AAFP Board Review – MSK Exam
Questions With Correct Answers
A 16-year-old female presents for follow-up after a tibial stress fracture.
| | | | | | | | | | |
The fracture was
| |
diagnosed 5 weeks ago by characteristic physical examination findings
| | | | | | | | |
and radiographs showing
| |
a transverse fracture of the tibial diaphysis. She was placed on non-
| | | | | | | | | | |
weight-bearing status for 2 | | |
weeks and after that was advised to limit activities that caused
| | | | | | | | | | |
discomfort. In addition, she was | | | |
placed on appropriate calcium and vitamin D supplementation based on
| | | | | | | | |
results of her laboratory
| | | |
workup. The patient is a basketball player and would like to begin
| | | | | | | | | | | |
practicing with the team in | | | |
1 week. She says she is now able to walk without discomfort but has not
| | | | | | | | | | | | | |
tried running or
| | |
jumping.
Which one of the following is necessary for this patient to be able to
| | | | | | | | | | | | | |
return to basketball
| |
participation next week? (check one) | | | |
,| A. Consultation with a sports medicine physician
| | | | | | |
| B. A normal physical examination of the affected area
| | | | | | | | |
C. Normal radiographs - CORRECT ANSWER✔✔-B. A normal physical
| | | | | | | | | |
examination of the affected area | | | |
In a patient with hyperuricemia who has experienced an attack of gout,
| | | | | | | | | | | |
which one of the following is LEAST likely to precipitate another gout
| | | | | | | | | | | |
attack? (check one) | |
| A. Red meat | | |
| B. Milk | |
| C. Seafood | |
| D. Nuts | |
| E. Beans - CORRECT ANSWER✔✔-B. milk
| | | | |
- milk, unlike other dairy product, decrease gout attack
| | | | | | | |
- nuts and beans are high in purines & worsens gout
| | | | | | | | | |
You test a patient's muscle strength and find that his maximum
| | | | | | | | | | |
performance consists of the ability to move with gravity neutralized. | | | | | | | | | |
This qualifies as which grade of muscle strength, on
| | | | | | | |
a scale of 0 to 5?
| | | | |
| (check one) |
| A. 0 | |
,| B. 1 | |
| C. 2 | |
| D. 3 | |
| E. 4 - CORRECT ANSWER✔✔-C. 2
| | | | |
Muscle strength is scored on a scale of 0 to 5.
| | | | | | | | | | |
0 - inability to contract a muscle is scored as 0.
| | | | | | | | | | |
1 - Contraction without movement constitutes
| | | | | |
2- Movement with the effect of gravity neutralized 3- while movement
| | | | | | | | | | |
against gravity only | |
4 - Movement against gravity plus some
| | | | | |
additional resistance indicates grade 4 | | | | |
5 - normal movement against substantial resistance.
| | | | | |
Question 7 of 10 | | |
Which one of the following is true concerning Paget's disease of bone?
| | | | | | | | | | | |
(check one) |
| A. It is a precursor of multiple myeloma
| | | | | | | |
| B. Both bone formation and bone resorption are increased
| | | | | | | | |
|C. The treatment of choice for symptomatic disease is a calcium
| | | | | | | | | | |
channel blocker | |
|D. Pagetic bone pain is difficult to relieve and resistant to medical
| | | | | | | | | | | |
treatment |
, |E. Extracellular calcium homeostasis is typically abnormal - CORRECT
| | | | | | | | |
ANSWER✔✔-B. Both bone formation and bone resorption area focal | | | | | | | | |
disorder of skeletal metabolism in which all elements of skeletal
| | | | | | | | | |
remodeling (resorption, formation, and mineralization) are increased.
| | | | | | |
increased |
- Treatment: one of the newer bisphosphonate
| | | | | |
- despite the massive bone turnover, extracellular calcium homeostasis
| | | | | | | | |
is almost invariably normal.
| | |
A factory worker sustains a forced flexion injury of the distal
| | | | | | | | | | |
interphalangeal (DIP) joint, resulting in a small bone fragment at the | | | | | | | | | | |
dorsal surface of the proximal distal phalanx (mallet fracture). Which
| | | | | | | | | |
one of the following is the most appropriate management strategy?
| | | | | | | | |
| A. Buddy taping and early range of motion
| | | | | | | |
| B. Splinting the DIP joint in extension
| | | | | | |
| C. Splinting the DIP joint in flexion
| | | | | | |
|D. Referral for surgical repair - CORRECT ANSWER✔✔-B. The
| | | | | | | | |
recommended treatment for a mallet fracture is splinting the distal | | | | | | | | | |
interphalangeal (DIP) joint in extension (SOR B). The usual duration of | | | | | | | | | | |
splinting is 8 weeks. | | | |
- If the finger fracture involves >30% of the intra-articular surface,
| | | | | | | | | | |
referral to a hand or | | | |
orthopedic surgeon can be considered. | | | | |
Questions With Correct Answers
A 16-year-old female presents for follow-up after a tibial stress fracture.
| | | | | | | | | | |
The fracture was
| |
diagnosed 5 weeks ago by characteristic physical examination findings
| | | | | | | | |
and radiographs showing
| |
a transverse fracture of the tibial diaphysis. She was placed on non-
| | | | | | | | | | |
weight-bearing status for 2 | | |
weeks and after that was advised to limit activities that caused
| | | | | | | | | | |
discomfort. In addition, she was | | | |
placed on appropriate calcium and vitamin D supplementation based on
| | | | | | | | |
results of her laboratory
| | | |
workup. The patient is a basketball player and would like to begin
| | | | | | | | | | | |
practicing with the team in | | | |
1 week. She says she is now able to walk without discomfort but has not
| | | | | | | | | | | | | |
tried running or
| | |
jumping.
Which one of the following is necessary for this patient to be able to
| | | | | | | | | | | | | |
return to basketball
| |
participation next week? (check one) | | | |
,| A. Consultation with a sports medicine physician
| | | | | | |
| B. A normal physical examination of the affected area
| | | | | | | | |
C. Normal radiographs - CORRECT ANSWER✔✔-B. A normal physical
| | | | | | | | | |
examination of the affected area | | | |
In a patient with hyperuricemia who has experienced an attack of gout,
| | | | | | | | | | | |
which one of the following is LEAST likely to precipitate another gout
| | | | | | | | | | | |
attack? (check one) | |
| A. Red meat | | |
| B. Milk | |
| C. Seafood | |
| D. Nuts | |
| E. Beans - CORRECT ANSWER✔✔-B. milk
| | | | |
- milk, unlike other dairy product, decrease gout attack
| | | | | | | |
- nuts and beans are high in purines & worsens gout
| | | | | | | | | |
You test a patient's muscle strength and find that his maximum
| | | | | | | | | | |
performance consists of the ability to move with gravity neutralized. | | | | | | | | | |
This qualifies as which grade of muscle strength, on
| | | | | | | |
a scale of 0 to 5?
| | | | |
| (check one) |
| A. 0 | |
,| B. 1 | |
| C. 2 | |
| D. 3 | |
| E. 4 - CORRECT ANSWER✔✔-C. 2
| | | | |
Muscle strength is scored on a scale of 0 to 5.
| | | | | | | | | | |
0 - inability to contract a muscle is scored as 0.
| | | | | | | | | | |
1 - Contraction without movement constitutes
| | | | | |
2- Movement with the effect of gravity neutralized 3- while movement
| | | | | | | | | | |
against gravity only | |
4 - Movement against gravity plus some
| | | | | |
additional resistance indicates grade 4 | | | | |
5 - normal movement against substantial resistance.
| | | | | |
Question 7 of 10 | | |
Which one of the following is true concerning Paget's disease of bone?
| | | | | | | | | | | |
(check one) |
| A. It is a precursor of multiple myeloma
| | | | | | | |
| B. Both bone formation and bone resorption are increased
| | | | | | | | |
|C. The treatment of choice for symptomatic disease is a calcium
| | | | | | | | | | |
channel blocker | |
|D. Pagetic bone pain is difficult to relieve and resistant to medical
| | | | | | | | | | | |
treatment |
, |E. Extracellular calcium homeostasis is typically abnormal - CORRECT
| | | | | | | | |
ANSWER✔✔-B. Both bone formation and bone resorption area focal | | | | | | | | |
disorder of skeletal metabolism in which all elements of skeletal
| | | | | | | | | |
remodeling (resorption, formation, and mineralization) are increased.
| | | | | | |
increased |
- Treatment: one of the newer bisphosphonate
| | | | | |
- despite the massive bone turnover, extracellular calcium homeostasis
| | | | | | | | |
is almost invariably normal.
| | |
A factory worker sustains a forced flexion injury of the distal
| | | | | | | | | | |
interphalangeal (DIP) joint, resulting in a small bone fragment at the | | | | | | | | | | |
dorsal surface of the proximal distal phalanx (mallet fracture). Which
| | | | | | | | | |
one of the following is the most appropriate management strategy?
| | | | | | | | |
| A. Buddy taping and early range of motion
| | | | | | | |
| B. Splinting the DIP joint in extension
| | | | | | |
| C. Splinting the DIP joint in flexion
| | | | | | |
|D. Referral for surgical repair - CORRECT ANSWER✔✔-B. The
| | | | | | | | |
recommended treatment for a mallet fracture is splinting the distal | | | | | | | | | |
interphalangeal (DIP) joint in extension (SOR B). The usual duration of | | | | | | | | | | |
splinting is 8 weeks. | | | |
- If the finger fracture involves >30% of the intra-articular surface,
| | | | | | | | | | |
referral to a hand or | | | |
orthopedic surgeon can be considered. | | | | |
