Musculoskeletal 1 The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37

Welcome to episode 37of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue tocover topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. Click here to download my interactive content blueprint checklist This week we will be covering 10 topic specific Musculoskeletalboard review questions. The Musculoskeletal Systemaccounts for 10% of your PANCE/PANRE board exam. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary boardreview includes over 72 GUspecific questions andis available to all members of the PANCE and PANRE Academy. You can download and listen to past FREE episodes here,oniTunes, Google Play andStitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. MusculoskeletalPANCE and PANREPodcast Quiz AUDIO PANCE AND PANRE MUSCULOSKELETAL Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Congratulations - you have completed AUDIO PANCE AND PANRE MUSCULOSKELETAL. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1Abduction of the shoulder against resistance helps localize pain in which of the following muscles of the shoulder girdle? ASupraspinatus BInfraspinatus Hint: Lateral rotation against resistance tests the infraspinatus and teres minor. CTeres minorHint: See B for explanation.DSubscapularisHint: Medial rotation against resistance tests the subscapularis.Question 1 Explanation: Abduction against resistance tests the supraspinatus.Question 2A 22 year-old male presents to the ED after sustaining a blow to the knee during football practice. The knee exam demonstrates significant forward translation of the tibia when the knee is in 15 degrees of flexion and external rotation at the hip. Which of the following knee maneuvers does this represent?AAbduction stress test Hint: The abduction stress test is performed to evaluate medial collateral ligament tears while applying valgus stress.BAnterior drawer sign Hint: The anterior drawer sign is performed to evaluate the anterior cruciate ligament; however, the patient is supine, CLachman testDMcMurray testHint: The McMurray test is performed to evaluate medial and la teral meniscal tears while rotating the lower leg internally and externally.Question 2 Explanation: The Lachman test is performed to evaluate the anterior cruciate ligament. The knee is placed in 15 degrees of flexion and external rotation of the hip.Question 3A 12 year-old female presents for a routine sports physical. The physical exam reveals asymmetry of the posterior chest wall on forward bending. This is the most striking and consistent abnormality of which of the following?ASpondylolysis Hint: Spondylolysis presents with limitation of lumbar flexibility and tight hamstring muscles. BspondylolisthesisHint: Spondylolisthesis presents with reduced lumbar lordosis and sacral kyphosis.CScoliosisDHerniated discHint: Herniated disc presents with lumbar muscle spasm and a positive straight leg test.Question 3 Explanation: Asymmetry of the posterior chest wall on forward bending is the most striking and consistent abnormality in patients with idiopathic scoliosis.Question 4Physical ex am findings in a 4 year-old child that include blue sclera and recurrent fractures indicates which of the followingAEhlers-Danlos syndrome Hint: Physical exam findings in Ehlers-Danlos include laxity and hypermobility of joints, mitral valve prolapse, and associated degenerative arthritis.BMarfan syndromeHint: Children with Marfan syndrome have hypotonia, arachnodactyly, joint laxity and dislocations.CAchondroplasiaHint: Children with achondroplasia are below normal standards on growth charts. They have difficulty balancing their large heads when beginning to walk.DOsteogenesis imperfectaQuestion 4 Explanation: Mild osteogenesis imperfecta presents with blue sclera, history of recurrent fractures and presenile deafness.Question 5A 65 year-old female presents to the office with a six-month history of back pain. The patient states that she is shrinking and thinks she is about an inch shorter than she was a year ago. Serum parathyroid hormone, calcium, phosphorus, and alkaline phosphat ase are all normal. Which of the following would you most likely see on the x-ray of her spine?ARadiolucent lesionsHint: Paget's disease of bone presents with bone pain, kyphosis, bowed tibias, large head, and deafness. The initial lesions are destructive and radiolucent. Paget's disease has a normal serum calcium and phosphate, but the serum alkaline phosphatase is elevated.BDemineralizationCChondrocalcinosisHint: Chondrocalcinosis is the presence of calcium-containing salts in articular cartilage and is commonly seen in hyperparathyroidism, diabetes, hypothyroidism, and gout.DSubperiosteal resorptionHint: Hyperparathyroidism is frequently asymptomatic. Serum parathyroid hormone and serum calcium are elevated. X-ray findings include demineralization, subperiosteal resorption of bone especially in the radial aspects of the fingers.Question 5 Explanation: Osteoporosis presents with varying degrees of back pain and loss of height is common. The serum calcium, parathyroid hormone, phos phorus, and alkaline phosphatase are normal. X- ray findings demonstrate demineralization in the spine and pelvis.Question 6In a trauma patient who has a suspected cervical spine injury, the x-ray view that will identify the majority of significant injuries isAlateralBobliqueHint: The oblique view is usually not included in the initial set of x-rays taken. Bilateral supine oblique is a view that may be ordered if all seven cervical vertebrae are not seen on the lateral view.CanteroposteriorHint: Anteroposterior view shows DodontoidHint: The odontoid view reveals 10% of significant injuries.Question 6 Explanation: The lateral view shows 70-80% of significant injuries. It is important to visualize all seven cervical vertebrae and the upper margin of T1 to avoid missing possible pathology.Question 7A 38-year-old male sustained a fracture of the left distal tibia following a 25-foot fall and is taken to the operating room for an open reduction internal fixation of the distal tibia. Sixt een hours post-op, the patient develops sustained pain, which is not relieved with narcotics. On passive range of motion of the toes the patient "yells" in agony. The patient also states that the top of his foot has decreased sensation. On physical examination the physician assistant notes that the leg is swollen and the foot is cool to touch. Based upon this information what diagnostic testing should be done?AX-ray of the lower leg and ankleHint: X-rays of the lower leg and ankle will only determine bone placement.BDoppler studiesHint: Doppler studies will confirm the presence of a decreased pulse.CBone scanHint: A bone scan is not indicated in the evaluation of compartment syndrome.DCompartment pressureQuestion 7 Explanation: Compartmental pressures should be obtained as soon as possible. If they are elevated this is a surgical emergency.Question 8A 32 year-old male presents with an acute onset of pain and swelling to his left ankle. On physical exam the ankle is warm, swollen and erythematous. Evaluation of the synovial fluid reveals only leukocytosis with a low glucose. Which of the following is the most likely diagnosis?AGoutHint: Gout and pseudogout are excluded by the failure to find crystals on synovial fluid analysis. BPseudogoutHint: See A for explanation.CAcute rheumatic fever Hint: Acute rheumatic fever commonly involves multiple joints.DSeptic arthritisQuestion 8 Explanation: Leukocytosis and a low synovial glucose are indicative of septic arthritis.Question 9A 32-year-old male presents with migratory arthralgias and profound malaise and fatigue. He states that one week ago he returned from a hunting trip in Pennsylvania. He is also complaining of a lesion on his left thigh that he noticed about 3 days ago. Physical exam reveals a large annular lesion with a bright red outer border and partial central clearing. Which of the following is the most likely diagnosis?ARheumatoid arthritisHint: Rheumatoid arthritis is a symmetrical arthritis that common ly affects the proximal interphalangeal and metacarpophalangeal joints. It is not associated with the rash of erythema migrans.BKawasaki diseaseHint: Kawasaki disease is an acute febrile, multisystem disease of children. It is characterized by unresponsiveness to antibiotics, nonsuppurative cervical adenitis, and changes in the skin and mucous membranes such as edema, erythema of the lips and palms, and desquamation of the skin of the fingertips.CLyme diseaseDNongonococcal arthritisHint: Nongonococcal arthritis occurs in patients with an underlying predisposition such as rheumatoid arthritis. The common presentation is involvement of a single jointQuestion 9 Explanation: After an incubation period of 3 to 32 days, erythema migrans develops at the site of the tick bite. Within days or weeks after the onset of erythema migrans the patients develop a severe headache, mild stiffness of the neck, migratory musculoskeletal pain, arthralgias and profound malaise and fatigue.Question 10A 22 year-old male presents with pain along the medial tibia. The pain initially began towards the end of soccer practice but now it is present earlier on. Physical exam reveals pain to palpation over the posterior tibialis muscle body. What is the most likely diagnosis?AShin splintBStress fractureHint: See A for explanation.COsgood-Schlatter diseaseHint: Osgood-Schlatter disease is an injury occurring at the insertion of the patellar tendon on the tibial tuberosity in a younger age group.DPatellofemoral pain syndromeHint: Patellofemoral pain syndrome is the most common cause of chronic anterior knee pain, more commonly seen in females.Question 10 Explanation: Shin splints cause pain over the posterior tibialis muscle body as opposed to discrete pain over the tibia with a stress fracture.Question 11A patient who demonstrates pain on the radial aspect of the wrist with abrupt ulnar movements while the thumb is flexed into the closed palm most likely hasAcarpal tunnel syndromeHint: Carpal tunnel is diagnosed by a positive Tinel's or Phalen's maneuver.Bradial tunnel syndromeHint: Radial syndrome is demonstrated by simultaneously extending the patient's wrists and fingers while the examiner passively flexes the patient's long finger, which causes pain.CtenosynovitisDgamekeeper's thumbHint: Gamekeeper's thumb is the most common injury to the metacarpophalangeal collateral ligaments, causing a sprain.Question 11 Explanation: Tenosynovitis is diagnosed using Finkelstein maneuver. The patient's thumb is placed in the palm of the hand and the wrist is abruptly deviated to the ulnar aspect of the wrist, causing pain on the radial aspect. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 11 questions to complete. List Return Shaded items are complete. 1234567891011End Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Not bad!Good work!Perfect! Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joiningThe PANCE and PANRE Exam Academy. I will bereleasing new episodes every few weeks. The Academy isdiscounted, so sign up now. Resources and Show Notes: My list of recommended PANCE and PANRE review books USE CODE PALIFE TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE This Podcast is also available on iTunes and Stitcher Radio for Android iTunes:The Audio PANCE AND PANRE Podcast iTunes Google Play: The Audio PANCE and PANRE Podcast Google Play Stitcher Radio:The Audio PANCE and PANRE Podcast Stitcher document.createElement('audio'); http://traffic.libsyn.com/pasquini/Episode_37_-_Musculoskeletal_1_-_The_Audio_PANCE_and_PANRE_Board_Review_Podcast_Topic_Specific_Review.mp3Podcast: Download () | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | Stitcher | RSS | PANCE and PANRE Podcast PlayerView all posts in this seriesThe Audio PANCE and PANRE Board Review Podcast Episode 1The Audio PANCE and PANRE Board Review Podcast Episode 3The Audio PANCE and PANRE Board Review Podcast Episode 5The Audio PANCE and PANRE Board Review Podcast Episode 7The Audio PANCE and PANRE Board Review Podcast Episode 9The Audio PANCE and PANRE Board Review Podcast Episode 11The Audio PANCE and PANRE Board Review Podcast Episode 13The Audio PANCE and PANRE Board Review Podcast Episode 15The Audio PANCE and PANRE Board Review Podcast Episode 17The Audio PANCE and PANRE Board Review Podcast Episode 19The Audio PANCE and PANRE Board Review Podcast Episode 21The Audio PANCE and PANRE Board Review Podcast Episode 23The Audio P ANCE and PANRE Board Review Podcast Episode 25Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Reproductive System 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 39Episode 41: The Audio PANCE and PANRE Board Review PodcastEpisode 43: The Audio PANCE and PANRE Board Review PodcastMurmur Madness: The Audio PANCE and PANRE Episode 45Episode 47: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 49: The Audio PANCE and PANRE Board Review Podcast Comprehen sive Audio QuizEpisode 51: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 53: General Surgery End of Rotation Exam The Audio PANCE and PANRE PodcastEpisode 55: The Audio PANCE and PANRE Board Review PodcastEpisode 57: The Audio PANCE and PANRE Board Review PodcastEpisode 59: Emergency Medicine EOR The Audio PANCE and PANRE Board Review PodcastEpisode 61: The Audio PANCE and PANRE Board Review PodcastEpisode 63: The Audio PANCE and PANRE PA Board Review PodcastPodcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-CPodcast Episode 67: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 69: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 71: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 73: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 77: The Audio PANCE and PANRE Board Review Podcast You may also like -Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Welcome to episode 35of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue tocover topic specific PANCE and PANRE review from the Academy course content following the NCCPA content []EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Welcome to episode 33of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue tocover topic specific PANCE and PANRE review from the Academy course content following the NCCPA content []Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Welcome to episode 29of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes, I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA []