Orthopedics Questions And Answers 2022

Orthopedics Questions And Answers 2022 A patient with sciatica is most likely to describe relief of symptoms with: sitting. standing. side lying or standing. walking. - ANS-side lying or standing. A patient has c ...

Orthopedics Questions And Answers 2022 A patient with sciatica is most likely to describe relief of symptoms with: sitting. standing. side lying or standing. walking. - ANS-side lying or standing. A patient has cut himself on a fence post while working outside. He has not had a tetanus shot in more than 10 years. How long can he wait before getting the immunization and still prevent tetanus? 24 hours 48 hours 72 hours 5 days - ANS-72 hours Which of the following is NOT true regarding cervical whiplash injury? This occurs after a traumatic event. It may be accompanied by severe pain, spasm. Is identifiable on MRI or CT, but not x-ray. Occipital pain and headache can occur. - ANS-Is identifiable on MRI or CT, but not x-ray. An 80 year-old patient is very active but presents today with posterior hip pain for the past week. Which of the following is least likely part of the differential diagnosis? Osteoarthritis Sacroiliac joint disease Lumbar radiculopathy Herpes zoster - ANS-Osteoarthritis . An elderly patient had a total knee replacement (TKR) 10 months ago. He is doing well. What information should he be given regarding the knee replacement? He should take an aspirin daily for the first year. He should receive an antibiotic prior to dental procedures. He should take the flu shot annually. There are no recommendations 6 months after his surgery. - ANS-He should receive an antibiotic prior to dental The average age of pubertal growth spurt in North American boys is: 9.5 - 11.5 years. 10 - 12 years. 12 - 14 years. 14 - 16 years. - ANS-12 - 14 years. A 12 year-old male with hip pain presents to the NP clinic. Hip pain has occurred with activity for the past 4-6 weeks but his pain is worse and now involves the knee. There is no history of trauma. How should the work-up be initiated? Order a hip and knee x-ray Order a hip x-ray and a sed rate Perform Trendelenburg's test in the office Have the child squat in the office to assess the hips - ANS-Perform Trendelenburg's test in the office A patient presents with right shoulder pain (7/10 on the pain scale) after an acute shoulder injury yesterday. He fell against a brick wall while working at his home. He reports pain that radiates into his upper arm. How should this be managed? Immobilize the right shoulder for 3 days Rest, ice, and naproxen for one week Order an x-ray of the right shoulder Prescribe physical therapy for the patient - ANS-Order an x-ray of the right shoulder A nurse practitioner has successfully reduced a nursemaid's elbow. How can the NP know that it was successful? X-rays Child moves the affected arm at the elbow A click is heard The deformity has resolved - ANS-Child moves the affected arm at the elbow Ankle inversion is a common complaint from a patient with a: medial ankle sprain. lateral ankle sprain. severely torn ligament. fracture of the medial malleolus. - ANS-lateral ankle sprain Management of a sprained ankle includes: x-rays. rest, ice, compression, elevation. anti-inflammatory medications. activity as tolerated. - ANS-rest, ice, compression, elevation 75 year-old patient has osteoarthritis and pain. Which of the following medications increases the risk of a GI related ulceration? Celecoxib Warfarin Tramadol Amitriptyline - ANS-Celecoxib The drop arm test is used to assess patients with suspected: cervical injury. rotator cuff injury. impingement syndrome. malingering. - ANS-rotator cuff injury A 50 year-old patient reports acute pain in his lower back that started 2 weeks ago after working in his yard. The pain radiates into his right leg intermittently. He has been managing his pain with over the counter NSAIDs. There are no red flags in his history or exam. When should consideration be given to imaging studies? Now At 4 weeks At 8 weeks There is no need - ANS-At 4 weeks A 70 year old patient has had intermittent back pain for more than 3 years. In the last year, it is constant (pain scale is 2-3/10) and at times is sharp. She is not a surgical candidate. What class of medication would be a good choice for improvement of chronic pain in this patient? Naproxen Codeine Amitriptyline Sertraline - ANS-Amitriptyline A 75 year-old female, who knits daily, has a positive Finkelstein test. What is her likely diagnosis? Gamekeeper's thumb De Quervain's tenosynovitis Osteoarthritis of the thumb Trigger thumb - ANS-De Quervain's tenosynovitis A 45 year-old male who is in good health presents with complaints of pain in his left heel. He states that the first few steps out of bed in the morning are extremely painful. He has no history of trauma. What is the likely etiology of his pain? Achilles tendinitis Plantar fasciitis Calcaneal spur Arthritis of the foot - ANS-Plantar fasciitis A young athlete is found to have a depression of the longitudinal arch of both feet. He complains of heel pain bilaterally. The rest of his foot is normal and he has continued with his activities. What could be recommended for his heel pain? An x-ray of the foot is needed first. He needs some heel support in his shoes. NSAIDs should be used initially. Rigid orthotics could be ordered for his shoes. - ANS-He needs some heel support in his shoes. Which of the following is true regarding metatarsus adductus? This is another term for clubfoot Mild flexible metatarsus usually spontaneously corrects X-rays are usually necessary to diagnose this Infants frequently require casting to correct - ANS-Mild flexible metatarsus usually spontaneously corrects A patient is at increased risk of osteopenia if she uses which form of birth control? Injectable progestin Intrauterine device Oral contraceptives Natural family planning - ANS-Injectable progestin A 66 year-old African American female has multiple risk factors for osteoporosis. Which choice listed below is NOT a risk factor for osteoporosis? Her age Her race Glucocorticoid intake Excessive alcohol intake - ANS-Her race A 60 year-old female presents with history of low back pain of recent origin. Her gait is antalgic and she reports loss of bladder function since the onset of back pain this morning. What should be done? Order physical therapy Refer to the emergency department Refer to a neurologist Keep non-weight bearing until x-rays are completed - ANS-Refer to the emergency department An adolescent athlete has sprained his ankle. What instruction should be given to him regarding activity? He can resume regular activities in about one week. He should be able to walk pain-free before he starts to run. His ankle should be taped prior to competition. He can resume activity when the edema has resolved. - ANS-He should be able to walk pain-free before he starts to run. Which symptom can be used to rule out a fracture? Degree of pain Extent of mobility Degree of swelling No symptom can rule out a fracture - ANS-No symptom can rule out a fracture An adolescent complains of knee pain. He is diagnosed with Osgood-Schlatter disease. What assessment finding is typical? The pain is always bilateral. Pain worsens with quadriceps contraction. There will be an avulsion of the quadriceps tendon. Assessments vary. An x-ray can be used for diagnosis. - ANS-Pain worsens with quadriceps contraction A 75 year-old female who is otherwise healthy has osteoarthritis in her right knee. She complains of pain not relieved by acetaminophen 2000 mg daily. What should be done? Increase her acetaminophen to 4 grams daily Consider an NSAID Continue acetaminophen and order physical therapy Continue acetaminophen and refer to orthopedics - ANS-Continue acetaminophen and order physical therapy A positive Trendelenburg's test could be used to identify a child with: scoliosis. Osgood-Schlatter disease. nursemaid's elbow. slipped capital femoral epiphysis. - ANS-slipped capital femoral epiphysis. Explanation: A characteristic of rheumatoid arthritis not typical in osteoarthritis is: weight loss. morning stiffness. symmetrical joint involvement. the presence of Bouchard's nodes. - ANS-symmetrical joint involvement. A male patient who injured his back lifting a heavy object reports that he has low back pain. He is diagnosed with a lumbar strain. He is afraid to continue activities of daily living and especially walking because he has pain with these activities. What statement below is true? Stop doing any activities that produce pain in your lower back. Continue your activities of daily living, but stop walking, except to go to the bathroom. Bedrest will help your back pain. Continue your activities of daily living and walking. - ANS-Continue your activities of daily living and walking. The Ottawa ankle rules help the examiner determine when: an inversion ankle injury has occurred. an anterior talofibular fracture has occurred. x-rays are needed with a suspected ankle sprain. referral to orthopedics should occur. - ANS-x-rays are needed with a suspected ankle sprain. What medication is recommended by American College of Rheumatology as a first line agent for a patient who has been unsuccessful with non-pharmacologic interventions for osteoarthritis pain? Naproxen Acetaminophen Ibuprofen Tramadol - ANS-Acetaminophen An 8 year-old has a painful limp. He reports that his knee hurts medially. On exam he has pain with internal rotation of the hip. How should the NP manage this situation? He should be immediately referred to orthopedics. The NP should order a hip x-ray, CBC and ESR. The NP should order a hip and knee x-ray. He should be referred for synovial fluid aspiration. - ANS-The NP should order a hip x-ray, CBC and ESR. Clubfoot: always requires an urgent neurosurgical referral. involves the foot and lower extremity. involves the foot only. can be corrected with casting and exercises. - ANS-involves the foot and lower extremity. Which beverage below does not increase the risk of gout in a male who is prone to this condition? Vodka Beer Wine Bourbon - ANS-Wine A nurse practitioner has successfully reduced a nursemaid's elbow. How can the NP know that it was successful? X-rays Child moves the affected arm at the elbow A click is heard The deformity has resolved - ANS-Child moves the affected arm at the elbow A 75 year-old has pain from osteoarthritis in her right knee. What intervention is considered first line to treat her pain? Exercise Acetaminophen Ibuprofen Tramadol - ANS-Exercise An adolescent athlete has injured his ankle playing basketball. He has right ankle pain, ecchymosis, significant edema, and he is unable to bear weight at the time of the clinical exam. Which diagnosis is least likely? An avulsion fracture Grade I sprain Correct Grade II sprain Grade III sprain - ANS-Grade I sprain Correct What is the most prevalent skeletal problem in the United States? Osteoarthritis Correct Stress fractures Osteoporosis Gouty arthritis - ANS-Osteoarthritis Correct An x-ray report of a patient's painful right knee indicates "joint space narrowing". What does this mean? The patient is agingGout is presentThis is a normal findingLoss of cartilage has occurred - ANS-Loss of cartilage has occurred Besides inadequate intake of Vitamin D in elder adults, what other factor contributes to deficiencies? Impaired synthesis of previtamin D Decreased physical activity Diminished hepatic function Decreased body mass - ANS-Impaired synthesis of previtamin D CONTINUES...