Ortho/Rheum 6

Hypertension is diagnosed in a 57-year-old man who has asymptomatic hyperuricemia. Which of the following is contraindicated in treatment of the hypertension?

A 19-year-old female fell on her outstretched left hand. She presents with swelling to the wrist, palmar abrasions, and marked tenderness over the anatomic snuffbox. X-ray is negative. Which of the following is the most appropriate treatment?

A patient presents complaining of an acute onset of severe low back pain. It started while bending to lift a heavy box and he describes it as a 10 on a scale of one to ten. There is no radiation of the pain. There are no neurological deficits. This is his second “attack” of back pain in the last six months. Which of the following is the recommended treatment for this patient’s condition?

A patient presents with extreme pain, edema and fever after receiving a puncture wound to the left foot from a nail that penetrated his tennis shoe and sock. The injury occurred 2 days ago. X-rays reveal bony involvement. Which of the following is the most likely organism to cause this condition?

An 89-year-old woman has had 3 episodes of blurred vision, each in her left visual field, and lasting 10 to 15 minutes. Which of the following laboratory values is most suggestive of giant cell arteritis?

A 21-year-old male presents with left-sided chest pain over the past 48 hours. He denies any trauma. It is aggravated with deep respirations and rotation at the trunk. Vital signs are stable. No swelling or lesions are noted to the chest wall, but localized tenderness to the mid-upper left anterior chest wall and left sternal border with light to moderate palpation. Vital signs are stable. Cardiac exam is unremarkable. Lungs are clear to auscultation. Which of the following is the most likely diagnosis?

A 21 year old male presents with progressive pain in the right femur that is worse at night. Exam is unremarkable. X-ray of the leg demonstrates a sunburst like periosteal reaction. The radiologist called it positive Codman’s triangle appearance. What is the suspected diagnosis?

A 10-year-old boy has painful swelling of his right knee that started 3 days after having fallen off his skateboard. Oral temperature 101.6 degrees Fahrenheit. Examination shows swelling, redness, and increased temperature over the knee. White blood count is 16,000/microL. Which of the following is the most likely diagnosis?

A woman has systemic sclerosis with the CREST syndrome. Which of the following is not a clinical manifestation of CREST?

A 38-year-old female complains of 3 weeks of gradually worsening pain at the base of the thumb and radial aspect of the wrist. She and her husband have been renovating their home for the past 2 months and it has become increasingly difficult for her to hold a hammer. She denies numbness or tingling. She denies any history of previous trauma to the wrist. On examination, there is tenderness over the distal radial styloid and pain reproduced with ulnar deviation of a fist clenched over the abducted thumb. Which of the following is the most likely diagnosis?

A 45-year-old male was playing tennis and fell on his right shoulder. He presents with complaints of moderate anterior shoulder pain. There is no deformity on inspection. Physical examination reveals diffuse tenderness over the deltoid. Apprehension sign and drop-arm test are positive. X-ray is negative for fracture and malalignment. Which of the following is the most likely diagnosis?

Simvastatin therapy is to be initiated in a 57-year-old man in treatment of dyslipidemia. He should be counseled that which of the following is a likely adverse effect requiring urgent evaluation?

A 42-year-old woman who has sarcoidosis is most likely to have which antibody positive?

Over a period of 3 months, a 56-year-old woman has developed bilateral carpal tunnel syndrome. Which of the following laboratory diagnostic tests should be ordered?

A 24-year-old woman playing field hockey twisted her left knee. She heard a “pop,” experienced immediate swelling, and was unable to continue playing. Examination disclosed a positive Lachman’s test and bulge sign. Which of the following structures is most likely involved?

Which of the following tests is suggestive of patellofemoral syndrome?

Which of the following is seen most consistently in ankylosing spondylitis?

A 36-year-old man twisted his knee while playing rugby. Physical examination discloses a positive posterior drawer test and Ballottement sign. Radiographs of the knee are normal. The most appropriate next step is:

A 4-year-old girl, recovering from a sore throat, arrives at the office suddenly refusing to walk. Examination discloses pain of the right hip with active and passive range of motion. Temperature is 39°C (102.2°F), with elevated white blood cell count and erythrocyte sedimentation rate. Radiographs of the hip show soft tissue swelling with periosteal elevation. The most appropriate next step is:

Which of the following clinical characteristics is seen most commonly in osteoarthritis?

Which of the following is the earliest radiographic change seen in ankylosing spondylitis?

Of the following, the most common complication of a Colles fracture is:

The incidence of avascular necrosis increases following a fracture of which of the following?

Which of the following clinical pictures best describes fibromyalgia?

Which of the following is the definitive procedure for osteochondritis dissecans?

Which of the following is a characteristic of osteoarthritis?

Where do most falls occur among elderly patients?

Which of the following relationships between joint diseases and radiographic findings is correct?

A 24-year-old male presents with pain in the left shoulder. Physical examination reveals a bump on the acromioclavicular joint. Based on the patient’s presentation, which of the following is the most appropriate diagnosis?

A 37-year-old female presents with night pain, numbness, and loss of strength in the right wrist. Physical examination reveals a positive Tinel’s sign and positive Phalen’s test. Based on the patient’s presentation and physical examination, which of the following is the most appropriate diagnosis?