Deck 12: Musculoskeletal Function

Question 1

Which assessment findings are associated with a risk for development of osteoporosis?

A) The patient is a white woman with a body mass index (BMI) of 19.4.
B) The patient drinks at least four cups of coffee every day.
C) The patient does tai chi exercises for 45 minutes every morning.
D) The patient has smoked two packs of cigarettes a day for 40 years.
E) The patient has taken estrogen (Premarin), 0.625 mg, daily since menopause at age 54.
F) The patient is a white woman with a body mass index (BMI) of 19.4, the patient drinks at least four cups of coffee every day, and the patient has smoked two packs of cigarettes a day for 40 years.

Answer 1

F

Question 2

Which of the following statements by a patient with osteoarthritis indicates that the patient understands how to slow the progression of the disease?

A) I will avoid exercising to minimize wear on my joints.
B) I will take calcium with vitamin D every day.
C) I will eat more vegetables and less meat.
D) I will start water aerobics 3 times a week.

Answer 2

D

Question 3

Which of the following instructions is most important for a family member to understand when caring for a relative with osteoporosis?

A) Monitor urinary output.
B) Clean up clutter in the room.
C) Perform passive range-of-motion exercises.
D) Encourage the patient to bathe herself or himself.

Answer 3

B

Question 4

A patient develops compartment syndrome from a severely fractured arm. How does compartment syndrome develop?

A) A bone fragment has injured the nerve supply in the area.
B) An injured artery causes impaired arterial perfusion through the compartment.
C) Bleeding and swelling cause increased pressure in an area that cannot expand.
D) The tissue and fascia swell with injury, causing pressure on underlying nerves and muscles.

Question 5

Which of the following patient statements indicates a correct understanding about taking probenecid (Benemid)?

A) I will take the medication every 4 to 6 hours as needed to control the pain in my feet.
B) The medication will help my body produce less uric acid so I won't hurt in my big toe.
C) The medication will help my kidneys get rid of uric acid so I should drink lots of fluids every day.
D) I should wash my hands often and avoid crowds because the medication will weaken my immune system.

Question 6

Prevention of osteoporosis focuses on:

A) increasing phosphorus intake.
B) increasing weight-bearing exercise.
C) limiting soy intake.
D) limiting vitamin D intake.

Question 7

Which of the following factors places a 30-year-old female patient at risk for osteoporosis?

A) Leading a sedentary lifestyle
B) Working as a waitress and gardening for a hobby
C) Having a hysterectomy and taking estrogen replacement therapy
D) Consuming one alcoholic drink per week

Question 8

Which of the following statements describes osteoprotegerin (OPG)?

A) It acts as a RANKL receptor decoy.
B) When bound to an osteoclast, it promotes resorption.
C) OPG stimulates RANKL.
D) Women have a higher level of OPG in comparison to men.

Question 9

Bone matrix hydroxyapatite crystals are composed of calcium and:

A) potassium and sodium.
B) phosphate and water.
C) magnesium and water.
D) sodium and water.

Question 10

Which of the following is the differences between cartilage and bone?

A) Cartilage is more vascular than bone.
B) Cartilage is made of collagen, and bone is not.
C) Bone is calcified, whereas cartilage is not.
D) There is no diffusion of substances in cartilage.

Question 11

Changes that occur in the cartilage as a result of aging includes:

A) increased hyaluronic acid.
B) decreased water content.
C) increased glycosaminoglycans.
D) decreased nerve supply.

Question 12

Characteristics of the shoulder joint include:

A) the joint cavity consists of hyaluronic acid, which is a solid substance that keeps the joint stable.
B) the joint capsule is composed of collagen without blood vessel.
C) it is an amphiarthroses-type joint with a gel-like nucleus cushion.
D) it contains a joint capsule with many ligaments supporting its attachment.

Question 13

A woman has just learned she is pregnant and asks questions about how her body will change. What information will be provided pertaining to her musculoskeletal system?

A) Hormones such as progesterone will make your cartilage harder.
B) The curve in your low back will become straighter to support your increasing weight.
C) Hormones such as estrogen will cause your ligaments to become more lax.
D) The bones in your pelvis will become narrower to hold the baby in place.

Question 14

A mother and father are being taught how to properly swaddle their newborn girl to avoid developmental hip dysplasia. Important points to teach are that swaddling should be in a position that:

A) keeps the legs fully extended.
B) keeps the hips fully adducted.
C) does allow the infant to move too much to avoid dislocation.
D) allows for hip flexion and abduction.

Question 15

Which of the following are manifestations of developmental hip dysplasia in a 2-month-old infant?

A) The hips can be easily subluxed with physical maneuvers.
B) Gluteal creases are symmetric.
C) Femur height is equal.
D) Hip adduction is limited.

Question 16

Developmental hip dysplasia occurs as a result of:

A) lack of femoral head cartilage development.
B) femoral head and acetabulum compressing together.
C) lack of normal contact between the femoral head and acetabulum.
D) lack of normal physiologic laxity during the newborn period.

Question 17

A 35-year-old man comes in complaining of right leg anterior shin pain. He states he has been training to run a half marathon. He is able to run, but the pain has been getting worse over the last 2-3 weeks. A __________ fracture is suspected.

A) incomplete
B) stress
C) pathologic
D) greenstick

Question 18

Which of the following findings is(are) consistent with structural scoliosis?

A) Symmetrical hip height
B) Asymmetrical shoulder height
C) Rib prominence
D) Symmetrical scapula
E) Asymmetrical shoulder height and rib prominence

Question 19

A 40-year-old man fractured his humerus while playing tackle football. He was placed in a splint and he wears it most of the time. He had an X-ray done after 1 month because he said it was hurting a bit. His distal pulse, sensation, skin color, and mobility were intact. The fracture appeared the same, but there was no callous formation noted on the X-ray. This finding should be interpreted as:

A) osteomyelitis.
B) normal because callous can take up to 6 weeks to start forming.
C) nonunion.
D) completion of healing.

Question 20

In which type of fracture sustained by a child is osteomyelitis more likely?

A) A 12-year old with a tibial stress fracture
B) A 8-year old with a rib fracture
C) A 6-year old with a greenstick forearm fracture
D) A 7-year old with an ulnar fracture through his growth plate.

Question 21

Which of the following scenarios is suspicious for child abuse?

A) A 4-year-old breaks his femur (midshaft) while learning to ride a bike.
B) A 10-year-old fractured his ulna and radius while skateboarding. His sister was with him and corroborates how he fell.
C) A 12-year-old fell and hit a curb while riding his bike and landed on his shoulder and broke his clavicle
D) A 3-year-old has a left arm radial head subluxation that he sustained while he was playing with his 15- year old cousin who was swinging him around holding his hands.

Question 22

A patient is complaining of elbow pain. Which manifestations would be consistent with epicondylitis?

A) Erythema
B) Focal tenderness
C) Edema
D) Warmth

Question 23

Carpal tunnel syndrome is a result of:

A) median nerve compression.
B) carpal ligament tear.
C) radial head wrist tendinitis.
D) thickening of the fascia.

Question 24

A 60-year-old woman is complaining that her ring finger seems to pop out of place, and sometimes when she flexes her finger, it locks. She denies any trauma. She has a history of hypertension and type 2 diabetes mellitus. The cause of her finger locking and popping is due to:

A) overuse with tendinitis.
B) ligament tear at the base of the finger.
C) abnormal thickening of the extensor tendon at the proximal interphalangeal joint.
D) abnormal thickening of the flexor tendon at the metacarpophalangeal joint.

Question 25

__________ is a risk factor for the development of slipped capital femoral epiphysis in children.

A) Type 1 diabetes mellitus
B) Rheumatoid arthritis
C) Obesity
D) Playing sports

Question 26

A 14-year-old boy who plays soccer comes in complaining of anterior knee pain that is worse when he runs and jumps and gets better when he rests his knee. His father says he's been getting tall very quickly in the past few months. An X-ray of the knee is normal. What is the likely cause of his knee pain?

A) The anterior patellar tendon is separating from the tibial tubercle.
B) The patella is loose and unstable.
C) The distal femur is encroaching on the knee joint.
D) The quadriceps muscle is strained.

Question 27

A 70-year-old man is complaining of calf pain that gets better when he leans forward or sits. He has a history of low back pain for several years and was told it was due to arthritis of his spine, but he never had this calf pain. He feels like his legs are a bit weaker. This pain pattern is characteristic of:

A) lumbar strain.
B) spinal stenosis.
C) osteoporosis.
D) ankylosing spondylitis.

Question 28

Why does the risk of osteoporosis increase after menopause?

A) RANKL levels decrease leading to increase osteoblast apoptosis.
B) RANKL levels increase leading to increased osteoclastic activity.
C) Osteoprotegerin (OPG) increases.
D) RANK and RANKL binding decreases.

Question 29

Which of the following dual energy X-ray absorptiometry (DEXA) scan finding is consistent with osteoporosis?

A) A T score of 2.9 in a 50-year-old woman who is not menopausal
B) A T score of 2.0 in a 55-year-old postmenopausal woman
C) A T score of 1.0 in a 60-year-old woman
D) A T score of 0.5 in a 70-year-old man

Question 30

A bone marrow that is infiltrated by excessive fibrous connective tissue and blood vessels is characteristic of:

A) osteoporosis.
B) osteomalacia.
C) rickets.
D) Paget disease.

Question 31

The most common clinical manifestation of osteoporosis is:

A) bone pain.
B) muscle strain.
C) usually asymptomatic.
D) pathologic fracture.

Question 32

A key pathologic change in the articular cartilage in osteoarthritis is:

A) the loss of proteoglycans, which is a substance that makes up cartilage.
B) increased osteoclastic activity leading to cartilage destruction.
C) autoimmune-mediated destruction.
D) chronic synovial membrane inflammation.

Question 33

A pharmacotherapeutic agent that can be used to stop, prevent, or slow injury in rheumatoid arthritis includes:

A) methotrexate.
B) nonsteroidal anti-inflammatory agents.
C) alendronate.
D) chondroitin sulfate.

Question 34

Which types of medication should be avoided in someone with gout?

A) Thiazide diuretics
B) Glucocorticoids
C) Nonsteroidal anti-inflammatory agents
D) Angiotensin-converting enzyme inhibitors