36Wolff's Law states that bone adapts to the loads placed upon it. Under sustained increased mechanical loading, bone typically:
bone response to stress
Medium
A.Converts to cartilage
B.Remodels to increase density and mass along stress lines
C.Remains structurally unchanged
D.Resorbs and loses density
Correct Answer: Remodels to increase density and mass along stress lines
Explanation:
By Wolff's Law, increased loading stimulates osteoblastic bone deposition, so bone strengthens and increases density along principal stress trajectories.
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37Astronauts in microgravity experience bone loss. This observation is best explained by which principle?
bone response to stress
Medium
A.Reduced mechanical loading triggers bone resorption (disuse osteopenia)
B.Bone density is independent of loading
C.Radiation directly dissolves hydroxyapatite
D.Increased loading causes hypertrophy
Correct Answer: Reduced mechanical loading triggers bone resorption (disuse osteopenia)
Explanation:
Without gravitational loading, bone remodeling shifts toward resorption per Wolff's Law, causing disuse osteopenia and progressive loss of bone mass.
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38Osteoporosis is diagnosed using DEXA scanning, which reports a T-score. Which T-score value indicates osteoporosis by WHO criteria?
Osteoporosis — causes, diagnosis, treatment
Medium
A.T-score
B.T-score
C.T-score between and
D.T-score of exactly
Correct Answer: T-score
Explanation:
The WHO defines osteoporosis as a T-score of or lower. A T-score between and indicates osteopenia; above is normal.
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39Post-menopausal osteoporosis is largely driven by declining estrogen. The mechanism by which estrogen deficiency accelerates bone loss is:
Osteoporosis — causes, diagnosis, treatment
Medium
A.Enhanced calcium absorption in the gut
B.Direct mineralization of collagen
C.Increased osteoclast activity and bone resorption
D.Increased osteoblast activity and bone formation
Correct Answer: Increased osteoclast activity and bone resorption
Explanation:
Estrogen normally restrains osteoclasts. Its decline after menopause increases osteoclast-mediated resorption, causing rapid bone loss and osteoporosis.
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40Bisphosphonates are a common osteoporosis treatment. Their primary pharmacological action is to:
Osteoporosis — causes, diagnosis, treatment
Medium
A.Increase collagen synthesis by fibroblasts
B.Directly deposit hydroxyapatite into the matrix
C.Inhibit osteoclast activity, reducing bone resorption
D.Stimulate osteoclasts to remove old bone
Correct Answer: Inhibit osteoclast activity, reducing bone resorption
Explanation:
Bisphosphonates bind bone mineral and inhibit osteoclast function and survival, slowing resorption so that formation can maintain or increase bone density.
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41A researcher demineralizes a cortical bone sample by removing all hydroxyapatite while leaving the organic matrix intact. Which change in mechanical behavior is most consistent with this treatment?
bone structure & composition
Hard
A.The sample increases in stiffness due to collagen cross-linking dominance
B.The sample becomes flexible and can be tied in a knot but loses compressive stiffness
C.The sample becomes brittle and shatters under minimal bending load
D.The sample retains full compressive strength but loses all tensile capacity
Correct Answer: The sample becomes flexible and can be tied in a knot but loses compressive stiffness
Explanation:
Hydroxyapatite provides stiffness and compressive strength, while collagen provides tensile flexibility. Removing the mineral leaves flexible collagen, so the bone becomes rubbery and can be knotted but cannot resist compression.
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42In lamellar bone, adjacent lamellae have collagen fibers oriented in alternating directions. From a materials standpoint, this arrangement primarily improves which property?
bone structure & composition
Hard
A.Osteoclast recruitment during remodeling
B.Rate of vascular perfusion through Haversian canals
C.Mineral-to-collagen ratio in the interstitial matrix
D.Resistance to crack propagation across multiple loading directions
Correct Answer: Resistance to crack propagation across multiple loading directions
Explanation:
The plywood-like alternating fiber orientation deflects and arrests cracks regardless of loading direction, enhancing toughness and multidirectional strength rather than affecting perfusion or cellular activity.
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43In a long bone, the nutrient artery supplies the inner cortex while periosteal vessels supply the outer cortex. If the nutrient artery is occluded in an adult, what is the expected consequence for the diaphyseal cortex?
blood circulation in bone
Hard
A.The entire cortex necroses uniformly because periosteal flow is negligible
B.The inner cortex survives via reversed venous flow while the outer cortex necroses
C.Blood flow direction reverses to become entirely centripetal without ischemia
D.The outer cortex survives via periosteal supply while the inner cortex is at greatest ischemic risk
Correct Answer: The outer cortex survives via periosteal supply while the inner cortex is at greatest ischemic risk
Explanation:
Normal cortical perfusion is centrifugal (inner to outer). The inner two-thirds depends on the nutrient/medullary supply; occlusion places it at ischemic risk, while the outer cortex is buffered by anastomosing periosteal vessels.
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44Cortical bone loaded to failure in tension versus compression along its longitudinal axis typically shows which relationship in ultimate strength?
mechanical properties of bone
Hard
A.Shear strength exceeds both tensile and compressive strength
B.Compressive strength exceeds tensile strength, both exceeding shear strength
C.Tensile and compressive strengths are equal, with shear being highest
D.Tensile strength exceeds compressive strength, both exceeding shear strength
Longitudinal cortical bone is strongest in compression ( MPa), weaker in tension ( MPa), and weakest in shear ( MPa), reflecting its mineral-dominated, anisotropic microstructure.
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45A bone specimen has a stress-strain curve with Young's modulus GPa and yields at a strain of . A second identical-geometry specimen from an osteoporotic donor shows the same modulus but yields at strain . Which conclusion is best supported?
mechanical properties of bone
Hard
A.The osteoporotic bone has higher yield stress due to lower yield strain
B.Both specimens absorb identical energy because modulus is equal
C.The osteoporotic bone stores less strain energy to yield despite equal stiffness
D.The osteoporotic bone is stiffer and therefore tougher
Correct Answer: The osteoporotic bone stores less strain energy to yield despite equal stiffness
Explanation:
Strain energy to yield . With equal , the lower yield strain () means less energy stored (), indicating reduced toughness.
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46Bone is loaded at two different strain rates in tension. Which combination of observations correctly reflects its viscoelastic nature?
viscoelastic properties of bone
Hard
A.Higher strain rate yields lower stiffness but higher strength
B.Strain rate has no effect on stiffness but lowers strength
C.Higher strain rate yields greater stiffness and higher ultimate strength
D.Lower strain rate yields greater stiffness and higher energy storage
As a viscoelastic material, bone is rate-dependent: faster loading increases both the elastic modulus (stiffness) and ultimate strength, though it also tends to make behavior more brittle.
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47During a creep test, a viscoelastic bone specimen is held at constant stress. Which strain-versus-time behavior is expected?
viscoelastic properties of bone
Hard
A.Constant strain with rising internal stress over time
B.Strain that decreases over time at constant stress
C.Instantaneous elastic strain followed by continued time-dependent strain increase
D.Instantaneous strain that immediately fully recovers under constant load
Correct Answer: Instantaneous elastic strain followed by continued time-dependent strain increase
Explanation:
Creep under constant stress shows an immediate elastic jump then gradual time-dependent deformation. (Decreasing stress at constant strain is stress relaxation, a distinct test.)
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48For a Maxwell model (spring and dashpot in series) subjected to a suddenly applied constant strain , the stress relaxes as with . What does this predict for stress as ?
Maxwell & Voight models
Hard
A.Stress increases without bound due to the dashpot
B.Stress approaches a nonzero equilibrium value characteristic of a solid
C.Stress decays to zero, so the model cannot represent a solid that sustains load
D.Stress remains constant at indefinitely
Correct Answer: Stress decays to zero, so the model cannot represent a solid that sustains load
Explanation:
The Maxwell model relaxes stress fully to zero, behaving like a fluid. This is why it cannot model a solid holding sustained load, motivating combined models like the standard linear solid.
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49The Kelvin-Voigt model (spring and dashpot in parallel) is subjected to a constant stress at . Which behavior does it predict, and what is its main limitation?
Maxwell & Voight models
Hard
A.Gradual asymptotic creep to with no instantaneous strain jump
B.Stress relaxation to zero at constant strain
C.Instantaneous strain jump followed by no further creep
D.Immediate full recovery with unbounded creep
Correct Answer: Gradual asymptotic creep to with no instantaneous strain jump
Explanation:
Under constant stress the Voigt model gives , creeping asymptotically. Its limitation is the absence of an instantaneous elastic response, since the parallel dashpot blocks a sudden strain jump.
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50A Maxwell element has spring constant GPa and dashpot viscosity GPa·s. After a step strain, what fraction of the initial stress remains at s?
Maxwell & Voight models
Hard
A.
B.
C.
D.
Correct Answer:
Explanation:
Relaxation time s. At s, .
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51In biphasic theory, the time-dependent creep of articular cartilage under constant compressive load is governed primarily by which mechanism?
viscoelastic properties of articular cartilage
Hard
A.Frictional drag from interstitial fluid exuding through the porous solid matrix
B.Viscous shearing of collagen fibrils sliding past one another
C.Delayed elastic recoil of chondrocyte membranes
D.Diffusion of calcium ions out of the mineralized zone
Correct Answer: Frictional drag from interstitial fluid exuding through the porous solid matrix
Explanation:
Cartilage viscoelasticity is largely biphasic (flow-dependent): compressive load drives interstitial fluid through the low-permeability solid matrix, and this fluid-solid frictional drag governs the time-dependent creep and stress relaxation.
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52During confined compression stress relaxation of cartilage, why does the peak stress far exceed the equilibrium stress?
viscoelastic properties of articular cartilage
Hard
A.Pressurized interstitial fluid initially carries most of the load before redistributing to the solid matrix
B.Proteoglycans dissolve under load, transiently increasing stress
C.The collagen network stiffens permanently after the first loading cycle
D.The equilibrium stress reflects fluid pressure while peak reflects only the solid phase
Correct Answer: Pressurized interstitial fluid initially carries most of the load before redistributing to the solid matrix
Explanation:
On rapid loading, the interstitial fluid pressurizes and bears the majority of the load (high peak stress). As fluid exudes over time, load transfers to the solid matrix and stress relaxes to the lower equilibrium value borne by the solid.
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53Cortical bone is often modeled as transversely isotropic rather than fully orthotropic or isotropic. What does transverse isotropy imply about its elastic constants?
anisotropy and composite models for bone
Hard
A.Properties differ in all three orthogonal directions independently
B.Only shear moduli vary with direction while normal moduli stay constant
C.Properties are identical in every direction, requiring only two constants
D.Properties are equal in all directions within the transverse plane but differ along the longitudinal axis
Correct Answer: Properties are equal in all directions within the transverse plane but differ along the longitudinal axis
Explanation:
Transverse isotropy means one axis of symmetry (the osteon/longitudinal axis): properties are the same in any transverse direction but different along the long axis, described by five independent elastic constants.
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54Treating bone as a composite of stiff hydroxyapatite reinforcement in a compliant collagen matrix, the Voigt (iso-strain) and Reuss (iso-stress) bounds give the upper and lower limits of composite modulus. Which loading assumption yields the upper bound?
anisotropy and composite models for bone
Hard
A.Iso-strain (Voigt), where components share equal strain and moduli combine by volume-weighted average
B.Iso-stress (Reuss), where components share equal stress and compliances add
C.Random orientation, giving the geometric mean of the two moduli
D.Equal-volume mixing regardless of loading configuration
Correct Answer: Iso-strain (Voigt), where components share equal strain and moduli combine by volume-weighted average
Explanation:
The Voigt bound assumes uniform strain (fibers parallel to load): , giving the stiff upper limit. The Reuss iso-stress bound gives the lower limit via added compliances.
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55According to Wolff's law and the mechanostat concept, a bone experiencing habitual strains within the physiological "lazy zone" (approximately 200–2500 microstrain) will most likely:
bone response to stress
Hard
A.Fracture from fatigue accumulation within days
B.Undergo rapid net bone formation regardless of strain magnitude
C.Resorb progressively because any strain triggers osteoclasts
D.Maintain its mass through balanced remodeling with no net gain or loss
Correct Answer: Maintain its mass through balanced remodeling with no net gain or loss
Explanation:
Frost's mechanostat proposes a homeostatic strain window where formation and resorption balance. Strains below it favor resorption and above it favor formation; within the lazy zone, bone mass is maintained.
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56A patient's limb is immobilized in a cast for 8 weeks. Which combination of changes best describes the expected disuse response of the underlying bone?
bone response to stress
Hard
A.Uniform cortical thickening from reduced fluid flow
B.No change because remodeling requires longer than 8 weeks
C.Increased osteoblastic formation and higher BMD from stress shielding
D.Increased osteoclastic resorption and reduced BMD due to strain below the maintenance threshold
Correct Answer: Increased osteoclastic resorption and reduced BMD due to strain below the maintenance threshold
Explanation:
Disuse drops habitual strain below the maintenance threshold, shifting remodeling toward resorption. This causes measurable bone loss (disuse osteopenia) with reduced bone mineral density during immobilization.
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57A postmenopausal woman has a DXA-derived T-score of at the femoral neck. Using WHO criteria, how is she classified, and what does the T-score represent?
Osteoporosis — causes, diagnosis, treatment
Hard
A.Osteopenia; SDs below the age-matched reference population
B.Osteoporosis; SDs below the mean BMD of a young healthy adult reference population
C.Severe osteoporosis; requires a prior fragility fracture regardless of score
D.Normal; SDs above the young-adult mean
Correct Answer: Osteoporosis; SDs below the mean BMD of a young healthy adult reference population
Explanation:
WHO criteria: T-score = osteoporosis. The T-score compares the patient's BMD to the young healthy adult mean in standard deviations, whereas the Z-score uses an age-matched reference.
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58Bisphosphonates and teriparatide both treat osteoporosis but by opposite primary mechanisms. Which pairing is correct?
Osteoporosis — causes, diagnosis, treatment
Hard
A.Both are antiresorptive but act on different osteoclast pathways
B.Both are anabolic, differing only in dosing frequency
C.Bisphosphonates are anabolic; teriparatide is antiresorptive
D.Bisphosphonates are antiresorptive (inhibit osteoclasts); teriparatide is anabolic (stimulates osteoblasts)
Correct Answer: Bisphosphonates are antiresorptive (inhibit osteoclasts); teriparatide is anabolic (stimulates osteoblasts)
Explanation:
Bisphosphonates suppress osteoclast-mediated resorption. Teriparatide (recombinant PTH 1-34), given intermittently, preferentially stimulates osteoblastic bone formation, making it anabolic.
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59Why does estrogen deficiency after menopause accelerate bone loss at the cellular level?
Osteoporosis — causes, diagnosis, treatment
Hard
A.Estrogen deficiency raises osteoblast apoptosis while sparing osteoclasts entirely
B.Estrogen loss directly mineralizes the matrix, reducing available calcium
C.Estrogen normally stimulates osteoclasts, so its loss reduces formation
D.Loss of estrogen increases osteoclast activity and lifespan, tipping remodeling toward net resorption
Correct Answer: Loss of estrogen increases osteoclast activity and lifespan, tipping remodeling toward net resorption
Explanation:
Estrogen normally restrains osteoclastogenesis and promotes osteoclast apoptosis (partly via RANKL/OPG regulation). Its withdrawal increases osteoclast number and lifespan, causing accelerated resorption exceeding formation.
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60Trabecular (cancellous) bone is affected earlier and more severely than cortical bone in early postmenopausal osteoporosis. What best explains this?
Osteoporosis — causes, diagnosis, treatment
Hard
A.Trabecular bone has a higher surface-area-to-volume ratio and turnover rate, exposing it to remodeling imbalance
B.Trabecular bone contains no collagen, so it demineralizes faster
C.Trabecular bone is fully mineralized and thus more brittle than cortical bone
D.Cortical bone lacks blood supply and cannot be remodeled at all
Correct Answer: Trabecular bone has a higher surface-area-to-volume ratio and turnover rate, exposing it to remodeling imbalance
Explanation:
Cancellous bone's large surface area supports high metabolic turnover, so a resorption-dominant remodeling imbalance manifests earliest and most severely there—hence early vertebral and distal radius fragility fractures.
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