NP Musculoskeletal Disorders Exam – 150
Questions, Answers And Rationale | Fully
Solved Test Bank (Latest 2025 Update)
1. A 65-year-old woman presents with gradual-onset knee pain that
worsens with activity and improves with rest. Which is the most
likely diagnosis?
Osteoarthritis
Osteoarthritis commonly presents in older adults with activity-
related joint pain, stiffness, and decreased range of motion. Pain
typically improves with rest.
2. A 24-year-old male presents with low back pain that improves
with exercise but worsens with rest. He also has stiffness in the
morning lasting 45 minutes. Which condition is most likely?
Ankylosing spondylitis
Ankylosing spondylitis typically affects young adults, with
inflammatory back pain improving with activity and morning
stiffness >30 minutes.
3. A patient has joint swelling, morning stiffness >1 hour, and
symmetrical joint involvement. Labs reveal positive RF and anti-
CCP antibodies. The most likely diagnosis is:
Rheumatoid arthritis
Rheumatoid arthritis presents with symmetrical polyarthritis,
prolonged morning stiffness, and seropositivity for RF and anti-
CCP.
4. Which imaging modality is most sensitive for detecting early
osteonecrosis of the hip?
MRI
, MRI is the most sensitive method for early detection of avascular
necrosis before radiographs show changes.
5. A 45-year-old male develops acute onset severe pain, redness,
and swelling of the first metatarsophalangeal joint. Lab results
show elevated serum uric acid. Diagnosis?
Gout
Gout often presents as acute monoarticular arthritis, typically
affecting the big toe, with hyperuricemia.
6. Which medication is first-line for acute gout attacks?
NSAIDs
NSAIDs are first-line therapy for acute gout due to rapid anti-
inflammatory effects.
7. A 30-year-old female reports fatigue, joint pain, and a malar rash.
Labs show ANA positivity. Most likely diagnosis?
Systemic lupus erythematosus
SLE is characterized by systemic symptoms, joint involvement,
malar rash, and ANA positivity.
8. Which lab is most specific for diagnosing SLE?
Anti-dsDNA antibody
Anti-dsDNA antibodies are highly specific for SLE and correlate
with disease activity.
9. Which joint is most commonly affected in osteoarthritis?
Knee
The knee, hip, and distal interphalangeal joints are most
commonly affected by OA.
10. A patient presents with sudden back pain after lifting a
heavy object. Straight leg raise is positive. Most likely diagnosis?
Lumbar herniated disc
, Herniated discs often present with acute low back pain radiating
down the leg with positive straight leg raise due to nerve root
compression.
11. Which test helps diagnose carpal tunnel syndrome?
Phalen’s test
Phalen’s test involves wrist flexion to reproduce symptoms and is
a common clinical test for carpal tunnel syndrome.
12. A 60-year-old man presents with bone pain, decreased
height, and kyphosis. Which condition is most likely?
Osteoporosis
Osteoporosis causes decreased bone mass, increasing fracture
risk, leading to height loss and kyphosis.
13. First-line pharmacologic therapy for osteoporosis in
postmenopausal women is:
Bisphosphonates
Bisphosphonates inhibit bone resorption, reduce fracture risk,
and are first-line for postmenopausal osteoporosis.
14. Which lab finding is characteristic of polymyalgia
rheumatica?
Elevated ESR
PMR presents with proximal muscle pain and stiffness, typically
with markedly elevated ESR.
15. A 35-year-old man presents with heel pain worse in the
morning, improved with activity, and associated with plantar
fascia tenderness. Diagnosis?
Plantar fasciitis
Plantar fasciitis causes heel pain, often worse in the morning,
due to inflammation of the plantar fascia.
Questions, Answers And Rationale | Fully
Solved Test Bank (Latest 2025 Update)
1. A 65-year-old woman presents with gradual-onset knee pain that
worsens with activity and improves with rest. Which is the most
likely diagnosis?
Osteoarthritis
Osteoarthritis commonly presents in older adults with activity-
related joint pain, stiffness, and decreased range of motion. Pain
typically improves with rest.
2. A 24-year-old male presents with low back pain that improves
with exercise but worsens with rest. He also has stiffness in the
morning lasting 45 minutes. Which condition is most likely?
Ankylosing spondylitis
Ankylosing spondylitis typically affects young adults, with
inflammatory back pain improving with activity and morning
stiffness >30 minutes.
3. A patient has joint swelling, morning stiffness >1 hour, and
symmetrical joint involvement. Labs reveal positive RF and anti-
CCP antibodies. The most likely diagnosis is:
Rheumatoid arthritis
Rheumatoid arthritis presents with symmetrical polyarthritis,
prolonged morning stiffness, and seropositivity for RF and anti-
CCP.
4. Which imaging modality is most sensitive for detecting early
osteonecrosis of the hip?
MRI
, MRI is the most sensitive method for early detection of avascular
necrosis before radiographs show changes.
5. A 45-year-old male develops acute onset severe pain, redness,
and swelling of the first metatarsophalangeal joint. Lab results
show elevated serum uric acid. Diagnosis?
Gout
Gout often presents as acute monoarticular arthritis, typically
affecting the big toe, with hyperuricemia.
6. Which medication is first-line for acute gout attacks?
NSAIDs
NSAIDs are first-line therapy for acute gout due to rapid anti-
inflammatory effects.
7. A 30-year-old female reports fatigue, joint pain, and a malar rash.
Labs show ANA positivity. Most likely diagnosis?
Systemic lupus erythematosus
SLE is characterized by systemic symptoms, joint involvement,
malar rash, and ANA positivity.
8. Which lab is most specific for diagnosing SLE?
Anti-dsDNA antibody
Anti-dsDNA antibodies are highly specific for SLE and correlate
with disease activity.
9. Which joint is most commonly affected in osteoarthritis?
Knee
The knee, hip, and distal interphalangeal joints are most
commonly affected by OA.
10. A patient presents with sudden back pain after lifting a
heavy object. Straight leg raise is positive. Most likely diagnosis?
Lumbar herniated disc
, Herniated discs often present with acute low back pain radiating
down the leg with positive straight leg raise due to nerve root
compression.
11. Which test helps diagnose carpal tunnel syndrome?
Phalen’s test
Phalen’s test involves wrist flexion to reproduce symptoms and is
a common clinical test for carpal tunnel syndrome.
12. A 60-year-old man presents with bone pain, decreased
height, and kyphosis. Which condition is most likely?
Osteoporosis
Osteoporosis causes decreased bone mass, increasing fracture
risk, leading to height loss and kyphosis.
13. First-line pharmacologic therapy for osteoporosis in
postmenopausal women is:
Bisphosphonates
Bisphosphonates inhibit bone resorption, reduce fracture risk,
and are first-line for postmenopausal osteoporosis.
14. Which lab finding is characteristic of polymyalgia
rheumatica?
Elevated ESR
PMR presents with proximal muscle pain and stiffness, typically
with markedly elevated ESR.
15. A 35-year-old man presents with heel pain worse in the
morning, improved with activity, and associated with plantar
fascia tenderness. Diagnosis?
Plantar fasciitis
Plantar fasciitis causes heel pain, often worse in the morning,
due to inflammation of the plantar fascia.
