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LSUHS Alexandria Family Medicine Board Review (Musculoskeletal) Flashcards | StudBud
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LSUHS Alexandria Family Medicine Board Review (Musculoskeletal)
LSUHS Alexandria Family Medicine Board Review (Musculoskeletal)
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1
A patient with an inversion injury reports mid-foot pain and tenderness over the navicular bone. Which is appropriate?
Lace-up ankle support, ice, compression, and clinical follow-up
Radiographs of the foot only
Radiographs of the foot and ankle
Radiographs of the ankle only
Crutches and no weight bearing for 2 weeks
2
A 52-year-old runner has developed a degenerative meniscal tear found on MRI. Which of the following is appropriate?
Conservative management
Hylan GF 20 (Synvisc)
Intra-articular corticosteroids
Arthroscopic meniscectomy
Arthroscopic meniscus repair
3
A 13-year-old has knee pain with tenderness and swelling to the tibial tuberosity. Before treatment, you should order?
No imaging
A bone scan
Ultrasonography
Plain film radiographs
MRI
4
Which one of the following is the most accurate and appropriate maneuver to detect an anterior cruciate ligament tear?
The pivot shift test
The anterior drawer test
The lever sign test
The Lachman test
The McMurray test
5
Which one of the following organisms is the most likely cause of septic arthritis of a knee joint?
Streptococcus pyogenes
Staphylococcus aureus
Candida albicans
Mycobacterium tuberculosis
Escherichia coli
6
A 72-year-old pictured below has developed progressive hand pain and stiffness. Which of these is most appropriate?
Methotrexate (Trexall)
Infliximab (Remicade) injections
Colchicine (Colcrys)
Hydroxychloroquine (Plaquenil)
Diclofenac (Zorvolex)
7
Which of the following is associated with a higher risk of developing adhesive capsulitis?
Rheumatoid arthritis
Diabetes mellitus
Hyperparathyroidism
Addison’s disease
Hypertension
8
Which one of the following disorders is caused by an underlying mechanism of osteochondrosis rather than apophysitis?
Sinding-Larsen-Johansson syndrome
Sever’s disease
Legg-Calvé-Perthes disease
Osgood-Schlatter disease
9
A 72-year-old with back pain undergoes an MRI which shows lumbar spinal stenosis. The most appropriate treatment is?
Referral to an orthopedic surgeon for elective surgical resolution
Referral to a neurosurgeon for urgent surgical resolution
Oral pregabalin (Lyrica), 75 mg twice daily
Oral diclofenac, 75 mg twice daily
Physical therapy
10
A patient has lateral hip pain and examination demonstrates a trendelenberg gait. Which is the most likely diagnosis?
Greater trochanteric pain syndrome
Femoroacetabular impingement
A labral tear
Sacroiliac joint dysfunction
A hamstring strain
11
A 13-year-old male is brought to your office for evaluation of back pain. Plain radiography would be indicated for?
intermittent pain that has persisted for 2 weeks
pain that is increased with flexion
pain that is localized to the midthoracic spine
pain that awakens him at night
a recent history of an upper respiratory infection
12
A patient presents with heel pain which is worse with the first steps after sitting or waking. First-line treatment is?
Acupuncture
Extracorporeal shock wave therapy
Night splints
Plantar fascia stretching exercises
Platelet-rich plasma injection
13
According to the Ottawa knee rule, which one of the following factors may warrant radiography for an acute knee injury?
The presence of a joint effusion within 24 hours of the injury
Injury from a fall or blunt trauma
A twisting mechanism of injury
Age <30
Inability to flex the knee to 90°
14
A patient has a displaced midshaft clavicular fracture which is shortened by 2 cm. Which management is appropriate?
Casting
Evaluation for surgical fixation
Closed reduction and a sling
A sling
A figure-of-eight splint
15
A diabetic has a fever and edema/erythema of the foot. There is a draining ulcer on exam. Preferred initial imaging is?
ultrasonography
CT
radiography
MRI
technetium 99m bone scintigraphy
16
A patient has an elevated alkaline phosphatase (ALP) but normal AST, ALT, and GGT. Which of these should be ordered now?
Plain radiography of the skull, pelvis, and tibia
A radionuclide bone scan
Right upper quadrant ultrasonography
A full-body CT scan
A HIDA scan
17
Which one of the following would you tell a patient regarding treatment options for his trigger finger?
Splinting of the affected finger can result in complete resolution
Less than 15% of cases spontaneously resolve by 1 year
NSAID injections are more effective than corticosteroid injections
Surgical release is the most cost-effective treatment
18
Which one of the following has been shown to be an appropriate therapeutic intervention for nonspecific low back pain?
A lumbar brace
Bed rest
Muscle relaxants
Yoga
Shoe insoles
19
A patient complains of MCP swelling and bilateral joint stiffness for 1 hour each morning. Which test is most specific?
Anti-citrullinated protein antibody
Leukocyte count and differential
C-reactive protein
Rheumatoid factor
Erythrocyte sedimentation rate
20
Which of the following non-prescription interventions is effective for treating bilateral knee osteoarthritis?
Physical therapy
Lateral wedge insoles
Hyaluronic acid injections
Glucosamine and chondroitin supplements
Vitamin D supplements
21
Which one of the following physical examination findings is most consistent with Dequervain's tenosynovitis?
Pain reproduced by repeated percussion over the volar wrist
Focal tenderness over the triangular fibrocartilage complex
Focal tenderness in the anatomic snuffbox
Pain upon ulnar wrist deviation with the thumb placed inside a closed fist
Pain upon thumb circumduction with axial load to the first MCP joint
22
A patient develops anterior kneecap pain with jogging and ascending stairs. Radiography is negative. The diagnosis is?
Iliotibial band syndrome
Patellofemoral pain syndrome
Osgood-Schlatter disease
Patellofemoral osteoarthritis
Osteochondritis dissecans
23
Which one of the following imaging modalities would be indicated initially for a suspected tibial stress fracture?
A plain film
Bone scintigraphy
Ultrasonography
CT
MRI
24
An 11-year-old's mother is concerned that she may have a curved spine. What scoliosis evaluation is appropriate first?
scoliometer measurement with the patient bent over to 90°
comparing the length from the pelvic brim to the pelvic floor
scoliometer measurement with the patient upright
determination of the Cobb angle with the patient bent over to 90°
determination of the Cobb angle with the patient upright
25
The initial treatment recommendation with the most proven efficacy for fibromyalgia is?
duloxetine (Cymbalta)
amitriptyline
tramadol
aerobic exercise
acupuncture
26
Which one of the following would be the safest and most appropriate initial management for Achilles tendinopathy?
Local injection with platelet-rich plasma
Physical therapy with eccentric calf-strengthening exercises
Surgical debridement of the calcification about the distal tendon
Local injection with a corticosteroid
Immobilization of the ankle in a cast or boot for 4–6 weeks
27
A 3-year-old has elbow pain after his father grabbed his wrist to prevent falling off a stool. Which do you recommend?
Referral to physical therapy
Attempted reduction of the subluxed radial head now
A radiograph of the right elbow
Splinting and close follow-up
Referral to an orthopedic surgeon
28
A patient has tenderness in the anatomical snuffbox after a fall. Radiography is negative for fractures. Treatment is?
Thumb spica splint and repeat radiography in 2 weeks
NSAIDs and repeat radiography in 2 weeks
Short arm case
Surgical fixation
Conservative management
29
Which one of the following would be the preferred management of an adult with a non-displaced radial head fracture?
Referral to an orthopedist for surgical repair
A long arm posterior splint for 6 weeks
Referral to an orthopedist for cast placement
A long arm cast for 6 weeks
Immobilization for 3 days followed by range-of-motion exercises
30
A plumber develops swelling of the elbow with no erythema, heat, tenderness, or fever. Which of these is appropriate?
Padding, ice, and elevation
Orthopedic referral
Bursal aspiration
Plain radiographs
Empiric antibiotics