Physician Assistant Physician Assistant Musculoskeletal System Disorders 2 — Questions and Answers
Question 1: A 16-year-old male presents with knee pain after a twisting injury during basketball. Exam shows a positive Lachman test and anterior drawer sign. What structure is most likely injured?
- Posterior cruciate ligament
- Medial collateral ligament
- Anterior cruciate ligament (Correct answer)
- Lateral meniscus
Correct answer: Anterior cruciate ligament
The Lachman test and anterior drawer sign both assess anterior tibial translation and are positive with anterior cruciate ligament (ACL) tears.
Question 2: Carpal tunnel syndrome results from compression of which nerve?
- Ulnar nerve
- Radial nerve
- Median nerve (Correct answer)
- Musculocutaneous nerve
Correct answer: Median nerve
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel, causing numbness and tingling in the thumb, index, middle, and radial half of the ring finger.
Question 3: Which of the following is the most appropriate initial imaging study for a patient with suspected osteoporosis?
- Plain X-ray of the spine
- CT scan of the lumbar spine
- DEXA scan (Correct answer)
- MRI of the hip
Correct answer: DEXA scan
DEXA (dual-energy X-ray absorptiometry) scan is the gold standard for measuring bone mineral density and diagnosing osteoporosis.
Question 4: A patient presents with pain and swelling over the lateral epicondyle of the elbow, worsened by wrist extension and gripping. What is the most likely diagnosis?
- Medial epicondylitis
- Lateral epicondylitis (tennis elbow) (Correct answer)
- Olecranon bursitis
- Radial tunnel syndrome
Correct answer: Lateral epicondylitis (tennis elbow)
Lateral epicondylitis (tennis elbow) involves overuse of the forearm extensor muscles, causing pain at the lateral epicondyle worsened by wrist extension and gripping.
Question 5: A T-score of -2.8 on DEXA scan indicates which diagnosis according to WHO criteria?
- Normal bone density
- Osteopenia
- Osteoporosis (Correct answer)
- Severe osteoporosis with fracture
Correct answer: Osteoporosis
A T-score of -2.5 or below indicates osteoporosis per WHO criteria; a T-score between -1.0 and -2.5 indicates osteopenia.
Question 6: Which sign is used to diagnose De Quervain tenosynovitis?
- Phalen sign
- Finkelstein test (Correct answer)
- Tinel sign
- McMurray test
Correct answer: Finkelstein test
The Finkelstein test, where ulnar deviation of the wrist with the thumb enclosed in the fist reproduces pain over the radial styloid, is used to diagnose De Quervain tenosynovitis.
Physician Assistant Physician Assistant Musculoskeletal System Disorders 2
A 16-year-old male presents with knee pain after a twisting injury during basketball.
Exam shows a positive Lachman test and anterior drawer sign.
What structure is most likely injured?