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NBCE Part 3 Vignettes: Clinical Case
Questions and Answers, Exams of Nursing
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24 year old female hand pain shiny skin on arms and hands provocative cold environment and cryotherapy x ray shows erosions of distal tufts and
calcinosis in hands - ANSWERS -scleroderma
DDX - ANSWERS -acro osteolysis
calcinosis cutis systemic sclerosis
associated signs - ANSWERS -raynaud's phenomenon
skin hardening increase ANA
sequelae - ANSWERS -dysphagia
gastric problems pulmonary fibrosis 62 yr old male
LBP
difficulty urinating polyuria in middle of night
x ray shows non enlarged ivory white vertebrae - ANSWERS -
blastic mets or prostate cancer
positive labs - ANSWERS -PSA
acid phosphatase alkaline phosphatase
DDX - ANSWERS -paget's disease
blastic mets hodgkin's diz
Follow up - ANSWERS -refer to oncologist
CT of spine Radionucleotide scan/ bone scan 39 yr old female falls on outstretched hand pain gets worse and radiates to shoulders
DDX - ANSWERS -os odontoideum
odontoid fx whiplash
other findings m/c associated - ANSWERS -congenital block
occipitalization atlas hyperplasia
tests - ANSWERS -flexion/extension x rays
neurological evaluation CT scan 32 year old female bilateral leg weakness vertigo diplopia recent bladder issues smoking for 10 years babinski's is positive
l hermitte's is positive - ANSWERS -multiple sclerosis
or UMNL
follow up - ANSWERS -MRI of brain
refer to neurologist electrodiagnosis
associated signs - ANSWERS -visual disturbances
diplopia +3 DTR
sequelae - ANSWERS -speech impairment SIN
spastic paralysis UMNL clonus UMNL 42 year old female insidious onset of right knee pain in popliteal fossa and swelling no injury or trauma
swelling and redness of MCP joints - ANSWERS -RA
most likely reason for pain - ANSWERS -RA
Bakers cyst popliteal bursitis
additional findings - ANSWERS -symmetrical joint space
narrowing haygarth's nodes
