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Advanced Assessment Interpreting Study Set 1

Medicine

Quiz 14 :

Musculoskeletal System

Quiz 14 :

Musculoskeletal System

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Your patient is a 40-year-old baseball player who needs his yearly physical examination. He reports a 5-year history of chronic lower back pain due to spinal stenosis. Which of the following findings indicate spinal stenosis?
Free
Multiple Choice
Answer:

Answer:

D

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Whenever a patient presents with acute nontraumatic shoulder pain, the clinician should make sure to exclude a:
Free
Multiple Choice
Answer:

Answer:

D

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A 33-year-old female reports general malaise, fatigue, stiffness, and pain in multiple joints of the body. There is no history of systemic disease and no history of trauma. On physical examination, the patient has no swelling or decreased range of motion in any of the joints. She indicates specific points on the neck and shoulders that are particularly affected. She complains of tenderness on palpation of the neck, both shoulders, hips, and medial regions of the knees. The clinician should include the following disorder in the list of potential diagnoses:
Free
Multiple Choice
Answer:

Answer:

C

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A 34-year-old female presents with fever, general malaise, fatigue, arthralgias, and rash for the last 2 weeks. On physical examination, you note facial erythema across the nose and cheeks. Serum diagnostic tests reveal positive antinuclear antibodies, anti-DNA antibodies, elevated C-reactive protein, and erythrocyte sedimentation rate. The clinician should include the following disorder in the list of potential problems:
Multiple Choice
Answer:
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Which of the following serological diagnostic tests is most specific for rheumatoid arthritis?
Multiple Choice
Answer:
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A 56-year-old male presents with complaints of right-sided neck pain with radiation down the right arm into the right index finger and thumb. He reports a recent fall from a scaffold while painting on the job. On physical examination, you note a 0/4 biceps reflex on the right compared to 2/4 on the left and 1/5 grip strength of the right hand compared to 5/5 of the left hand. Which of the following is a test that can be performed to assist in the diagnosis of cervical disk herniation?
Multiple Choice
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Sarcoidosis is an autoimmune disease that presents with nonspecific symptoms of fatigue, fever, and arthralgias. Which of the following signs should raise suspicion of this disorder?
Multiple Choice
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A 75-year-old female patient complains of fatigue, as well as pain and stiffness of the shoulders and neck. There is no history of trauma or exercised-induced pain. Medications include a beta blocker and ACE inhibitor. Medical history includes giant cell arteritis and Raynaud's syndrome. Physical examination is unremarkable. There is no swelling or erythema over the temporal arteries. There is no swelling, erythema, limitation in range of motion, or point tenderness over the shoulder joints. The neck has normal range of motion and no tenderness or swelling. Which of the following disorders should be included in the list of possible diagnoses?
Multiple Choice
Answer:
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Your patient is a 55-year-old male who presents with sudden, severely tender, swollen, erythematous elbow. The patient reports that he experienced similar symptoms in the past. You note the right elbow has a swollen, tender, soft, 3 cm round nodule. The clinician should recognize these are signs and symptoms of:
Multiple Choice
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Which of the following disorders has a strong genetic component and causes loss of spinal mobility and progressive erosion of the sacroiliac joint?
Multiple Choice
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A 55-year-old patient complains of lower back pain due to heavy lifting at work yesterday. He reports weakness of the left leg and paresthesias in the left foot. On physical examination, the patient has diminished ability to dorsiflex the left ankle. Which of the following symptoms should prompt the clinician to make immediate referral to a neurosurgeon?
Multiple Choice
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A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of:
Multiple Choice
Answer:
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A 17-year-old male complains of severe right knee pain. He was playing football when he heard a pop at the moment of being tackled and his knee gave way from under him. On physical examination, there is right knee swelling and decreased range of motion. There is a positive anterior drawer sign. These findings indicate:
Multiple Choice
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A 60-year-old female patient complains of pain in the hands that is worse in the morning. On physical examination, the thumb metacarpophalangeal joint is swollen on both hands. There is swelling of the proximal and distal interphalangeal joints bilaterally. These are typical signs of:
Multiple Choice
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Muscle strength is assessed by:
Multiple Choice
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A 20-year-old male construction worker is experiencing new onset of knee pain. He complains of right knee pain when kneeling, squatting, or walking up and down stairs. On physical examination, there is swelling and crepitus of the right knee and obvious pain with resisted range of motion of the knee. He is unable to squat due to pain. Which of the following disorders should be considered in the differential diagnosis?
Multiple Choice
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Your 66-year-old male patient has recently started treatment for metabolic syndrome and is currently taking an ACE inhibitor and beta blocker for treatment of hypertension. He is also taking a statin medication, simvastatin for hyperlipidemia, and a biguanide, metformin, for type 2 diabetes. The patient complains of myalgias of the legs bilaterally, and blood work shows elevated serum creatine kinase. Which of the medications can cause such a side effect?
Multiple Choice
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To assess muscle tone, the clinician should:
Multiple Choice
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Which of the following infectious diseases is often the cause of a reactive arthritis?
Multiple Choice
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Which of the following microorganisms causes Lyme disease?
Multiple Choice
Answer:
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