Family Practice Exam Musculoskeletal 2

Question 1

A 55-year-old woman presents with bilateral knee pain worsened by activity and relieved by rest. X-ray shows joint space narrowing and osteophytes. What is the most likely diagnosis?

Accepted Answer

Osteoarthritis

Answer

Osteoarthritis is characterized by joint space narrowing, osteophytes, and pain worsened with activity in older patients.

Question 2

A 30-year-old male athlete presents with anterior knee pain worsened by climbing stairs and prolonged sitting. There is pain on palpation of the patellar tendon. What is the most likely diagnosis?

Accepted Answer

Patellar tendinopathy

Answer

Patellar tendinopathy (jumper's knee) causes tenderness at the patellar tendon, common in jumping athletes.

Question 3

Which finding on physical exam is most specific for a lateral collateral ligament (LCL) injury of the knee?

Accepted Answer

Varus stress test laxity at 30°

Answer

Varus stress testing at 30° of knee flexion assesses the lateral collateral ligament specifically.

Question 4

A 70-year-old man presents with acute monoarthritis of the first MTP joint. Arthrocentesis shows negatively birefringent, needle-shaped crystals. What is the treatment of choice for acute flare?

Accepted Answer

Indomethacin or colchicine

Answer

Acute gout flares are treated with NSAIDs (e.g., indomethacin), colchicine, or corticosteroids.

Question 5

A 45-year-old woman has morning stiffness >1 hour, symmetric small joint swelling, and elevated RF and anti-CCP antibodies. Which medication is considered a first-line DMARD?

Accepted Answer

Methotrexate

Answer

Methotrexate is the anchor DMARD for rheumatoid arthritis and is typically the first agent initiated.

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Family Practice Exam Musculoskeletal 2