NSG6001 Musculoskeletal/Immune Disorder Exam 2024

NSG6001 Musculoskeletal/Immune Disorder Exam 2024 3. A patient who is a distance runner reports pain in one heel that is worse in the morning and seems to improve with exercise. The provider notes localized swelling and a bony prominence at the heel. What is the initial treatment for this condition? a. Cessation of all sports activities and exercise b. Crutches and partial weight bearing c. Physical therapy for ultrasound therapy d. Referral to an orthopedist for MRI and evaluation ANS: A This patient has symptoms consistent with Achilles tendonitis. Immediate cessation of sports and exercise is the first step in management. Crutches and partial weight bearing may be indicated if symptoms do not improve with rest and NSAIDs. Physical therapy is used as adjunctive therapy. Symptoms that do not improve require referral 1. Which treatments may be used to manage bone pain in patients with bone tumors? Select all that apply. a. Bisphosphonates b. Exercise c. External beam radiation d. Massage e. Vertebralplasty ANS: A, B, C, E Bisphosphonates can decrease pain by preventing growth and development of existing and new bone lesions. Exercise is useful to maintain function and reduce pain. External beam radiation is useful in the majority of patients. Vertebralplasty involves injecting bone cement to stabilize bone. Massage is not recommended. 2. A patient reports persistent lower back pain and constipation. A digital rectal examination reveals a mass at the sacrum. What will the primary care provider do to manage this patient? a. Order spinal radiographs in 3 months b. Perform an MRI of the sacrum c. Refer the patient to an oncologist d. Schedule the patient for a biopsy C. Patients with chordoma, which is a type of sarcoma with a predilection for the sacrum will have these symptoms and a palpable mass coming out of the sacrum. A referral to an oncologist is necessary. These tumors have a significant risk for malignancy, so waiting 3 months is not an option. The oncologist will order a CT and body scan and possibly biopsy or surgery