FITZGERALD TEST MSK

Dietary recommendations for a person with gouty arthritis include avoiding foods high in: artificial flavors and colors purine vitamin C protein

purine

To help prevent meniscal tear, you advise: limiting participation in sports quadriceps strengthening exercises using a knee brace applying ice to the knees before exercise

quadriceps strengthening exercises

Risk factors for ankle sprain include all of the following except: poor conditioning running on paved surfaces inappropriate footwear lack of warm up period prior to exercising

running on paved surfaces

Approximately what percent of patients with radiological findings of OA of the knee will report having symptoms? 25 50 70 95

50

Which of the following patients with acute gouty arthritis is the best candidate for local corticosteroid injection? 66 yo with gastric ulcer 44 yo taking thiazides 68 yo with T2DM 32 yo binge drinker

66 yo with gastric ulcer

Up to what percent of patients with medial epicondylitis recover without surgery? 35% 50% 70% 95%

95%

Changes to the joint during OA can typically include all of the following except: widening of joint space articular cartilage wears away formation of bone spurs synovial membrane thickens

widening of joint space

Deformity of the PIP in an elderly patient with OA is known as: Heberden nodes Bouchard nodes Hallus valgus Dupuytren contracture

Bouchard nodes

Common symptoms of a patient with sarcoidosos include all of the following except: arthralgia DOE blurred vision cardiac palpitation

Cardiac palpitation

Drug classes used in the treatment of fibromyalgia include all of the following except: TCA antiepileptics SSRI opioids

opiods

Xray findings of OA of the knee often reveal: microfractures decreased density of subchondral bone osteophytes no apparent change to joint

osteophytes

Pseudogout has been linked with abnormal activity of the: liver kidney parathyroid adrenal gland

parathyroid

When discussing physical activity with a 40 yo woman with fibromyalgia, you advise that:

physical activity aimed at increasing flexibility is an important part of treatment

Which of the following medication is approved for pain management in fibromyalgia?

pregabalin

Extracorporeal shock wave therapy can be used in the treatment of epicondylitis as a means to: improve ROM build forearm strength promote the natural healing process stretch the extensor tendon

promote the natural healing process

A 36 yo man has shoulder pain with tendonitis for the past 4 months despite NSAIDs and PT. An appropriate next step would include: systemic steroids shoulder XR shoulder MRI upper arm sling

shoulder MRI

The most common locations for tophi include all of the following except auricles elbows extensor surface of hands shoulders

shoulders

Likely sequelae of intrabursal corticosteroid injection include: irreversible skin atrophy infection inflammatory reaction soreness at site of injection

soreness at site of injection

To confirm results of a McMurray test you ask the patient to squat walk flex knee rotate ankle

squat

The use of all of the following medications can trigger gout except: ASA statins diuretics niacin

statins

Patients with olecranon bursitis typically present with: swelling and redness over affected area limited elbow ROM nerve impingement destruction of the joint space

swelling and redness over affected area

The primary treatment option for sarcoidosis is the use of: parental methotrexate systemic corticosteroids oral acetaminophen oral hydroxychloroquine

systemic corticosteroids

Complications of Achilles tendonitis include: tendong rupture neurological sequelae stress freacture bursitis

tendon rupture

You see a 42 yo woman recently diagnosed with sarcoidosis. She is reluctant to because of severe adverse effects experienced previously. you consider prescribing: hydroxychloroquine tofacitinib infliximab asathioprine

tofacitinib

The most common type of injury causing a sport related meniscal tear involves twisting of the knee hyperextension of the knee repetitive hard impact on the knee an unknown origin in most cases

twisting of the knee

Clinical findings of the knee in OA include all of the following except: coarse crepitus joint effusion warm joint knee often locks up or pops

warm joint

Risk factors for medial epicondylitis include playing: tennis golf baseball volleyball

golf

Risk factors for lateral epicondylitis include all of the following except: repetitive lifting playing tennis hammering gout

gout

The most common site of sprain is the: wrist shoulder ankle knee

ankle

Secondary gout can be caused by all of the following conditions except: psoriasis hemolytic anemia bacterial cellulitis renal failure

bacterial cellulitis

The most common cause of acute bursitis is: inactivity joint overuse fibromyalgia bacterial infection

joint overuse

What presentation is inconsistent with fibromyalgia?

joint swelling

Differentiation between gout and pseudogout can involve all of the following diagnostic approaches except: blood mineral analysis joint fluid analysis joint xray thyroid function

joint xray

A short leg cast is often needed for what type of ankle sprain? grade I grade II grade III grade IV

grade III

A diagnosis of fibromyalgia requires detecting at least how many tender points?

11

For a grade I ankle sprain, weight bearing should be avoided for at least: 24 hours 72 hours 1 week until full ROM is restored

24 hours

A risk factor for sarcoidosis is: male gender African American race age older than 60 T2DM

African American

A grade III ankle sprain is best described as: minor swelling and minimal joint instability moderate joint instability without swelling or bruising moderate swelling, mild to moderate bruising, and moderate joint instability complete ankle instability, significant swelling, and moderate to severe bruising

Complete ankle instability, significant swelling, and moderate to severe bruising

Which of the following joints is most likely to be affected by OA? wrists elbows MCP DIP

DIP

Which of the following statements about tendonitis is false? It is usually an overuse injury It is a result of macroscopic or partial tear of the tendon Acute pain results when firm pressure is applied to the tendong Signs of tendonitis include redued ROM caused by stiffness and discomfort

It is the result of macroscopic or partial tear of the tendon

First line treatment options of bursitis usually include: corticosteroid injection heat to area weight bearing exercise NSAID

NSAID

Evaluation for disease progression in a patient with sarcoidosos can involve: PFT and CO tests skin biopsy Check for WBCs in urine Phalen test

PFT and CO tests

Clinical conditions with a presentation similar to acute bursitis include: (select all that apply) RA septic arthritis joint trauma pseudogout

RA septic arthritis joint trauma pseudogout

Fibromyalgia is more common in patients with:

RA and SLE

Fibromyalgia is caused by:

a largely unknown mechanism

Treatment of pseudogout includes all of the following except: NSAIDs colchicine allopurinol oral corticosteroids

allopurinol

Which of the following diagnostic approaches is used to confirm a sarcoidosis diagnosis? chest XR CT scan biopsy ANA fluorescent staining

biopsy

Activities that commonly contribute to the development of rotator cuff tendonitits include all of the following except: swimming throwing a football bowling pitching a baseball

bowling

Which of the following dietary supplements is associated with increased risk for gout? vitamin A gingko biloba brewers yeast glucosamine

brewers yeast

First line therapy of prepatellar bursitis should include: bursal aspiration intrabursal corticosteroid injection acetaminophen knee splinting

bursal aspiration

Which of the following is often found with rotator cuff tendonitis? OA tendon rupture bursitis joint effusion

bursitis

Pseudogout is caused by the formation of what type of crystals in joints? uric acid calcium oxalate struvite calcium pyrophosphate dihydrate

calcium pyrophosphate dihydrate

When examining the patient with fibromyalgia, tender points:

can wax and wane throughout the day

With initial presentation, the diagnosis of tendonitis is usually made from: clinical presentation plain XR CT scan laboratory diagnosis

clinical presentation

Patients with fibromyalgia should be encouraged to do all of the following except

consider adopting a high intensity aerobic activity such as jogging

Initial treatment of lateral epicondylitis includes all of the following except: rest and activity modification corticosteroid injection topical or oral NSAIDs counterforce bracing

corticosteroid injection

Patients with medial epicondylitis typically present with: forearm numbness reduction in ROM pain on elbow flexion decreased grip strength

decreased grip strength

Patients with lateral epicondylitis typically present with: electric like pain elicited by tapping over the median nerve reduced joint ROM pain that is worst with elbow flexion decreased hand grip strength

decreased hand grip strength

Analgesics used in the management of fibromyalgia include all of the following except: acetaminophen NSAIDs fentanyl patches topical capsaicin

fentanyl patches

The clinical presentation of acute gouty arthritis affecting the base of the great toe includes: slow onset of discomfort over many days greatest swelling and pain along the median aspect of the joint improvement of symptoms with joint rest fever

greatest swelling and pain along the median aspect of the joint

A laboratory finding commonly observed in patients with sarcoidosis is: hyponatremia hypercalcemia hypokalemia hyperkalemia

hypercalcemia

First line therapy for biceps tendonitis usually includes: ice local steroid injection orthopedic referral nerve block

ice

Diagnosis of fibromyalgia involves

identifying multiple tender points throughout the body

Which of the following best describes the presentation of a patient with complete meniscal tearing? joint effusion heat over knee inability to kneel loss of smooth joint movement

inability to kneel

Patients with gluteus medius or deep trochanteric bursitis typically present with: increased pain from resisted hip abduction limited hip ROM sciatic nerve pain heat over affected area

increased pain from resisted hip abduction

The most helpful diagnostic test to perform during acute gouty arthritis is: ESR serum uric acid joint aspirate analysis XR

joint aspirate analysis

Initial treatment for meniscal tear includes all of the following except: NSAID use applying ice to affected area elevation of limb joint aspiration of affected knee

joint aspiration of the affected knee

Which of the following is not usually prat of sprain treatment? immobilization applying ice to area joint rest local steroid injection

local steroid injection

Patients with subscapular bursitis typically present with: limited shoulder ROM heat over affected area localized tenderness under the superomedial angle of the scapula cervical nerve root irritation

localized tenderness under the superomedial angle of the scapula

Patients with a grade III ankle sprain should be advised that full recovery is likely to take: a few days 2 to 3 weeks 4 to 6 weeks many months

many months

A grade II ankle sprain is best described as: minor swelling and minimal joint instability moderate joint instability without swelling or bruising moderate swelling, mild to moderate bruising, and moderate joint instability complete ankle instability, significant swelling, and moderate to severe bruising

moderate swelling, mild to moderate bruising, and moderate joint instability

All of the following are common symptoms of wrist tendonitis except: muscle cramping reduced ROM swelling of the wrist muscle weakness

muscle cramping

First line treatment for acute gouty arthritis usually includes: ASA naproxen allopurinol probenecid

naproxen

Tophi are best described as: ulcerations originating on swollen joints swollen lymph nodes abscesses with draining pus nontender, firm nodules in soft tissue

nontender, firm nodule located in soft tissue