NR 509 APEA EXAM – ORTHO
Question:
A tool for assessing risk factors for osteoporotic fractures is the:
... [Show More]
DEXA.
FRAX:Correct
BRCA1.
HAARM:Incorrect
Explanation:
The FRAX calculator generates fracture risk based on age, body mass index, parental fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and Asian women in the USA and has calculators that are country and continent specific. Duel energy x-ray absorptiometry, DEXA, is the optimal standard for measuring bone density. BRAC1 is a gene that can mutate and increase the risk of breast cancer. HAARM is the melanoma risk model.
Question:
Anserine bursitis arises from:
excessive running:Correct
excessive kneeling:Incorrect
arthritis.
trauma
Explanation:
Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A popliteal or “baker’s” cyst arises from distention of the gastrocnemius semimembranous bursa from underlying arthritis or trauma.
Question:
When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) Stress Test?
Pain in the lateral joint line: Correct
Pain in the medial joint line:Incorrect
Pain in the anterior joint line
A click along the medial joint line.
Explanation:
The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one hand on the medial side of the knee and one hand on the ankle, an adduction force is gently applied. If pain is noted in the lateral joint line, this could be indicative of a lateral collateral ligament tear. When tenderness extends more to the proximal or distal joint line, the collateral ligament may be the cause of pain instead of the meniscus.
Question:
When assessing the knee, the examiner instructs the patient to straighten his knee. This motion would assess knee:
flexion.extension:Correct
internal rotation.
external rotation.
Explanation:
Having the patient straighten his leg assesses extension of the knee. The examiner instructs the patient to bend his knee. This maneuver assesses knee flexion. Internal rotation of the knee could be elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to swing his leg away from his midline while sitting assesses external rotation of the knee.
Question:
When performing an examination of a tender left finger on an adult, the surrounding tissue reveals warmth, edema, and redness. This finding could be suggestive of:
carcinoma.
muscular atrophy.
Synovitis:Incorrect
gouty arthritis:Correct
Explanation:
Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis infection, or possibly rheumatoid arthritis.
Question:
An example of a fibrous joint would be the:
vertebral bodies of the spine.
Skull:Correct
Shoulder:Incorrect
pubic symphysis of the pelvis.
Explanation:
The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints.
Question:
To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the:
lateral joint line of the knee.
on either side of the patella.
upper edge of the tibial plateau:Correct
top of the patella.
Explanation:
To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the lateral joint line by placing the patient's knee in slight flexion. To palpate the tibiofemoral joint, face the patient's knee and place the thumbs in the soft-tissue depressions on either side of the patellar tendon.
Question:
A patient complains of a sharp burning pain in the neck and right arm with associated paresthesias and weakness. These symptoms may be associated with:
mechanical neck pain.
mechanical neck pain with whiplash.
cervical radiculopathy:Correct
cervical myelopathy.
Explanation:
With cervical radiculopathy, nerve root compression is the etiology. Symptoms may include sharp burning or tingling pain in the neck and one arm with associated paresthesias. Mechanical neck pain is described as aching pain in the cervical paraspinal muscles and ligaments with associated muscle spasm and stiffness and tightness in the upper back and shoulder, lasting up to 6 weeks. In patients with mechanical neck pain with whiplash, the paracervical pain and stiffness begins the day after injury and may be accompanied by occipital headaches, dizziness, and malaise. In cervical myelopathy, cervical cord compression, the neck pain is associated with bilateral weakness and paresthesias in both upper and lower extremities.
Question:
A patient complains of lateral hip pain while pointing near the trochanter. This type of pain could be suggestive of:
Sciatica: Incorrect
radicular pain.
polyarticular arthritis.
Bursitis:Correct
Explanation:
Lateral hip pain near the greater trochanter suggests trochanteric bursitis. Sciatica symptoms usually include a shooting pain below the knee, commonly in the lateral leg or posterior calf and accompanied by low back pain. Radicular pain refers to pain that radiates along the dermatome of a nerve due to inflammation or irritation of a nerve root, as with sciatica pain. Polyarticular arthritis refers to arthritis involving several joints.
Question:
The muscle of the scapulohumeral group that crosses the glenohumeral joint posteriorly and inserts on the greater tubercle is known as the:
infraspinatus muscle: Correct
pectoralis major.
subscapularis muscle: Incorrect [Show Less]