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patho final > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

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

A

Comminuted

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2
Q

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

A

Osteoporosis

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3
Q

Which condition results from insufficiency of Vitamin D?

A. Septic arthritis
B. Rickets
C. Osteochondrosis
D. Scoliosis

A

Rickets

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4
Q

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

A

Geographic

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5
Q

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

A

Positive Murphy sign

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6
Q

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

A

Keep hydrated

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7
Q

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

A

Open transverse

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8
Q

The following is not a risk factor for rheumatoid arthritis.

A. Smoking
B. Genetics
C. Male sex
D. Periodontal disease

A

Male sex

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9
Q

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

A

Collagen

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10
Q

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

A

Malignant hyperthermia

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11
Q

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

A

Is normal, and the NP will notify the patient of the results

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12
Q

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

A

Comminuted fracture

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13
Q

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

A

Aspirin

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14
Q

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

A

Osgood-Schlatter disease

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15
Q

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

A

Duchenne muscular dystrophy

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16
Q

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

A

Collagen fibers

17
Q

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

A

Osteomyelitis

18
Q

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

A

Osgood-Schlatter disease

19
Q

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

A

Disease-modifying antirheumatic drugs (DMARDs)

20
Q

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

A

Rhabdomyolysis

21
Q

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

A

Myotonic Muscular dystrophy (MMD)

22
Q

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

A

Compartment syndrome

23
Q

The classic triad of symptoms for rhabdomyolysis includes all of the following except:

A. Myalgias
B. Excessive thirst
C. Muscle weakness
D. Dark urine

A

Excessive thirst

24
Q

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.

A

Quit smoking cigarettes

25
Q

A varsity football player presents to your clinic a few days after practicing on a 100 degree day, with complaints of fatigue and brown-colored urine. Routine labs show a CK of 16k and creatinine of 1.4mg/dL. Which of the following actions would be the most appropriate?

A. Advise him that his labs are WNL and he can return to practice the following day.
B. Advise him to drink at least 2 gallons of PO fluids daily for the following 3 days and not to practice during that time.
C. Place an IV in the office and administer 2L NS.
D. Transfer to the ED for more aggressive fluid resuscitation and monitoring.

A

Transfer to the ED for more aggressive fluid resuscitation and monitoring.

26
Q

The classic triad of muscle pain, weakness, and dark urine are clinical manifestations to which disease:

A. Compartment syndrome
B. Muscle strains
C. Myoglobinuria
D. Rhabdomyolysis

A

Rhabdomyolysis

27
Q

As a NP who moonlights between the OR and ER you know that succinylcholine precipitates which disease when used for an anesthetic:

A. Myasthenia Gravis
B. Malignant Hyperthermia
C. Muscular Dystrophy
D. Myxedema Coma

A

Malignant Hyperthermia

28
Q

A mother brings in her 4 year old child for repeated evaluation of left knee pain. There is notable erythema and swelling, the child limps when he walks, and has limited range of motion due to pain. Other than normal trips and falls there has been no significant trauma. As the provider you begin suspecting juvenile idopathic arthritis (JIA). You know all of the following are true except:

A. Serum blood tests for rheumatoid factor will positive
B. Slit lamp eye examination is required every 6 months
C. Large joints are most often effected
D. The symptoms must be present for 6 weeks

A

Serum blood tests for rheumatoid factor will positive

29
Q

A nurse practitioner is working in an orthopedic office. She is caring for a variety of patients. Which of the following patients is most at risk for pathologic fractures?

A. A 22 year old male who runs ultramarathons
B. A 63 year old female with Rheumatoid arthritis
C. A 44 year old male who was in a snowmobile accident
D. A 14 year old female who does gymnastics

A

A 63 year old female with Rheumatoid arthritis

30
Q

A nurse practitioner in a primary care office receives a phone call from a patient to make an appointment. The patient states they ran the Boston Marathon for the first time a few days ago and since then have been experiencing muscle pain, weakness, and dark urine. Which of the following should the nurse practitioner suspect?

A. Compartment syndrome
B. Malignant hyperthermia
C. Rhabdomyolysis
D. Bursitis

A

Rhabdomyolysis

31
Q

A nurse practitioner is caring for newborn with idiopathic congenital clubfoot. Which of the following should not be included in the education for the parents?

A. Ponseti casting will need to be changed every week for six weeks
B. Treatment is most successful if done immediately after birth
C. Lengthening or transection of the Achilles tendon may be needed
D. Clubfoot is usually the first sign of a further neuromuscular disorder

A

Clubfoot is usually the first sign of a further neuromuscular disorder

32
Q

A 16-year-old boy reports severe knee pain following an injury during a soccer game. The provider evaluates the knee joint to check for any injuries. Based on its movement and connective structure, how is the knee joint classified?

A Synarthrosis; fibrous joint
B. Amphiarthrosis; cartilaginous joint
C. Diarthrosis; synovial joint
D. Synthromsis joint

A

Diarthrosis; synovial joint

33
Q

A 70-year-old patient with a history of osteoarthritis (OA) presents to the clinic with chronic hip pain and stiffness and difficulty walking for exercises. What is the most important information for the nurse practitioner to convey about managing osteoarthritis?

A. Encourage weight-bearing exercise to strengthen the joints.
B. Discuss weight management to reduce joint stress.
C. Advise complete rest to avoid further joint damage.
D. Prescribe only nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management.

A

Discuss weight management to reduce joint stress.

34
Q

A 3-year-old child is diagnosed with Legg-Calve-Perthes (LCP) disease during a primary care visit. What information is the most important for the nurse practitioner to provide to the parents about managing LCP disease?

A. Suggest immediate surgical intervention to prevent complications.
B. Explain that LCP often resolves within 2 to 5 years if properly managed.
C. Encourage the parents to enroll the child in high-impact sports to strengthen the hip joint.
D. Avoid physical therapy because the condition resolves on its own.

A

Explain that LCP often resolves within 2 to 5 years if properly managed.

patho final (7 decks)

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