a. Mechanical grinding of the bone matrix
b. Synthesis of alkaline phosphatase
c. Response to vitamin D through receptors on its cell membrane
d. Regulation by PTH receptors on its cell membrane
e. Proton pump activity similar to a parietal cell
109.LDC is a 45-year-old woman who presents with symmetric polyarticu-
lar joint pain, swelling, joint stiffness lasting an hour or more (particularly in
the morning), malaise, fatigue, tenderness and pain, and is seropositive for RF.
Analysis of synovial fluid reveals synovitis with a white blood cell count of
2500 (normal less than 2000/mm^3 ). Physical examination shows decreased
abduction and external rotation of the right and left shoulders. She has some
swelling in her right and left knees with full range of motion. Which joint
changes will most likely be associated with LDC’s disease?
a. Loss of the proteoglycan matrix and fibrillation in the articular cartilage during
the early stages
b. Decreased levels of fibrinogen in the synovial fluid
c. Formation of osteophytes at the articular margins and eburnation of large weight-
bearing joints in the later stages
d. Decreased number of leukocytes including PMNs in the synovial fluid
e. Heterologous autoantibodies directed against the synovium
Specialized Connective Tissues: Bone and Cartilage 197B(B. Micrograph courtesy of Dr. John K.Young.)