Family Practice Exam Musculoskeletal 4

Question 1

A 28-year-old male presents with a painful, warm, swollen knee after a minor fall. Arthrocentesis reveals WBC 85,000/µL with 95% neutrophils. What is the most likely diagnosis?

Accepted Answer

Septic arthritis

Answer

Synovial fluid WBC >50,000/µL with neutrophil predominance is highly suggestive of septic arthritis and requires urgent treatment.

Question 2

A 55-year-old diabetic woman presents with shoulder pain and severely limited range of motion in all planes for 4 months. X-ray is normal. What is the most likely diagnosis?

Accepted Answer

Adhesive capsulitis

Answer

Adhesive capsulitis (frozen shoulder) causes global shoulder motion restriction and is more common in diabetics.

Question 3

Which of the following is the MOST appropriate initial imaging for suspected lumbar disc herniation in a patient with 6 weeks of radiculopathy?

Accepted Answer

MRI of the lumbar spine

Answer

MRI is the gold standard for evaluating lumbar disc herniation and nerve root compression.

Question 4

A 70-year-old man presents with acute onset of severe low back pain after lifting. X-ray shows a vertebral compression fracture at L2. What is the most important underlying condition to evaluate?

Accepted Answer

Osteoporosis

Answer

Vertebral compression fractures in elderly patients most commonly result from osteoporosis and warrant DEXA scanning and fracture risk assessment.

Question 5

A 45-year-old female presents with diffuse musculoskeletal pain, fatigue, sleep disturbance, and multiple tender points for >3 months. Labs and imaging are normal. What is the first-line pharmacologic treatment?

Accepted Answer

Duloxetine or pregabalin

Answer

FDA-approved treatments for fibromyalgia include duloxetine, milnacipran, and pregabalin; opioids and steroids are not recommended.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Musculoskeletal 4