Download ORTHO PACKRAT QUESTIONS & ANSWERS and more Exams Nursing in PDF only on Docsity!
ORTHO PACKRAT QUESTIONS & ANSWERS
In the young child, unequal thigh folds may indicate A. coxa vara. B. nondisplaced hip fracture. C. developmental hip dysplasia. D. slipped capital femoral epiphysis - Answers - B. Developmental hip dysplasia A 36-year-old PA educator has a history of recurrent low back pain. When lifting a stack of books yesterday, he experienced sudden, severe pain in the lumbar area. He denies radicular pain His lower extremity examination is unremarkable, and his back examination is normal, except for paraspinal muscle tenderness and increased pain with flexion at the waist. Which of the following management options should be instituted at this time? A. Refer the patient to orthopedic surgery. B. Continue ordinary activities as tolerated. C. Confine the patient to bed with traction. D. Recommend sleeping on a softer mattress. - Answers - B. Continue ordinary activities as tolerated Which of the following injuries should be anticipated in a football quarterback who is sacked and falls directly on the lateral aspect of his shoulder? A. rotator cuff tear B. anterior dislocation C. posterior dislocation D. acromioclavicular separation - Answers - D. Acromioclavicular separation A practitioner is following a 10-year-old girl with scoliosis to monitor the potential progression of the curvature. At what minimal degree of curve angulation should treatment begin? A. 10 B. 20 C. 30 D. 40 - Answers - B. 20 Which of the following tests would be included in the physical exam to evaluate a high ankle sprain with instability? A. Anterior drawer B. Lachman C. Vibratory sense D. Thompson - Answers - A. Anterior drawer A 35 year-old male placed in a thumb spica cast for a scaphoid fracture presents complaining of forearm and hand pain that is not relieved with pain medication and
elevation. Which of the following is the earliest physical exam sign for his current condition? A. Slow capillary refill B. Loss of two-point discrimination C. Absent peripheral pulses D. Pain with passive stretch. - Answers - B. Loss of two-point discrimination Which of the following is the most sensitive screening test for systemic lupus erythematosus? A. Anti-Ribonuclear protein (U1-RNP) B. Antinuclear antibody (ANA) C. Anti-double-stranded DNA (anti-ds-DNA) D. Anti-Smith anti-body (anti-Sm) - Answers - B. Antinuclear antibody (ANA) Chronic oral steroid use can predispose a patient to which of the following? A. Charcot's joint B. Osteoarthritis C. DeQuervains syndrome D. Avascular necrosis of the femoral head - Answers - D. Avascular necrosis of the femoral head A 35 year-old female who was a back seat passenger in a vehicle which was involved in a head-on collision is brought to the ED. She is able to tell you that she is having difficulty moving both of her legs and is experiencing bilateral leg pain as well. She is embarrassed because she has "wet myself." Physical examination reveals markedly diminished sensory and motor function of both legs and decreased rectal sphincter tone. Which of the following is the most likely diagnosis? A. Herniated disc at L5-S1 and L4-L B. An anterior cord lesion C. Cauda equina syndrome D. An L2 lesion - Answers - C. Cauda equina syndrome 25 year-old male presents to the ED with left calf pain and cramping, as well as nausea and vomiting. He admits to "partying with cocaine all night". He describes his urine as a dark brown color. Serum creatine kinase (CK) is 1325 IU/L (Normal Range 32- 267 IU/L). Which of the following is the initial mainstay of therapy for this condition? A. IV rehydration B. Fasciotomy C. Toradol (Ketorlac) D. Hydrotherapy - Answers - A. IV rehydration A 24-year-old female presents with complaints of pain over the r~t metatarsal region. She began an intensive jogging program 2~weeks earlier An initial x-ray of the foot fails to reveal a fracture. Which of the following is the most appropriate next step? A. Order a bone scan.
C. The base of the 2nd MTP joint D. Between the third and fourth metatarsal - Answers - D. Between the third and fourth metatarsal A 25 year-old female presents to the ED with an open fracture of the left fibula sustained from an auto accident. The patient has no neurological findings. In addition to stabilization of the patient which of the following should be immediately initiated? A. Antibiotic therapy B. Apply a bi-valve cast C. Reduce the fracture D. Surgical debridement - Answers - A. Antibiotic therapy A patient who has chronic Crohn's disease now complains of a nondeforming asymmetric oligoarthritis of his large joints. The patient also notes that he has been having a flare of his Crohn's disease. Which of the following is the best treatment to alleviate both the inflammatory bowel disease and arthritic symptoms? A. Indomethacin B. Methotrexate C. Infliximab (Remicade) D. Cyclophosamide (Cytoxan) - Answers - C. Infliximab (Remicade) A 42 year-old male presents with localized dysesthesias on the plantar medial aspect of the left foot. Symptoms are aggravated with activity and relieved by rest. Patient also complains of nocturnal symptoms. Four weeks prior the patient sustained an eversion ankle sprain that is non tender to walk on, but he is left with some residual diffuse swelling. Which of the following is most likely diagnosis? A. Plantar fasciitis B. Tarsal tunnel syndrome C. Peroneus longus tendonitis D. Bone spur of the calcaneus - Answers - B. Tarsal tunnel syndrome Which of the following is the most significant complication of a dislocation of the knee? A. Ligament damage B. Inability to bear weight C. Instability of the joint D. Arterial injury - Answers - D. Arterial injury A 60 year-old patient who has a 20 year history of diabetes mellitus arrives at the clinic with a complaint of mild to moderate ankle pain. There is no history of trauma. You note on exam that the joint is unstable but not erythematous or warm. On x-ray you would expect to see A. osteopenia. B. loss of articular cartilage. C. disintegration of the joint with osteophytes. D. subchondral cysts. - Answers - C. Disintegration of the joint with osteophytes
An otherwise healthy 67 year-old Caucasian female presents with a spinal compression fracture after falling down two steps. She has a bone density of 2.1 standard deviations below expected. Which of the following is the best pharmacotherapeutic approach at this time? A. Alendronate (Fosamax) B. Estrogen-Progesterone(Prempro) C. Oxandrolone (Oxandrin) D. Raloxifene (Evista) - Answers - A. Alendronate (Fosamax) Adduction is defined as the extremity A. moving towards the midline. B. angulating the distal part towards midline of the body. C. turning towards the ceiling. D. rotating about its axis toward midline. - Answers - A. Moving towards the midline A 53 year-old female with a history of type 2 diabetes presents with complaints of left shoulder pain and loss of motion. She describes the pain as gradual in onset, localized superiorly with radiation down the deltoid muscle. She notes not sleeping well secondary to pain when lying on the left shoulder. No history of trauma is noted. Active and passive motion is severely restricted in all planes of motion. Neurological and vascular examinations are normal. What is the most likely diagnosis? A. Thoracic outlet syndrome B. Rotator cuff tear C. Adhesive capsulitis D. Pancoast tumor - Answers - C. Adhesive capsulitis A 60 year-old female presents for pre-op evaluation for surgical treatment of a tri- malleolar fracture of the left ankle. Which of the following puts her at an increased risk for infection post surgery? A. Recent URI B. Diabetes mellitus C. Heart murmur D. Swelling of the ankle - Answers - B. Diabetes mellitus Which of the following nerves commonly gets injured with anterior shoulder dislocations? A. Brachial B. Ulnar C. Axillary D. Radial - Answers - C. Axillary A 45 year-old patient presents with pain in the left wrist after a FOOSH (fall on outstretched hand) injury. On examination he has snuff box tenderness with limited range of motion. Which of the following immobilization devices is the most appropriate intervention? A. Sugar tong splint
A. corticosteroids B. supervised exercise program C. hydrocodone (Vicodin) D. refer to endocrinologist - Answers - B. Supervised exercise program A 14 year-old male who is overweight presents with complaints of left knee and anteromedial thigh pain for the past month. He states the pain gets better with rest and denies any known trauma. On examination of the gait, a slight limp is noted. X-ray films of the left knee are normal. The most likely diagnosis is A. genu valgum. B. Legg-Calve-Perthes disease. C. Osgood-Schlatter disease. D. slipped capital femoral epiphysis. - Answers - D. Slipped capital femoral epiphysis Which of the following fractures is associated with the greatest risk of avascular necrosis of the femoral head? A. intertrochanteric B. femoral neck C. subtrochanteric D. pelvic rim - Answers - B. Femoral neck A 22 year-old male presents to the ED after sustaining a blow to the knee during football practice. The knee exam demonstrates significant forward translation of the tibia when the knee is in 20 degrees of flexion and the tibia is forced forward while the femur is stabilized. Which of the following knee maneuvers does this represent? A. abduction stress test B. anterior drawer sign C. Lachman test D. McMurray test - Answers - C. Lachman test Which of the following would demonstrate rotational misalignment in a patient with a fracture of the fourth metacarpal? A. base of the ring fingernail and index fingernail line up in the partially closed hand B. fingernails of the open hand form an asymmetric arc C. ring finger of the closed hand overlaps the little finger D. ring finger of the open hand is shortened - Answers - C. Ring finger of the closed hand overlaps the little finger A 32 year-old medical transcriptionist presents with burning and tingling in her right wrist and hand for the past month. On physical exam, Phalen's test is positive; however, there is no atrophy of the thenar eminence. Which of the following is the initial step in management of this patient? A. wrist splints B. corticosteroid injection C. surgical referral D. propoxyphene (Darvocet) - Answers - A. Wrist splints
An x-ray reveals a break in the cortex of one side of the ulna shaft without a separation or break of the opposite cortex describes what type of fracture? A. greenstick B. transverse C. torus (buckle) D. epiphyseal - Answers - A. Greenstick A 67 year-old female presents with progressive pain in her left knee that is worse with activity and relieved with rest. She notes stiffness of the knee that last about 20 minutes after activity is resumed. She exercises regularly. No known drug allergies. On physical exam she is 5' 5", 225 pounds. Her left knee exam reveals mild effusion without erythema or warmth. Radiographs of the left knee reveal medial joint space narrowing and subchondral bone sclerosis. Her sodium is 138 mEq/L, potassium 4.3 mEq/L, bicarbonate 24 mEq/L, chloride 104 mEq/L, BUN 23 mg/dl and creatinine 1.8 mg/dl. Which of the following medications is most appropriate for this patient's worsening pain? A. naprosyn B. prednisone C. acetaminophen D. methotrexate - Answers - C. Acetaminophen An 18 year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis? A. avascular necrosis B. myositis ossificans C. compartment syndrome D. reflex sympathetic dystrophy - Answers - C. Compartment syndrome A 58 year-old male presents complaining of anterior right shoulder pain the day after performing extensive yard work. The pain is localized over the anterior proximal humerus with distinct point tenderness. There are no visible abnormalities. The patient has full range of motion and strength with all shoulder movements. The pain is reproduced by asking the patient to resist the examiner during supination of the right elbow. Which of the following is the most likely diagnosis? A. supraspinatus tendonitis B. subacromial bursitis C. rotator cuff tear D. bicipital tendonitis - Answers - D. Bicipital tendonitis A 12 year-old female presents for a routine sports physical. The physical exam reveals asymmetry of the posterior chest wall on forward bending. This is most consistent with which of the following? A. spondylolysis B. spondylolisthesis C. scoliosis
radicular pain. His lower extremity examination is unremarkable, and his back examination is remarkable for paraspinal muscle tenderness and increased pain with flexion at the waist. Which of the following management options should be instituted at this time? A. refer the patient to orthopedic surgery B. continue ordinary activities as tolerated C. confine the patient to bed with traction D. recommend sleeping on a softer mattress - Answers - B. Continue ordinary activities as tolerated Abduction of the shoulder against resistance helps localize pain in which of the following muscles of the shoulder girdle? A. Supraspinatus B. Infraspinatus C. Teres minor D. Subscapularis - Answers - A. Supraspinatus A 22 year-old male presents to the ED after sustaining a blow to the knee during football practice. The knee exam demonstrates significant forward translation of the tibia when the knee is in 15 degrees of flexion and external rotation at the hip. Which of the following knee maneuvers does this represent? A. Abduction stress test B. Anterior drawer sign C. Lachman test D. McMurray test - Answers - C. Lachman test A 12 year-old female presents for a routine sports physical. The physical exam reveals asymmetry of the posterior chest wall on forward bending. This is the most striking and consistent abnormality of which of the following? A. Spondylolysis B. Spondolisthesis C. Scoliosis D. Herniated disc - Answers - C. Scoliosis Physical exam findings in a 4 year-old child that include blue sclerae and recurrent fractures indicates which of the following? A. Ehlers-Danlos syndrome B. Marfan syndrome C. Achondroplasia D. Osteogenesis imperfecta - Answers - D. Osteogenesis imperfecta A 65 year-old female presents to the office with a six-month history of back pain. The patient states that she is shrinking and thinks she is about an inch shorter than she was a year ago. Serum parathyroid hormone, calcium, phosphorus, and alkaline phosphatase are all normal. Which of the following would you most likely see on the x- ray of her spine?
A. Radiolucent lesions B. Demineralization C. Chondrocalcinosis D. Subperiosteal resorption - Answers - B. Demineralization In a trauma patient who has a suspected cervical spine injury, the x-ray view that will identify the majority of significant injuries is A. lateral. B. oblique. C. anteroposterior. D. odontoid. - Answers - A. Lateral A 38 year-old male sustained a fracture of the left distal tibia following a 25-foot fall and is taken to the operating room for an open reduction internal fixation of the distal tibia. Sixteen hours post-op, the patient develops sustained pain, which is not relieved with narcotics. On passive range of motion of the toes the patient "yells" in agony. The patient also states that the top of his foot has decreased sensation. On physical examination the physician assistant notes that the leg is swollen and the foot is cool to touch. Based upon this information what diagnostic testing should be done? A. X-ray of the lower leg and ankle. B. Doppler studies. C. Bone scan. D. Compartment pressure - Answers - D. Compartment pressure A 32 year-old male presents with an acute onset of pain and swelling to his left ankle. On physical exam the ankle is warm, swollen and erythematous. Evaluation of the synovial fluid reveals only leukocytosis with a low glucose. Which of the following is the most likely diagnosis? A. Gout B. Pseudogout C. Acute rheumatic fever D. Septic arthritis - Answers - D. Septic arthritis A 22 year-old male presents with pain along the medial tibia. The pain initially began towards the end of soccer practice but now it is present earlier on. Physical exam reveals pain to palpation over the posterior tibialis muscle body. What is the most likely diagnosis? A. Shin splint B. Stress fracture C. Osgood-Schlatter disease D. Patellofemoral pain syndrome - Answers - A. Shin splint A patient who demonstrates pain on the radial aspect of the wrist with abrupt ulnar movements while the thumb is flexed into the closed palm most likely has A. carpal tunnel syndrome. B. radial tunnel syndrome.
B. Interferon C. Sulfasalazine D. Methotrexate - Answers - A. Indomethacin Why are fractures of the scaphoid bone prone to aseptic necrosis? A. Disrupted arterial supply B. Lack of weight bearing C. Inadequate immobilization D. Impaired venous drainage - Answers - A. Disrupted arterial supply An elderly patient presents to the ED complaining of right shoulder pain occurring after falling on his right outstretched hand with the elbow extended. On physical examination the arm is pale and pulseless and there is tenderness of the upper arm. Which of the following structures is most likely injured? A. Axillary artery B. Subclavian vein C. Superior thoracic artery D. Ulnar vein - Answers - A. Axillary artery Which of the following is indicated as the first-line treatment of an initial case of acute gouty arthritis? A. Indomethacin (Indocin) B. Colchicine (Probenicid) C. Methylprednisolone (Medrol) D. Allopurinol (Zyloprim) - Answers - A. Indomethacin An afebrile 50 year-old male presents with an acute onset of an exquisitely painful first metatarsophalangeal joint. Examination reveals a red and swollen joint with tenderness on palpation. Which of the following test results will most likely be found in this patient? A. Hyperuricemia B. Negative birefringent crystals C. Evidence of a septic joint with needle aspiration D. Calcium pyrophosphate dehydrate crystals - Answers - B. Negative birefringent crystals A 4 week-old female is seen for a well child visit. Birth history is significant for breech presentation and weighing 9 pounds 8 ounces at delivery. Which of the following is indicated to rule out developmental dysplasia of the hip? A. Ultrasound B. Physical examination C. Anterior/posterior radiograph D. Computed tomography - Answers - B. Physical examination A 20 year-old male is brought to the ED by ambulance for evaluation of a neck injury after diving into shallow water. A radiograph reveals a moderately displaced C1 atlas fracture. Which of the following is the indicated management of this fracture?
A. Surgical fusion of C1-C B. Halo vest C. Cervical traction D. Cervical collar - Answers - B. Halo vest An obese 12 year-old male presents with a 1 month history of right thigh pain worsened with weight bearing. Examination is normal, however, radiographs reveal a posterior and medial displacement of the femoral head. Which of the following is the most likely diagnosis? A. Legg Calvé Perthes disease B. Developmental dysplasia of the hip C. Slipped capital femoral epiphysis D. Osgood-Schlatter disease - Answers - C. Slipped capital femoral epiphysis A 50 year-old female presents with a two-month history of fatigue and morning stiffness involving both hands. It is now difficult for her to perform simple tasks at home and work. Examination reveals swelling and warmth of the metacarpophalangeal and proximal interphalangeal joints, sparing the distal interphalangeal joints. Elevation of which of the following laboratory test results would best support the suspected diagnosis? A. Antinuclear antibodies B. Rheumatoid factor C. HLA-B D. C-reactive protein - Answers - B. Rheumatoid factor A 13 year-old patient presents to the orthopedic surgeon's office for a follow-up evaluation for scoliosis. The Cobb angle is measured at 65 degrees. Which of the following is indicated at this time? A. Observation for 4 months B. Physical therapy C. Leg length measurements D. Pulmonary function testing - Answers - D. Pulmonary function testing A 45 year-old female secretary presents with complaints of numbness, tingling, and pain in the thumb, index, and third fingers. On examination the patient experiences numbness and tingling while holding her wrists in a flexed position for 60 seconds. This suggests compression of which of the following nerves? A. Radial B. Ulnar C. Median D. Brachial - Answers - C. Median Focal ulcerated areas of cartilage with bone eburnation, development of bone cysts and the presence of osteophytes best demonstrates the pathophysiology of which of the following? A. Osteoarthritis
D. Ewing sarcoma - Answers - A. Osteomyelitis Which of the following is the initial treatment of choice for a Baker's cyst? A. Needle aspiration B. Intra-articular injection of corticosteroid C. Surgical excision D. Incision and drainage - Answers - B. Intra-articular injection of corticosteroid A 50 year-old male with a history of alcohol abuse presents complaining of nodular thickening of the palmar aspect of the left hand. Examination reveals flexion of the 3rd, 4th, and 5th metacarpophalangeal and proximal interphalangeal joints. Which of the following is indicated at this time? A. Refer to physical therapy B. Refer to a hand surgeon C. Prescribe a nonsteroidal antiinflammatory D. Apply a splint for 4 weeks - Answers - B. Refer to a hand surgeon A 17 year-old female presents to the ED after injuring her knee in a soccer match earlier today. The injury occurred while suddenly decelerating and cutting to run in another direction. She heard a pop in the knee and complains the knee now gives out with any twisting motion. Which of the following tests is the most useful in eliciting the most likely diagnosis? A. Posterior drawer test B. Lachman test C. McMurray test D. Valgus stress test - Answers - B. Lachman test A 14 year-old male athlete presents complaining of a painful "bump" on his right lower extremity just below his knee and associated pain during and after activity. Examination of the right leg reveals a prominent tender tibial tubercle. Which of the following is the most likely diagnosis? A. Osgood-Schlatter disease B. Osteochondritis dissecans C. Tibia vara D. Patellofemoral syndrome - Answers - A. Osgood-Schlatter disease Which of the following is most appropriate to delay the progression of osteoporosis? A. Estrogen B. Bisphosphonate C. Glucocorticoid D. Parathyroid hormone - Answers - B. Bisphosphonate A fracture of the distal 5th metacarpal is most likely to occur after which of the following events? A. Falling on an outstretched hand B. Punching a wall
C. Closing the finger in a car door D. Twisting the finger playing basketball - Answers - B. Punching a wall A patient presents with chronic back pain. On physical examination testing, the patient is found to have abnormalities of proprioception and vibration discrimination. Which of the following portions of the spinal column are most likely affected? A. Lateral spinothalamic tract B. Ventral spinothalamic tract C. Posterior column D. Transection of the cord - Answers - C. Posterior column In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis? A. Femur B. Humerus C. Vertebral spine D. Tibia - Answers - C. Vertebral spine Which of the following medications is the treatment of choice for patients with chronic gout to prevent recurrence of symptoms during its quiescent phase? A. Probenecid (Benemid) B. Allopurinol (Zyloprim) C. Colchicine D. Indomethacin (Indocin) - Answers - B. Allopurinol Intraarticular injection of hyaluronic acid has been approved for treatment of patients with which of the following conditions? A. Rheumatoid arthritis of the knee B. Osteoarthritis of the knee C. Olecranon bursitis D. Gouty arthritis - Answers - B. Osteoarthritis of the knee A 75 year-old female presents with medial knee pain that worsens with stair climbing. Physical examination reveals swelling and point tenderness inferior and medial to the patella and tenderness overlying the medial tibial plateau. Which of the following is the most likely diagnosis? A. Pes anserine bursitis B. Prepatellar bursitis C. Infrapatellar bursitis D. Trochanteric bursitis - Answers - A. Pes anserine bursitis A 28 year-old female, who has experienced occasional painful migratory arthralgias, complains now of a tender, swollen, and hot left ankle. The joint was aspirated and the synovial fluid showed 55,000 WBCs, 75% polymorphonuclear lymphocytes, low glucose level, and no crystals. Which of the following would be the most likely diagnosis? A. Rheumatoid arthritis
A 75 year-old female falls on her outstretched arm. She sustains a humeral mid-shaft fracture. Nerve impingement occurs due to the fracture. What is the most likely physical examination abnormality that will be encountered? A. Inability to extend the wrist against resistance B. Numbness over the deltoid muscle in the shoulder C. Winging of the scapula D. Weakness of the rotator cuff - Answers - A. Inability to extend the wrist against resistance A 55 year-old female presents with complaints of stiffness, aching, and pain in the muscles of her neck, shoulders, lower back, hips, and thighs. There is no associated weakness associated with the stiffness and achiness. Laboratory evaluation shows an elevated C reactive protein and erythrocyte sedimentation rate. Which of the following medications is used to treat this condition immediately and will also serve to prevent a known complication from this disorder? A. Glucocorticoids B. Cyclophosphamide (Cytoxan) C. Methotrexate (Rheumatrex) D. Azathioprine (Imuran) - Answers - A. Glucocorticoids An 18 year-old male presents with pain in his wrist after he fell off of a moving motor cycle. Physical examination reveals tenderness in the anatomic snuffbox. No fracture is noted on plain radiography of the wrist. Which of the following is the recommended treatment for this patient? A. Ace wrap of the wrist B. Closed reduction of the fracture site C. Thumb spica cast application D. Open reduction of the fracture site - Answers - C. Thumb spica cast application A 53 year-old male is seen in the emergency department following a motor vehicle collision in which his knee impacted against the dashboard. The patient has a posterior knee dislocation that is promptly reduced in the emergency department. The patient currently has a palpable pulse in the dorsalis pedis and posterior tibial areas. Which of the following studies is mandatory? A. Anterior plain film of knee B. Sunrise view of the knee C. Measurement of compartment pressures D. Angiography - Answers - D. Angiography A 65 year-old male presents with back pain two days after he was shoveling snow. The patient complains of pain in his low back that radiates into his buttocks, posterior thigh and calf, and the bottom of his foot. There is associated numbness of his lateral and plantar surface of his foot. Which of the following disc herniations is most likely to be affected? A. L3-L
B. L4-L
C. L5-S
D. S1-S2 - Answers - C. L5-S Endotracheal intubation should be performed with caution in patients with which of the following underlying conditions due to the propensity to cause subluxation of C1 on C2? A. Rheumatoid arthritis B. Osteoarthritis C. Gout D. Pseudogout - Answers - A. Rheumatoid arthritis Which of the following rotator cuff tendons is most likely to sustain injury because of its repeated impingement (impingement syndrome) between the humeral head and the undersurface of the anterior third of the acromion and coracoacromial ligament? A. Supraspinatus B. Infraspinatus C. Teres minor D. Subscapularis - Answers - A. Supraspinatus A 33 year-old male presents to your office with a complaint of right knee injury associated with pain and swelling. He states he was running after his loose dog and suddenly stopped, hyperextended his knee, heard a pop and noticed immediate swelling. On physical examination, the Lachman test and anterior drawer test demonstrates joint laxity. Which of the following ligaments is most likely injured? A. Medial collateral B. Lateral collateral C. Posterior cruciate D. Anterior cruciate - Answers - D. Anterior cruciate A 60 year-old right hand dominant male presents to your office complaining of right shoulder pain and progressively worsening arm weakness. His symptoms are aggravated when working above the shoulder level. On physical examination, there is no evidence of muscle atrophy. He has strong (5/5) adduction of his right shoulder but considerable weakness (1/5) with abduction when raising his arm above his head. Passive range of motion is intact. Which of the following is the most likely diagnosis? A. Rotator cuff tear B. Subacromial bursitis C. Adhesive capsulitis D. Supraspinatus tendonitis - Answers - A. Rotator cuff tear A 57 year-old male recently on a high protein diet presents with an exquisitely tender, erythematous, warm right great toe. Which of the following is the treatment of choice for this patient? A. Corticosteroids B. Colchicine C. Allopurinol
