NP Test 5: Musculoskeletal explores common conditions and treatments related to the musculoskeletal system. Topics include bursitis causes, symptoms, and first-line treatments, focusing on real-world applications and diagnostic skills relevant for healthcare professionals.
Cauda equina syndrome
Muscular spasm
Vertebral fracture
Sciatic nerve involvement
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Inactivity
Joint overuse
Fibromyalgia
Bacterial infection
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Slow onset of discomfort over many days
Greatest swelling and pain along the median border of the joint.
Improvement of symptoms with joint rest
Fever
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Reproduction of symptoms with forced flexion of the wrists
Abnormal tingling when the median nerve is tapped
Pain on internal rotation
Palmar atrophy
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NSAIDs
Applying ice
Elevation
Joint aspiration
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Anemia of chronic disease
Elevated CRP level
Narrowing of the joint space on radiograph
Elevated antinuclear antibody (ANA) test
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Straight-leg raising should be avoided
Heat should be applied to painful joints after exercise
Quadriceps-strengthening exercises should be performed
Physical activity should be avoided
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Worst symptoms in weight-bearing joints later in the day
Symmetrical early-morning stiffness
Sausage-shaped digits with characteristic skin lesions
Back pain with rest and anterior uveitis
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Irreversible skin atrophy
Infection
Inflammatory reaction
Soreness at the site of injection
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Rheumatoid arthritis
OA
Reiter syndrome
Gouty arthritis
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Limiting participation in sports
Quadriceps-strengthening exercises
Using a knee brace
Applying ice to the knee before exercise
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Reproduction of symptoms with forced flexion of the wrists
Abnormal tingling when the median nerve is tapped.
Pain on internal rotation
Palmar atrophy
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Intra-articular injection
Joint splinting
Systemic corticosteroids
Referral for surgery
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L1 and L2
L3 and L4
L5 and S1
S2 and S3
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Direct irritative effect
Slowing GI motility
Thinning of the protective gastric mucosa
Enhancing prostaglandin synthesis
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Elevated levels of rheumatoid factor
Abnormally high ESR
Depressed total white blood cell count
Positive ANA titer
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Corticosteroid bursal injection
Heat to area
Weight-bearing exercises
NSAIDS
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A 28-year-old man with and ankle sprain who has taken ibuprofen for the past week and who drinks four to six beers each weekend
A 40-year-old woman who smokes and takes about 6 doses of naproxen sodium per month to control dysmenorrhea
A 43-year-old man with dilated cardiomyopathy who uses ketoprofen 1-2 times weekly for low back pain
A 72-year-old man who takes aspirin 4 times a day for control of OA
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Joint erosions are often evident on radiographs or MRI
RA is seldom associated with other autoimmune diseases
A butterfly-shaped facial rash is common
Parvovirus B19 infection can contribute to its development
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Systemic lupus erythematosus
Vasculitis
Sjogren syndrome
Scleroderma
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Lumbosacral radiograph series
ESR measurement
MRI
Bone scan
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L1 to L2 and L2 to L3
L2 to L3 and L4 to L5
L4 to L5 and L5 to S1
L5 to S1 and S1 to S2
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Thiazide diuretic use
Female gender
Rheumatoid arthritis
Joint trauma
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Worst symptoms in weight-bearing joints later in the day
Symmetrical early morning stiffness
Sausage-shaped digits with associated skin lesions
Back pain with rest and anterior uveitis
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Spurling
McMurray
Lachman
Newman
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Swelling and redness over the affected area
Limited elbow ROM
Nerve impingement
Destruction of the joint space
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Repetitive lifting
Playing tennis
Hammering
Gout
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Heberden nodes
Bouchard nodes
Hallus valgus
Dupuytren contracture
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Dilated eye retinal exam
Bone marrow biopsy
Pulmonary fx test
Exercise tolerance test
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L3
L4
L5
S1
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Limited shoulder ROM
Heat over affected area
Localized tenderness under the superomedial angle of the scapula
Cervical nerve root involvement
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Joint effusion
Heat over the knee
Inability to kneel
Loss of smooth joint movement
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An acute precipitating event
Disk herniation
Muscle or ligamentous strain
Nerve impingement
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L3
L4
L5
S1
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L1 to L2
L3 to L4
L5 to S1
S2 to S3
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Initial therapy with an NSAID, then adding other meds as directed by clinical response
Early use of disease-modifying antirheumatic drugs (DMARDs) to slow or halt joint damage
Pain relief as the chief therapeutic goal
Recognizing that joint splinting is seldom advisable
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Tennis
Golf
Baseball
Volleyball
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More common in women at a 3:1 ratio
Family history of rheumatoid disease often reported by patient
Peak age for disease onset in individuals age 50 to 70 years
Wrists, ankles, and toes often involved
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Increased pain from resisted hip abduction
Limited hip ROM
Sciatic nerve pain
Heat over the affected area
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Screening for thyroid dysfunction
Treatment of OA
Stretching and toning exercises
Wrist splinting
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You should not exercise until you are free of pain
Back-strengthening exercises may cause mild muscle soreness
Electric-like pain is to be expected
Conditioning exercises should be started immediately
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Aspirin
Naproxen sodium
Allopurinol
Probenecid
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A 66-year-old patient with a gastric ulcer
A 44-year-old patient taking a thiazide diuretic
A 68-year-old patient with type 2 diabetes
A 32-year-old patient who is a binge drinker
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Wrists
Elbows
Metacarpophalangeal joint
Distal interphalangeal joint
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Acetaminophen
Naproxen
Celecoxib
Intra-articular corticosteroid injection
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Antimicrobial therapy
Corticosteroid therapy
Antirheumatic medications
Immunosuppressive drugs
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Inflammatory response
Pain transmission
Maintenance of gastric protective mucosal layer
Renal arteriole function
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Inflammatory response
Pain transmission
Maintenance of the gastric protective mucosal layer
Renal arteriole constriction
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