NR 511 final
After starting levothyroxine how often should the patient's levels
be checked? Correct Answer In 4-8 weeks, to evaluate TSH
level
children with Philadelphia chromosome positive ALL benefit
from what targeted therapy? Correct Answer Imantinib
(Gleevec)
health promotion to prevent sport r/t msk inuries Correct
Answer wearing protective gear (helmets, wrist pads,
kneepads), maintain adequate hydration and proper diet, stretch
before activity, stop when you are injured do not try to "tough it
out"
how do sx progress in stenosis? Correct Answer proximal to
distal direction
How do yo conduct the finkelstein's test? Correct Answer have
pt. touch thumb into palm and make a fist, test is positive if
moving wrist into ulnar deviation causes pain
How do you assess for achilles rupture? Correct Answer
Thompson test
How do you assess for the Tinel's sign? Correct Answer
Percuss the median nerve of the wrist. If the patient c/o tingling
in fingers the test is positive (compression at site of percussion
likely--carpal tunnel syndrome)
,How do you do conduct the apley scratch test? Correct Answer
-measures abduction and external rotation
-have pt. reach behind head and touch superior aspect of
opposite scapula
-internal rotation and adduction of shoulder tested by pt.
reaching behind back and touch inferior aspect of opposite
scapula
How do you manage myofascial pain? Correct Answer
injections at trigger point with saline, anesthetic, or
corticosteroid,
dry needling, muscle relaxant tizanidine (Zanaflex), topical
creams ( capsaicin, lidocaine), NSAIDs, tricyclic antidepressants
(amitriptyline, Elavil), limit narcotics, cyclooxgenase-2
inhibitors (Celebrex and Bextra)
How do you manage sprains/strains? Correct Answer PRICE-
protect, rest, ice, compression, elevation
limit activity, PT, NSAIDS, referral to ortho
How do you perform Lachman test? Correct Answer knee is
flexed to 25-30° and
the tibia is gently pulled forward while the femur is stabilized;
inc. motion of the tibia indicates complete ACL tear
How do you perform the phalens test? Correct Answer Have
pt. maintain forced flexion of wrist for one minute or more with
dorsal surfaces of each hand pressed together. If pt. c/o
numbness and paresthesia in gingers the test is positive
,How do you perform the thumb test? Correct Answer Pt. is
supine, flex knee 90* w/foot supported, If PCL is injured the
proximal tibia falls back and areas available to thumb decreased
when tibial plateaus are flush with femoral condyles there is
10mm or more of posterior laxity, consistent with complete tear
of PCL
How do you perform Thompson test? Correct Answer With pt.
pronated, squeeze calf of leg, it should cause foot to plantar flex.
If not, test is positive
AKA calf compression test, Simmond's test
How do you perform valgus stress test? Correct Answer
Support thigh to relax the quadriceps muscle. Apply stress
initially with the knee extended and then flexed to 25 degrees.
With the thigh supported and the knee extended, place one hand
on the lateral side of the knee, grasp the medial distal tibia with
one hand on the lateral side of the knee, grasp the medial distal
tibia with the other hand, and abduct the knee. If the knee opens
in a valgus direction more than the opposite knee, the patient has
either a complete or partial tear of the MCL.
How do you perform varus stress test Correct Answer Assess
LCL stability with the knee in extension and 25-degree flexion
by reversing the stress pattern used for the MCL. If the knee
opens more than the opposite knee in a varus direction, the
patient has either a complete or partial tear of the LCL.
how do you prevent osteopenia? Correct Answer -no smoking
(prevents Ca uptake), get enough Vit D and Ca, ETOH in
, moderation, limit corticosteroid and anticonvulsant medications,
get at least 30 minutes of weight bearing exercise,
How do you treat cauda equina syndrome? Correct Answer
medical emergency! Should go to ER, surgical lumbar
decompression is necessary
how do you treat stenosis? Correct Answer surgical
decompression, NSAIDS, folic acid, vitamin B12, PT flexing
the spine, bicycling
-weight loss especially intra-abdominal helpful
-exercise on all fours, arching the back, fetal position
How does osteopenia occur? Correct Answer s/t uncoupling
osteoclast-osteoblast activity resulting in a decrease in bone
mass.
How is gout diagnosed? Correct Answer Usually clinical
presentation and medical hx are sufficient to dx,
a definitive dx is only made with identification of Na urate
crystals in the aspirated fluid of the affected joint
How is osteopenia categorized? Correct Answer by the level of
T-scores in r/t results of a dual energy x-ray absorptiometry scan
(DXA scan)
how long is tx for ALL? Correct Answer Usually 2-3 years,
most intense during the first few months
After starting levothyroxine how often should the patient's levels
be checked? Correct Answer In 4-8 weeks, to evaluate TSH
level
children with Philadelphia chromosome positive ALL benefit
from what targeted therapy? Correct Answer Imantinib
(Gleevec)
health promotion to prevent sport r/t msk inuries Correct
Answer wearing protective gear (helmets, wrist pads,
kneepads), maintain adequate hydration and proper diet, stretch
before activity, stop when you are injured do not try to "tough it
out"
how do sx progress in stenosis? Correct Answer proximal to
distal direction
How do yo conduct the finkelstein's test? Correct Answer have
pt. touch thumb into palm and make a fist, test is positive if
moving wrist into ulnar deviation causes pain
How do you assess for achilles rupture? Correct Answer
Thompson test
How do you assess for the Tinel's sign? Correct Answer
Percuss the median nerve of the wrist. If the patient c/o tingling
in fingers the test is positive (compression at site of percussion
likely--carpal tunnel syndrome)
,How do you do conduct the apley scratch test? Correct Answer
-measures abduction and external rotation
-have pt. reach behind head and touch superior aspect of
opposite scapula
-internal rotation and adduction of shoulder tested by pt.
reaching behind back and touch inferior aspect of opposite
scapula
How do you manage myofascial pain? Correct Answer
injections at trigger point with saline, anesthetic, or
corticosteroid,
dry needling, muscle relaxant tizanidine (Zanaflex), topical
creams ( capsaicin, lidocaine), NSAIDs, tricyclic antidepressants
(amitriptyline, Elavil), limit narcotics, cyclooxgenase-2
inhibitors (Celebrex and Bextra)
How do you manage sprains/strains? Correct Answer PRICE-
protect, rest, ice, compression, elevation
limit activity, PT, NSAIDS, referral to ortho
How do you perform Lachman test? Correct Answer knee is
flexed to 25-30° and
the tibia is gently pulled forward while the femur is stabilized;
inc. motion of the tibia indicates complete ACL tear
How do you perform the phalens test? Correct Answer Have
pt. maintain forced flexion of wrist for one minute or more with
dorsal surfaces of each hand pressed together. If pt. c/o
numbness and paresthesia in gingers the test is positive
,How do you perform the thumb test? Correct Answer Pt. is
supine, flex knee 90* w/foot supported, If PCL is injured the
proximal tibia falls back and areas available to thumb decreased
when tibial plateaus are flush with femoral condyles there is
10mm or more of posterior laxity, consistent with complete tear
of PCL
How do you perform Thompson test? Correct Answer With pt.
pronated, squeeze calf of leg, it should cause foot to plantar flex.
If not, test is positive
AKA calf compression test, Simmond's test
How do you perform valgus stress test? Correct Answer
Support thigh to relax the quadriceps muscle. Apply stress
initially with the knee extended and then flexed to 25 degrees.
With the thigh supported and the knee extended, place one hand
on the lateral side of the knee, grasp the medial distal tibia with
one hand on the lateral side of the knee, grasp the medial distal
tibia with the other hand, and abduct the knee. If the knee opens
in a valgus direction more than the opposite knee, the patient has
either a complete or partial tear of the MCL.
How do you perform varus stress test Correct Answer Assess
LCL stability with the knee in extension and 25-degree flexion
by reversing the stress pattern used for the MCL. If the knee
opens more than the opposite knee in a varus direction, the
patient has either a complete or partial tear of the LCL.
how do you prevent osteopenia? Correct Answer -no smoking
(prevents Ca uptake), get enough Vit D and Ca, ETOH in
, moderation, limit corticosteroid and anticonvulsant medications,
get at least 30 minutes of weight bearing exercise,
How do you treat cauda equina syndrome? Correct Answer
medical emergency! Should go to ER, surgical lumbar
decompression is necessary
how do you treat stenosis? Correct Answer surgical
decompression, NSAIDS, folic acid, vitamin B12, PT flexing
the spine, bicycling
-weight loss especially intra-abdominal helpful
-exercise on all fours, arching the back, fetal position
How does osteopenia occur? Correct Answer s/t uncoupling
osteoclast-osteoblast activity resulting in a decrease in bone
mass.
How is gout diagnosed? Correct Answer Usually clinical
presentation and medical hx are sufficient to dx,
a definitive dx is only made with identification of Na urate
crystals in the aspirated fluid of the affected joint
How is osteopenia categorized? Correct Answer by the level of
T-scores in r/t results of a dual energy x-ray absorptiometry scan
(DXA scan)
how long is tx for ALL? Correct Answer Usually 2-3 years,
most intense during the first few months
