Quiz 5

Question 1

This patient has injured his ulnar collateral ligament (UCL)

Answer 1

The UCL is the primary restraint to valgus
stress on the elbow during overhead throwing. These injuries often occur in athletes participating in sports
that require overhead throwing, such as baseball, javelin, and volleyball. Patients often report a pop
followed by immediate pain and bruising around the medial elbow. The moving valgus stress test has 100%
sensitivity and 75% specificity for diagnosing UCL injuries.

Question 2

Medial epicondylitis

Answer 2

usually presents with an insidious onset of pain related to a recent increase in
occupational or recreational activities. Patients also often report weakened grip strength. The point of
maximal tenderness is 5–10 mm distal to and anterior to the medial epicondyle. It is most often a
tendinopathy of the flexor carpi radialis and the pronator teres.

Question 3

Biceps tendinopathy

Answer 3

usually presents with a history of vague anterior elbow pain and a history of repeated
elbow flexion with forearm supination and pronation, such as dumbbell curls. Resisted supination produces
pain deep in the antecubital fossa.

Question 4

Tendinopathy of the triceps insertion

Answer 4

is more common in weight lifters or athletes who repetitively extend
their elbows against resistance. Pain occurs at the posterior elbow with resisted extension, and tenderness
is located over the triceps insertion.

Question 5

A 63-year-old female with corticosteroid-dependent COPD has developed pneumonia. Which
one of the following pathogens should the antibiotic regimen cover in this patient that would be
unlikely in someone with pneumonia and otherwise healthy lungs?
Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Haemophilus influenzae
D. Staphylococcus aureus
E. Pseudomonas aeruginosa

Answer 5

Pseudomonas aeruginosa

Question 6

You decide that outpatient treatment would be appropriate. Which one of the following alcohol
withdrawal management options is supported by the best evidence?

Answer 6

Chlordiazepoxide (benzo)

Question 7

In a 15-year-old female with no known chronic medical conditions, which one of the following
is essential before initiating oral combined hormonal contraception?

Answer 7

the
only medical evaluation identified as essential before prescription of combined hormonal contraception is
measurement of blood pressure, as severe hypertension is a contraindication to oral contraception.