2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
NPLEX II – Orthopedics Questions and
Correct Answers | Latest Update
A man in his late 40s is experiencing a throbbing pain in his big toe (1st metatarsophalangeal
jt) that is swollen, erythematous, with limited mobility. He denies any injuries.
PMHx: HTN, DM II, and he is obese.
Meds: Hydrochlorothiazide
Diet is mainly meat, beer, and seafood.
What diagnosis do you suspect and which labs would you run? etiology?
✓ -:- Gout
✓ Serum: uric acid
✓ X-ray: tophii
✓ Joint aspirate is most diagnostic
HTN meds, chronic dieases, diet, and unmodifiable risk factors (gender, age)
10 years ago you diagnosed psoriasis in a patient of yours. They have now come to you with
a complaint of swelling on the tips of their fingers that appear sausage shaped and with
pitting in their nails. In addition, they also have joint pain just on their left side. You suspect
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
psoriatic arthritis. While there is no diagnostic test, which tests can be done to strengthen
your diagnosis?
✓ -:- CRP & ESR elevated
negative RF
Which homeopathic remedy would be indicated for a case of gout with swelling of the feet
that are > with a tremendous desire to place feet in ice water?
✓ -:- Ledum
What are seronegative arthrotides?
✓ -:- Arthritic conditions that lacks RF and involves the axial skeleton
AND associated genetically with HLA -B27
When disseminated, Staph. aureus can wreak havoc on many systems in the body
(endocarditis, for example). How might it affect the joints and what would the condition be
called?
✓ -:- septic arthritis - usually affecting monoarticular joints - knee is most
common, presenting with inflammation (red, swelling, heat, and reduced
ROM) + systemic inxn sxs (fever, leukocytosis)
2|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
Joint aspirate & if (+) treat immediately!
A male younger than 40 has been complaining of lower back pain with stiffness for the past
3 months. He notices that it is worse in the morning, late at night, and with inactivity and
that he must move around often as this improves his symptoms.
physical exam: posterior pelvic tilt and loss of lumbar lordosis
You send for an X-ray, which reveals 'Bamboo spine" and is diagnostic of ankylosing
spondylitis.
What are the complications/extra-articular manifestations of this condition? and which
homeopathic is best indicated?
✓ -:- Joint fusion
Uveitis
Aortic insufficiency
Restrictive lung diseases (in late stage dt costovertebral involvement preventing lungs from
expanding)
Rhus Tox
3|P a g e | G r a d e A + | 2 0 2 0 2 5
NPLEX II – Orthopedics Questions and
Correct Answers | Latest Update
A man in his late 40s is experiencing a throbbing pain in his big toe (1st metatarsophalangeal
jt) that is swollen, erythematous, with limited mobility. He denies any injuries.
PMHx: HTN, DM II, and he is obese.
Meds: Hydrochlorothiazide
Diet is mainly meat, beer, and seafood.
What diagnosis do you suspect and which labs would you run? etiology?
✓ -:- Gout
✓ Serum: uric acid
✓ X-ray: tophii
✓ Joint aspirate is most diagnostic
HTN meds, chronic dieases, diet, and unmodifiable risk factors (gender, age)
10 years ago you diagnosed psoriasis in a patient of yours. They have now come to you with
a complaint of swelling on the tips of their fingers that appear sausage shaped and with
pitting in their nails. In addition, they also have joint pain just on their left side. You suspect
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
psoriatic arthritis. While there is no diagnostic test, which tests can be done to strengthen
your diagnosis?
✓ -:- CRP & ESR elevated
negative RF
Which homeopathic remedy would be indicated for a case of gout with swelling of the feet
that are > with a tremendous desire to place feet in ice water?
✓ -:- Ledum
What are seronegative arthrotides?
✓ -:- Arthritic conditions that lacks RF and involves the axial skeleton
AND associated genetically with HLA -B27
When disseminated, Staph. aureus can wreak havoc on many systems in the body
(endocarditis, for example). How might it affect the joints and what would the condition be
called?
✓ -:- septic arthritis - usually affecting monoarticular joints - knee is most
common, presenting with inflammation (red, swelling, heat, and reduced
ROM) + systemic inxn sxs (fever, leukocytosis)
2|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
Joint aspirate & if (+) treat immediately!
A male younger than 40 has been complaining of lower back pain with stiffness for the past
3 months. He notices that it is worse in the morning, late at night, and with inactivity and
that he must move around often as this improves his symptoms.
physical exam: posterior pelvic tilt and loss of lumbar lordosis
You send for an X-ray, which reveals 'Bamboo spine" and is diagnostic of ankylosing
spondylitis.
What are the complications/extra-articular manifestations of this condition? and which
homeopathic is best indicated?
✓ -:- Joint fusion
Uveitis
Aortic insufficiency
Restrictive lung diseases (in late stage dt costovertebral involvement preventing lungs from
expanding)
Rhus Tox
3|P a g e | G r a d e A + | 2 0 2 0 2 5
