Wk 10, Adv. Assess., Goolsby, MSK Certification Exam Examples Questions And Answers Solved.

What conditions are frequently associated w/ joint pain? - correct answer OA, tendonitis, infection, gout/pseudogout, and RA What are red flags in the assessment of the musculoskeletal system? - correct answer *Hx of major trauma *Hot and/or swollen joint(s) *Systemic/constitutional symptoms *Focal or diffuse weakness *Neurogenic pain *Claudication *Unrelenting nighttime pain *Poorly localized pain How may diuretic use affect the MSK system? - correct answer By increasing uric acid levels (hyperuricemia) that may lead to gout or renal calculi How may anti-inflammatories, statins, fibrates, and erythromycins affect the MSK system? - correct answer May cause rhabdomyolysis How may chemotherapies for malignancies affect the MSK system? - correct answer May increase hyperuricemia How may hydralazine, procainamide, chlorpromazine, methyldopa, isoniazid, and oral contraceptives affect the MSK system? - correct answer Trigger systemic lupus erythematosus What may flaccid or hypotonic muscles indicate? - correct answer Peripheral nervous system disease Cerebellar disease Spinal cord problems What are the findings of cogwheeling or lead-pike rigidity associated with? - correct answer Parkinsonism What are polyarthralgias? - correct answer Refers to arthralgia, or pain, in five or more joints, as opposed to monoarthralgia involving only one joint or oligoarthralgia involving two to four joints. How can you differentiate arthralgia from arthritis? - correct answer In arthralgia, there is simply joint discomfort or pain In arthritis the joint discomfort or pain is accompanied by joint inflammation When it comes to the joints most likely affected, what is the difference in RA and OA? - correct answer RA mainly affects smaller joints such as those in the hands and feet OA is more likely to affect larger weight bearing joints such as the hips and knees but may also affect the hands What are the most common s/s of fibromyalgia? - correct answer Generalized pain Stiffness Decreased ROM Multiple-point tenderness Where are the most common tender sites in fibromyalgia? - correct answer Neck, shoulders, spine, and hips What is systemic lupus erythematosus (SLE)? - correct answer A chronic autoimmune disorder that has widespread effects. Much higher prevalence in women, particularly in childbearing yrs. What is the classic finding of SLE? What are the other common findings? - correct answer Malar rash is the classic finding Other common findings: arthralgias, myalgias, fever, fatigue, Raynaud's syndrome, and neuropathy What is sarcoidosis? - correct answer An inflammatory disorder in which pts develop granulomas and a wide range of symptoms, including arthritis. Discuss reactive arthritis. - correct answer *A syndrome described by several terms, including Reiter's syndrome and seronegative arthritis, and is the most common cause of migratory arthritis in young males. *Develops following an infection, usually chlamydia. *S/S: multiple joints involved, primarily those of the lower extremities, as well as the vertebrae Discuss gonococcal arthritis. - correct answer *A polyarthritis that is also common in young men and follows infection w/ gonorhea. * S/S: polyarthritis is often migratory and affects lower extremities as well as the hands * Generalized muscle aches and fever What should be considered when polyarthritis recurs over a long period of time? - correct answer Gout What causes lyme disease? - correct answer Bacterium Borrelia burgdorferi from a deer tick bite Discuss acute rheumatic fever. - correct answer *Becoming more rare in U.S. *Should be considered when children and young adults develop polyarthralgia *Occurs following an infection w/ streptococci, typically streptococcal pharyngitis *Cardiac symptoms may be present What are the red flags in the assessment of the pt w/ neck pain? - correct answer *Hx of injury/trauma preceding onset of pain *Associated neck stiffness (nuchal rigidty) w/ fever *Neck pain in a child *Pain that is unrelenting and/or worsening in pts who have tried and failed conservative treatment *Acute, severe pain, w/ or w/out radicular symptoms, upon awakening in the morning *Pain relieved by elevating the arm above the head on the side of the pain *Severe pn, with or w/out radicular symptoms, on flexion or extension of the neck *Chronic neck pn w/ weakness of upper or lower extremity(ies), strumbling, muscle atrophy, bowel or bladder incontinence *Pain w/ a hx of malignancies Discuss cervical disk disease: - correct answer *Results from compression associated w/ herniated cervical disks *Frequently manifested by morning tightness, stiffness, and/or pain *Coughing and straining can increase the pain, which may radiate to the should and arm (elevating arm may provide relief) Discuss cerviacl spondylosis/stenosis: - correct answer *Results from bone spur development associated w/ degenerative arthritis *The bony osteophytes compress the spinal cord so that both motor and sensory neurological symptoms may result *S/s: neck tenderness is most common finding What is syringomyelia (syrinx, hydrosyringomyelia), common cause, s/s? - correct answer *A fluid cavity in the spinal cord that can occur in the cervical and/or thoracic areas *Most common cause of syringomyelia is Chiari malformation (condition where brain tissue extends into the spinal canal) *S/S: burning pn in the neck or thoracic area and paresthesias or numbness in the neck or thoracic areas as well as in the extremities Discuss herniated intervertebral discs? - correct answer *A disk protrusion, most common after age of 30 *A flexion injury or trauma may precede the onset of symptoms *Lying w/ hips flexed provides pain relief *Major prolapse may be associated w/ bilateral wkness and bowel and bladder dysfunction Discuss spinal stenosis. - correct answer *Caused by progressive degenerative spine changes *Most common at middle age or later *Worse during the day and aggravated by standing and relieved by rest What are compression fracture most commonly associated with? Highest incidence? Causes? - correct answer Osteoporosis Have a higher incidence w/ age Kyphosis results from thoracic fx and lordosis from lumbar fracture What is ankylosing spondylitis? - correct answer An inflammatory disorder that has a genetic predisposition It is one of the spondyloarthropathies Early symptoms: low back pn and stiffness which gradually become persistent and increase in severity Injury to the rotator cuff is typically due to what? Most common in who? S/s? - correct answer Chronic impingement with degenerative changes over time Most common in persons over 40 yrs of age *S/S: anterior and lateral shoulder pain that increases w/ arm elevation and reaching overhead What are the S/S of a rotator cuff tear? - correct answer *Pain is sudden in onset and may be worse at night. Associated wkness and atrophy to surrounding structures, and limited ROM. *Crepitus with rotation What is biceps tenosynovitis? - correct answer Inflammation of the biceps tendon. Can also lead to shoulder pain. Common in athletes who do repetitive throwing motion What is the term used for a frozen shoulder? - correct answer Adhesive capsulitis What is glenohumeral instability? - correct answer Instability of the shoulder that can result in displacement of the humeral head in various directions. Most common in young pts who are physically active S/S: sudden onset of pain and pt is unwilling to move the arm What is epicondylitis? - correct answer Inflammation of the tendon/tendon insertion of the forearms. It results either in lateral elbow pain associated w/ overuse of the wrist extensors (tennis elbow) or in medial elbow pain associated w/ overuse of involving wrist flexion and rotation (golfer's elbow) What is olecranon bursitis? - correct answer The olecranon bursa lies between the loose skin and po