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Module 3 - Musculoskeletal disorders

front 1

"A 65-year-old female is admitted to hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?"

back 1

The fracture line is diagonal to the shaft of the bone.

front 2

"A six-year-old male presents with fever, pain, swelling and warmth. Tests reveal osteomyelitis and development of an involucrum. Treatment should include:"

back 2

surgical debridement and antibiotics;

front 3

A 51-year-old male experiences severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?

back 3

Trauma, drugs or alcohol.

front 4

Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis)?

back 4

Admitted to the hospital for hip surgery and has had problems with anaesthesia in the past.

front 5

Fibromyalgia is a chronic musculoskeletal disorder characterised by:

back 5

"diffuse pain, fatigue and point tenderness;"

front 6

An isolated muscle is believed to be a type 1 fibre. Which of the following should be observed upon stimulation?

back 6

Slow contraction speed.

front 7

An isolated muscle is believed to be a type 2 fibre. Which of the following should be observed upon stimulation?

back 7

Fast contraction speed.

front 8

A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:

back 8

synovial membrane;

front 9

Which of the following structures is the contractile unit of a muscle cell?

back 9

Myofibril

front 10

The elbow joint is an example of:

back 10

diarthrosis

front 11

Diarthroses

back 11

freely moveable joint

front 12

Synarthroses

back 12

immovable joint

front 13

Amphiarthroses

back 13

Slightly moveable joint

front 14

Which of these structures are not present in compact bone?

back 14

Trabeculae

front 15

"The internal structure of bone is maintained by remodelling, a three-phase process in which existing bone is resorbed and new bone is laid down to replace it. Resorption is carried out by bone cells called:"

back 15

osetoclasts

front 16

"The internal structure of bone is maintained by remodelling, a three-phase process in which existing bone is resorbed and new bone is laid down to replace it. Bone building is carried out by bone cells called:"

back 16

osteoblasts

front 17

A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

back 17

decreased oestrogen levels.

front 18

A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?

back 18

Vertebral and sacroiliac

front 19

A patient will begin taking hydroxychloroquine for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient?

back 19

That an eye exam is necessary at the beginning of therapy with this drug.

front 20

A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol and colchicine. The nurse will include which statement when teaching the patient about this drug regimen?

back 20

You will take both drugs initially and then stop taking the colchicine.

front 21

"Although _____ is similar to osteomalacia, it occurs in growing bones of children."

back 21

Rickets

front 22

A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called:

back 22

epicondylitis.

front 23

A patient who has developed postmenopausal osteoporosis will begin taking alendronate. The nurse will teach this patient to take the drug:

back 23

while sitting upright with plenty of water;

front 24

The major effect of aging on the skeletal system is

back 24

loss of bone mass.

front 25

With normal weight bearing what type of fracture can occur in an abnormal bone.

back 25

Insufficiency fracture.

front 26

Myoglobinuria (rhabdomyelosis) can be a serious life threatening complication of

back 26

severe muscle trauma.

front 27

Fibromyalgia is

back 27

a chronic musculoskeltal syndrome characterised by diffuse pain and tender points.

front 28

Legg-Calve-Perthes disease is

back 28

one of the most common osteochondroses.

front 29

Legg-Calve-Perthes disease is characterised by

back 29

epiphyseal necrosis or degeneration of the head of the femur.

front 30

Muscle fibres contain

back 30

bundles of myofibrils

front 31

Myofibrils are arranged in

back 31

parallel along the longnitudinal axis of the muscle fibre.

front 32

Osteomalacia is

back 32

a metabolic bone disease.

front 33

Osteomalacia is characterised by

back 33

inadequate bone mineralisation.

front 34

Osteoarthritis is a common aged related disorder of

back 34

the synovial joints.

front 35

Osteoarthritis primary defect is a

back 35

loss of articular cartilage.

front 36

Rheumatoid arthritis is

back 36

an inflammatory joint disorder (Auto immune disease).

front 37

Rheumatoid arthritis is characterised by the destruction of

back 37

synovial membrane, articular cartilage, joint capsule, ligaments and tendons.

front 38

Bisphophonates undergo incorporation into bone by

back 38

inhibiting bone resorption by decreasing osteoclast activity.

front 39

Rhabdomyolysis is

back 39

where damaged muscle fibers break down and release myoglobin.

front 40

The most dangerous electrolyte imbalance associated with rhabdomyolysis is

back 40

hyperkalemia

front 41

The classic clinical manisfestation of rhabdomyolysis is

back 41

profound muscle weakness with pain

front 42

The key characteristic of excessive myoglobin is

back 42

dark, reddish brown urine.

front 43

Treatment for rhabdomyolysis is

back 43

IV crystalloid solutions

front 44

Sodium bicarbonate affects rhabdomyolysis by

back 44

rendering myoglobin insoluble.

front 45

Compartment syndrome is

back 45

an increase in compartment contents or compression of the compartment increases the pressure.

front 46

The most common area that compartment syndrome is found

back 46

lower legs

front 47

Most common cause of compartment syndrome is

back 47

extremity fracture.

front 48

What is FES

back 48

Fat embolism syndrome

front 49

Fat embolism syndrome is

back 49

due to a long bone fracture where a drop of fat has traveled to lungs or other organs following fracture.

front 50

Osteoporosis

back 50

is where there is more bone absorbed by the body than what is being formed. Higher risk in women as menopause accelerates bone loss.

front 51

Risk factors for osteoporosis

back 51

insufficient calcium intake

lack of weight bearing exercise

smoking

alcohol

post menopausal

female

low body weight and short in stature.

too much phosphate

use of glucocorticoids and not enough sun exposure.

front 52

Drug of choise for osteoporosis

back 52

alendronate 5 mg once daily

front 53

Strain

back 53

tear or injury to the tendon

front 54

Sprain

back 54

tear or injury to the ligament

front 55

Avulsion

back 55

Complete separation of a tendon or ligament from its bony attachment site.

front 56

Tendon attaches

back 56

bone to muscle

front 57

Ligament attaches

back 57

bone to bone

front 58

Tendinitis

back 58

inflammation of the tendon

front 59

Tendinosis

back 59

painful degradation of the collagen fibres

front 60

Bursitis

back 60

Inflammation of the bursa

front 61

Epicondylitis

back 61

inflammation of a tendon where it attaches to the bone

front 62

Teriparatide

back 62

drug that increases bone formation

front 63

Oligoarthritis

back 63

less than three joints affected

front 64

Polyarthritis

back 64

5 or more joints affected

front 65

Stills disease

back 65

has a severe systemic onset

front 66

What are the distinct modes of onset for juvenile arthritis?

back 66

Oligoarthritis

Polyarthritis

Stills disease

front 67

NSAIDs

back 67

Non steroidal anti inflammatory drugs

front 68

DMARDS

back 68

disease modifying anti rheumatic drugs (methotrexate, sulfasalazine)

front 69

Glucocorticoids

back 69

adrenal corticosteroids

front 70

Ankylosing spondylitis

back 70

chronic inflammatory joint disease characterised by stiffening and fusion of the spine and sacroiliac joints.

front 71

Methotrexate

back 71

DMARD takes 3 - 6 week to take effect can be hepatotoxic, taken once a week.

front 72

Sulfasalazine

back 72

Anti inflammatory and immunomodulatory actions, slows progression of joint deterioration and has GI side effects.

front 73

Allopurinol

back 73

reduces uric acid production (inhibits uric acid formation)

front 74

Probenecid

back 74

increases uric acid excretion

front 75

Colchicine

back 75

anti inflammatory properties does not reduce uric acid formation or excretion.

front 76

Muscular dystrophies

back 76

Group of disorders that cause degeneration of skeletal muscle fibres.

front 77

Duchennes muscular dystrophy

back 77

most common

caused by mutation in the gene located on the short arm of the x chromosome.

progressive appears by approximately 3 years of age.

no cure