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* 17 18 19 20
 #139390  
  angioplasty - 11/17/06 15:05
 
  17. A 20-year-old man comes to the health center because of ankle pain. Two days ago he sustained an inversion injury of his left ankle in a basketball game. He has been able to walk unassisted since the injury. Today he has pain and moderate swelling and discoloration over the lateral malleolus. Physical examination shows tenderness on palpation over the anterolateral corner of the ankle joint. He has had two similar injuries in the past. Which of the following is the most appropriate initial management?

A

) An ankle-strengthening exercise program

B
C

) Application of a short-leg cast for 3 weeks

D

) Protected weight bearing

E

) Surgical repair of the ankle ligaments



18. A 52-year-old woman comes to the office because of a 4-day history of increasing pain of the right hip and thigh. The pain is exacerbated by lying on her right side while sleeping. She says the pain often awakens her and is accompanied by a burning sensation along the right side of her posterior thigh that radiates to her knee. She usually has stiffness and pain in the hip during the following morning that gradually diminishes as she walks around her house and does house chores. She says the pain is also triggered by sitting with her right leg crossed over the left leg. The patient is otherwise healthy and takes no medications. She is 168 cm (5 ft 6 in) tall and weighs 63 kg (140 lb); BMI is 23 kg/m2. Vital signs are normal. Physical examination discloses tenderness on deep palpation of the right trochanter. Which of the following is the most likely diagnosis?

A

) Arthritis of the hip

B

) Aseptic necrosis of the femoral head

C

) Bursitis

D

) Gout

E

) Osteosarcoma of the femoral head




19. An 18-year-old man comes to the health center because he has had pain in his right leg for the past 5 days. He says that he recently added jogging to his weight-lifting workouts, and he started running 5 miles per day 2 weeks ago. He is 180 cm (5 ft 11 in) tall and weighs 83 kg (185 lb). On physical examination he has moderate tenderness over the midtibia. X-ray of the leg will most likely show which of the following?

A

) A bone cyst

B

) Displaced fracture

C

) Metastatic disease

D
) Soft-tissue calcification

E

) Normal findings




20. A 58-year-old woman comes to the office for follow-up of fibromyalgia. You had been treating her for the past several years for nonspecific muscular aches and pains. In the past you noted that occasionally the pain could be reproduced on physical examination by applying pressure to certain muscles; however, these trigger points seemed to change on each physical examination. Fibromyalgia was diagnosed 3 months ago and amitriptyline therapy was started at that time. At a follow-up visit 3 weeks ago she showed little response to the amitriptyline therapy, and naproxen was added to her regimen. Today she returns to the office complaining that "every time I get the least little bump on my hands the skin seems to tear." Her physical examination is unchanged except for the lesions shown. Which of the following is the most appropriate management?

A

) Discontinue the amitriptyline

B

) Discontinue the naproxen

C

) Prescribe oral corticosteroids

D

) Prescribe topical corticosteroids

E

) Prescribe topical 5-fluorouracil




) Application of a long-leg cast for 3 weeks
 
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* Re:17 18 19 20
#562750
  pk007 - 11/17/06 15:35
 
  17) D
18) C
19) E
20) B???????....................... NO IDEA AT ALL.....JUST GUESSING
 
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* Re:17 18 19 20
#562921
  tea - 11/17/06 17:19
 
  d
a
e
d
 
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* Re:17 18 19 20
#562988
  anand11anupa - 11/17/06 18:20
 
  a
a
d osgood schlatter disease overuse apphysitis of tibial tubercle
d although ideal would have been reassurance and TENS therapy
 
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* Re:17 18 19 20
#563106
  pedres - 11/17/06 20:08
 
  C - LIGAMENT SPRAIN
?
E - STRESS FRACTURE -HAIRLINE FRACTURE
B- DISCONTINUE NAPROXEN
 
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* Re:17 18 19 20
#563175
  humerus - 11/17/06 21:30
 
  c
c
e
b
 
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* Re:17 18 19 20
#563180
  knock_knock - 11/17/06 21:38
 
  17) The Rx of uncomplicated ankle sprain is rest and not exercise. Cast not applied in general as it will cause stiffness. Protected wt bearing is used to treat LL fractures. Given the options, I will go with: D

18) C. No f/o nerve irritation in arthritis alone.

19) E

20) B. Some NSAIDS are notorious for rash: Naproxen being one.
 
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