Ortho/Rheum 3

A 68-year-old man who is a retired school teacher has chronically abused alcohol. He has bilateral painless contractures of the 4th and 5th fingers of his hands. Which of the following is the most likely diagnosis of his disorder?

A 29-year-old woman has a 2 month history of diffuse pain in muscles and joints, tingling in the arms and legs, and fatigue. Fibromyalgia is diagnosed. Which of the following is the preferred initial medicinal therapy?

A 32-year-old professional basketball player experienced sudden pain in the posterior region of his ankle and heel after attempting to change direction and drive for a layup shot. The Thompson test is positive on the affected side and he is unable to stand on the ball of his foot. The most likely diagnosis is:

An epiphyseal plate fracture that extends transversely through the epiphyseal plate is classified as a:

A passenger involved in a head-on collision is brought into the emergency room for evaluation and treatment. In addition to other exam findings, you note that the left leg is adducted, internally rotated, and shortened. Which of the following is the most likely diagnosis?

A 15-year-old athletic boy has a 2 week history of left knee pain. Examination shows tenderness of the tibial tuberosity and swelling of the joint, but without overlying erythema or heat. Osgood Schlatter disease is diagnosed. Which of the following is proper counseling for the patient?

Which type of shock is most commonly associated with a long bone fracture?

What is the most common organism responsible for nongonococcal septic arthritis?

A 38-year-old male sustains a twisting injury to his right knee. He is placed in the supine position and the knee is placed in a position of maximal flexion. On rotating the leg externally and gradually extending the knee (McMurray’s test), a clicking sensation is noted. This is suggestive of which of the following diagnosis?

A 9-year-old male presents to the ER with right wrist pain after falling while skateboarding approximately 30 minutes ago. The patient states his skateboard hit a rock and as he tried to maintain his balance, he fell on his outstretched hand. PE reveals a swollen, ecchymotic right wrist with no break in the skin. X-ray of the right wrist demonstrates dorsal displacement and shortening of the distal radius. What is the most likely diagnosis?

A middle school basketball player comes to the office complaining of pain just below his right knee for the last 2 months. The patient has no history of trauma, but he says the pain gets worse when he plays or walks down stairs. Examination reveals mild swelling over the tibial tuberosity of his right knee. The most likely diagnosis is:

An 18-month-old girl is brought to the office holding her right arm flexed at the elbow with her forearm pronated. She will not use her arm. Which of the following is the most likely diagnosis?

A patient with myasthenia gravis is put on pyridostigmine. A side effect of this drug is:

A 33-year-old man has undergone ORIF of the left tibia. Fifteen hours postoperatively, the patient complains of increased pain and swelling of his left leg. Physical examination demonstrates decreased sensation and painful paralysis of toes. Which of the following is the most likely diagnosis?

The purpose of a secondary survey in evaluating a trauma patient is:

Which of the following is least likely to be associated with the development of cataracts?

Which of the following is a clinical characteristic of osteomalacia?

Monoarticular joint pain is most likely associated with which of the following?

Which of the following is a characteristic of pseudogout?

A 24-year-old woman twisted her ankle, forcing it into inversion. The most likely ankle ligament damaged is:

A 16-year-old female softball pitcher comes to the clinic complaining of pain and tenderness on the inside of her right elbow. She is a right-handed pitcher and reports increased pain that radiates down her forearm when she attempts to throw a ball. She has not fallen or suffered any direct trauma to the site recently. Based on this information, which of the following diagnoses is most likely to be correct?

A 58-year-old male is seen at the clinic and complains of back and leg pain. He reports a burning back pain that spreads down his legs as he walks. He also reports that he can frequently alleviate the pain by leaning forward. He displays a normal posture. Radiographic imaging tests reveal soft-tissue and thecal narrowing. Based on this information, which of the following diagnoses is most likely to be correct?

A 28-year-old football player arrives in the emergency room with a forearm fracture. An X-ray reveals a fracture that runs diagonally across the bone. Which type of fracture has the patient endured?

A 47-year-old female patient arrives at the clinic complaining of severe left hip pain. The joint is warm, swollen, tender, and has limited range of movement. You diagnose her with septic arthritis. Diagnostic testing reveals that Staphylococcus aureus is the infecting pathogen. Based on this information, which of the following clinical interventions would be most necessary?

A 71-year-old male patient who is currently hospitalized after a hip replacement begins to show signs of sepsis. Which of the following symptoms would indicate a severe case of sepsis?

A 32-year-old female patient arrives at the clinic presenting with pain and swelling around the base of her right thumb. She has difficulty moving the thumb and experiences increased pain when she does. You diagnose her with de Quervain’s disease. Which of the following treatment options would be least likely for the patient’s condition?

A 16-year-old male presents with pain in his hand following a fight. Physical examination reveals puncture wounds over the fourth and fifth metacarpal phalangeal joints. X-ray reveals fractures on the metacarpal necks of these fingers. Based on the patient’s presentation, physical examination, and test results, which of the following is the most appropriate diagnosis?

A 40-year-old woman presents with a persistent lump on her wrist. Which of the following is the most appropriate diagnosis?

A 39-year-old female comes to the office complaining of pain in the heel of her right foot. She is overweight (170 pounds) and has recently taken up walking for exercise. She has started walking a mile a day on relatively flat, paved terrain. She limps slightly when she walks, and the pain is worst when she first gets out of bed. She states there has been no specific injury to her foot. Pain is temporarily relieved by ibuprofen and ice packs, but as soon as she starts using her foot again, the pain returns. What is the most likely diagnosis?

A 19-year-old woman comes to the clinic complaining of localized, dull pain along the 2nd distal metatarsal area of the right foot. She states the pain happened spontaneously during running and was not related to any type of specific injury or trauma. The upper portion of the foot is slightly edematous, and when the 2nd metatarsal area is palpated, the patient complains of pain. She has difficulty lifting her toes on the affected foot. The patient is limping slightly. She states she has run track for 4 years, and is on the women’s track team in college. Recently the patient has stepped up her training to prepare for a major track event. An X-ray of her foot shows no obvious fracture. What is her most likely diagnosis?