Musculoskeletal Flashcards
A 25-year-old male presents to the emergency room with a broken arm, he states he got it crushed underneath a car he was working on, an x ray reveals a fracture with multiple bone fragments. What kind of fracture is this?
A. Transverse
B. Comminuted
C. Oblique
D. Avulsion
Comminuted
A middle-aged woman who is post-menopausal is more at risk for which of the following?
A. Paget disease
B. Osteoporosis
C. Osteomyelitis
D. Osteomalacia
Osteoporosis
Which condition results from insufficiency of Vitamin D?
A. Septic arthritis
B. Rickets
C. Osteochondrosis
D. Scoliosis
Rickets
Which of the following patterns of bone destruction is being described: well-defined margins separated from surrounding normal bone.
A. Permeative
B. Moth- eaten
C. Geographic
D. None of the above
Geographic
Developmental dysplasia of the hip is a spectrum of disorders related to abnormal development of the hip joint. Which of the following is not a clinical manifestation of DDH?
A. Positive Murphy sign
B. Positive Galeazzi sign
C. Positive Ortolani sign
D. Positive Tredelenburg sign
Positive Murphy sign
Kennedy is a nurse practitioner student who currently at primary care clinical. She is preparing to speak with a patient who has a known history of gout, and has been experiencing extreme toe joint pain for the past 2 months. Which of the following activities should this patient be advised to do to prevent gout flare ups?
A. Taking aspirin daily
B. Eating fried food
C. Keep hydrated
D. Maintain a diet rich in seafood
Keep hydrated
A 27 year old female presents to the ED post bicycle accident. X Ray shows her left femur is broken perpendicular to the long bone. There is also a wound on the skin just above the fracture. What type of fracture is this?
A. Closed linear
B. Open impacted
C. Open transverse
D. Closed communicated
Open transverse
The following is not a risk factor for rheumatoid arthritis.
A. Smoking
B. Genetics
C. Male sex
D. Periodontal disease
Male sex
The clinician knows that osteogenesis imperfecta is a disease that has its dysfunction in the synthesis of what?
A. Collagen
B. Keratin
C. Calcium
D. Cartilage
Collagen
After a primary C-section for the arrest of labor, the patient is noted to have an unexplained HR of 125 bpm, a temperature of 103.1 F (>39.5), and a BP of 89/54 in the PACU. The patient also appears stiff and unable to move in the bed. The NP will anticipate treating the patient for:
A. Constipation
B. Atelectasis
C. Malignant Hyperthermia
D. Deep Vein Thrombosis
Malignant hyperthermia
The patient plans to get pregnant next year and visited the NP last month for preconception counseling. The patient returns to the clinic for the results of her genetic testing and is noted to have a mutation in the SMN1 gene. The NP understands that this:
A. Is normal, and the NP will notify the patient of the result.
B. The patient is a carrier for Facioscapulohumeral Muscular Dystrophy
C. The patient is diagnosed with Myotonic Muscular Dystrophy
D. The patient is a carrier of Spinal Muscular Atrophy
Is normal, and the NP will notify the patient of the results
A 68-year-old man presents to his local emergency department after falling off his roof approximately 10 feet. During examination by the provider, he reports severe pain in his right leg and that he is unable to bear any weight on it. Significant ecchymosis was noted, but no breaks were observed in the skin. An x-ray of the affected extremity is completed, showing that his right femur is fractured into three fragments. What type of fracture is the imaging showing?
A. Comminuted fracture
B. Transverse fracture
C. Greenstick fracture
D. Complete (open) fracture
Comminuted fracture
The patient presents to the clinic for a follow-up appointment and reports pain in the joint of the great toe. The patient is diagnosed with gout. Which of the following is NOT a first-line option for the pharmacologic treatment of acute gout?
A. NSAIDs
B. Corticosteroids
C. Oral colchicine
D. Aspirin
Aspirin
An 11-year-old boy goes to his local urgent care after being injured in a volleyball game. He reports that he has been having pain over the past several months that has been gradually increasing in his right knee. Upon examination, the boy demonstrated difficulty in extending his right leg. There is also reported localized pain, swelling, and tenderness around the distal patellar tendon and his tibial tubercle just below his knee. Lab work and examination demonstrate no signs of infection. An x-ray of the knee shows irregularity and fragmentation of his femoral condyle. The clinician is thinking that the boy has osteochondrosis, but which form of it is most likely?
A. Legg-Calve-Perthes disease
B. Osgood-Schlatter disease
C. Sever disease
D. Osseous necrosis
Osgood-Schlatter disease
A 4-year-old boy is brought by his parents to his pediatric provider’s office due to progressive weakness. His parents report that he has difficulty rising from the floor, climbing stairs, and running. Upon physical examination, it is revealed that he has a waddling gait and hypertrophy in his calves. Blood levels show an elevation in his serum creatine kinase levels. Genetic testing is then conducted, revealing that he has a mutation in the dystrophin gene. The practitioner is considering muscular dystrophy, but which type of it is most likely the case with this pediatric patient?
A. Becker muscular dystrophy
B. Limb-girdle muscular dystrophy
C. Duchenne muscular dystrophy
D. Myotonic dystrophy
Duchenne muscular dystrophy
Which of the following components is the primary substance of bone matrix that provides structural support?
A. Collagen fibers
B. Adipocytes
C. Osteocytes
D. Chondrocytes
Collagen fibers
A 55-year-old male presents to the emergency department with a 2-week history of increasing left foot pain and swelling. He has a history of diabetes mellitus and was recently treated for a skin infection on his foot. On examination, there is redness, warmth, and tenderness over the metatarsal region of the left foot. Labs show an elevated white cell count and CRP. MRI shows bone marrow edema. What would you, as the practitioner, suspect this patient is experiencing?
A. Cellulitis
B. Osteomyelitis
C. Gout
D. Tendonitis
Osteomyelitis
An 11-year-old boy named Ethan presents to the pediatric clinic with complaints of knee pain for the past few weeks. His mother reports that he plays soccer regularly and has recently increased his practice sessions. The pain is localized just below the kneecap and tends to worsen during physical activity, especially running and jumping. Upon examination, there is tenderness over the tibial tuberosity, and the boy has a noticeable bump in that area. His range of motion is normal, but he experiences discomfort when the knee is put under strain. What would you, as the practitioner, suspect would be a likely diagnosis for Ethan’s condition?
A. Patellar tendonitis
B. Osgood-Schlatter disease
C. Meniscus tear
D. Anterior cruciate ligament injury
Osgood-Schlatter disease
A patient presents with joint pain, swelling, and stiffness in several joints, particularly in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the fingers. Physical examination reveals swelling, edema, and redness, with warmth noted in the inflamed joints. Subcutaneous nodules are observed over the extensor surfaces of the fingers. Swan neck and Boutonnière deformities are also noted. Based on this presentation and after diagnosis, which medication therapy should be prioritized?
A. Allopurinol
B. Disease-modifying antirheumatic drugs (DMARDs)
C. Colchicine
D. NSAIDs
Disease-modifying antirheumatic drugs (DMARDs)
A new patient, a 45-year-old female, presented with a new onset of generalized myalgia, muscle weakness, oliguria, and tea-colored urine for the past 24 hours. Lab shows Creatine Kinase (CK) level found to be 12000 U/L with elevated potassium and phosphorus. She is on a statin and reports taking ibuprofen several times to treat the muscle pain. Which diagnosis is most likely?
A. Hyperthyroidism
B. Rhabdomyolysis
C. Fibromyalgia
D. Chronic fatigue syndrome
Rhabdomyolysis
A 16-year-old boy presents with symptoms of myotonia. For example, he has difficulty relaxing his grip after a handshake and struggles to open his eyes after tightly closing them. His mother reports that he has progressive muscle weakness and has recently been experiencing blurred vision. Physical examination reveals testicular atrophy, and an EKG shows first-degree heart block. Genetic testing reveals mutations in the ZNF9 gene on chromosome 3. Which of the following diagnoses is most likely?
A. Myotonic Muscular dystrophy (MMD)
B. Legg-Calve-Perthes (LCP) disease
C. Osteogenesis Imperfecta
D. Clubfoot
Myotonic Muscular dystrophy (MMD)
A patient with a recent right lower leg fracture presents with increasing pain, paleness, pulselessness, and impaired sensation in the affected leg. Elevated intracranial pressure (ICP) is confirmed using a manometer. Based on these findings, which of the following is the most likely diagnosis?
A. Deep venous thrombosis
B. Compartment syndrome
C. Atherosclerosis
D. Acute osteomyelitis
Compartment syndrome
The classic triad of symptoms for rhabdomyolysis includes all of the following except:
A. Myalgias
B. Excessive thirst
C. Muscle weakness
D. Dark urine
Excessive thirst
Your patient with a history of gout is asking about modifications to lifestyle factors that could help reduce their attacks. All of the following would be good advice, except:
A. Quit smoking cigarettes
B. Quit drinking alcohol
C. Avoid foods like red meat, seafood, soda, and gravies
D. Maintain a regular exercise schedule.
Quit smoking cigarettes
