Deck 9: Musculoskeletal Diseases and Disorders

Question 1

A postmenopausal woman slips while stepping off a curb, falls, and cracks her pelvic bone. During diagnosis, the primary care provider begins to consider the possibility of osteoporosis.
a. What are the symptoms of osteoporosis
b. What diagnostic procedures would the primary care provider order to verify the diagnosis of osteoporosis
c. If the diagnosis is verified, what treatment will be initiated
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Answer 1

a)
Osteoporosis is defined as disorder of bones that occurs when there is loss of bone mass density and materials like calcium and minerals. It gets so weak and fragile that it can fracture easily.
Osteoporosis generally does not show any symptom until any fracture occurs. So it is also called silent disease. Some common symptoms of osteoporosis that occur are severe back pain, frequent fracture, height loss and stooped posture or kyphosis.
b)
Diagnosis : The health care provider provides a physical examination along with personal and family history. In order to verify osteoporosis, he will get a series of x-ray done and perform a bone density check. Some other test likes as blood and urine test may be done to check the level of calcium, vitamin D, parathyroid hormones and testosterone and biochemical tests for certain bone resorption markers.
c)
The treatment for osteoporosis varies from person to person due to many factors like severity of the condition or bone density, age, gender, and medical history of the patient. It includes medication treatment along with life style changes to improve the bone density. In case of severe fracture, surgery is recommended. In the present case, woman is postmenopausal. Surgery cannot be done. Local heat and physical therapy especially warm water therapy would be beneficial. Non-steroidal anti-inflammatory drugs (NSAIDs) should be prescribed. Along with these, a balanced diet rich in calcium and vitamin D should be advised.
Calcium and vitamin D supplements enriched with calcium (1000mg) and vitamin D should be taken daily to improve the bone density.

Question 2

Place a checkmark next to the correct answer:
Fibromyalgia is
____________a. An acute condition common in men.
____________b. Progressive bilateral wasting of skeletal muscles.
____________c. Accompanied by pain, fatigue, and inability to sleep well.
____________d. Diagnosed by muscle biopsy.
____________e. All of the above.

Answer 2

Fibromyalgia refers to a chronic condition which is characterized by muscle and joint pain, fatigue, and inability to sleep well. It is more common in women than men.
Hence, the correct option is c.
Fibromyalgia is a chronic condition more common in women. Thus, option "a" is incorrect.
Progressive bilateral wasting of skeletal muscles is a characteristic of Duchenne muscular dystrophy. Lack of protein dystrophin results in muscle degeneration that causes muscular weakness, and tiredness. Thus, option "b" is incorrect.
Fibromyalgia is diagnosed by physical therapy Muscle biopsy is not required. Thus, option "d" is incorrect.
Option "c" is correct as it shows the characteristic of Fibromyalgia. All the other options are wrong with respect to Fibromyalgia. Thus, option "e" is incorrect.

Question 3

Name and define five types of fractures:
a.
b.
c.
d.
e.

Answer 3

The following are the types of fractures:
a. Closed simple fracture
b. Open or compound fracture
c. Simple fracture
d. Impacted fracture
e. Incomplete partial fracture
a. Closed simple fracture
A fracture in the bone without external wounds on the skin is known as closed simple fracture.
b. Compound fracture
A fracture in the bone and the ends of broken bone tear the skin through which bone and skin is exposed is known as compound fracture.
c. Simple fracture
A break in the bone without breaking the overlying skin and damage to the tissue is known as simple fracture.
d. Impacted fracture
A break in the bone to one end forced by the other is known as impacted fracture.
e. Comminuted fracture
A fracture in the bone and crushed into two pieces is known as comminuted fracture.

Question 4

True/False Circle the correct answer:
T F Lordosis is also known as humpback.

Question 5

Compare and contrast bursitis and tendonitis.
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Question 6

Place a checkmark next to the correct answer:
Myasthenia gravis is
____________a. A failure in transmission of muscle impulses at the neuromuscular junction.
____________b. A condition in which there is too much acetylcholine released at the junction.
____________c. Diagnosed by muscle biopsy.
____________d. Easily cured and prevented.
____________e. Only b and c above.

Question 7

What is the difference between a sprain and a strain
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Question 8

True/False Circle the correct answer:
T F Osteomyelitis involves both the bone marrow cavity and the bone itself.

Question 9

Place a checkmark next to the correct answer:
Carpal tunnel syndrome
____________a. Is a syndrome that compresses the lateral nerve in the wrist.
____________b. Is inflammation of the tendon sheaths passing through the carpal tunnel.
____________c. Has a poor prognosis.
____________d. All of the above.
____________e. Only b and c above.

Question 10

True/False Circle the correct answer:
T F Plantar fasciitis is a condition of pain in the palms.

Question 11

Place a checkmark next to the correct answer:
____________A chronic, progressive disease of connective tissue characterized by edema, inflammation, and degeneration of skeletal muscles is
____________a. Systemic lupus erythematosus.
____________b. Myasthenia gravis.
____________c. Rheumatoid arthritis.
____________d. Polymyositis.
____________e. Osteoporosis.

Question 12

True/False Circle the correct answer:
T F Paget disease is also called osteitis deformans.

Question 13

Place a checkmark next to the correct answer:
Systemic lupus erythematous
____________a. Affects women more than men.
____________b. Is likely an autoimmune response.
____________c. Often causes a characteristic "butterfly rash."
____________d. May be worsened by stress, pregnancy, or immunizations.
____________e. All of the above.

Question 14

True/False Circle the correct answer:
T F Osteoarthritis is an acute degeneration and deterioration of joint cartilage.

Question 15

True/False Circle the correct answer:
T F Rheumatoid arthritis is a chronic, systemic inflammatory disease affecting synovial membranes of multiple joints.

Question 16

True/False Circle the correct answer:
T F Gouty arthritis is a metabolic disease affecting more men than women.

Question 17

Leon Best, a mail carrier in the middle of his daily 5-mile delivery route, suddenly experiences excruciating pain in his great left toe. As soon as his route is done, he calls his primary care provider.
What are some possible diagnoses

Question 18

Dennis had been a surgical nurse for 20 years, working 8-hour shifts in his local hospital. Some shifts found Dennis on his feet for close to 5 hours before there was any break and the opportunity to sit down. After suffering from a great deal of foot and heel pain, Dennis consulted a specialist, who diagnosed plantar fasciitis.
What might the treatment plan be for Dennis

Question 19

Thirty-five-year-old Donna Duckworth is learning how to care for her newborn of 5 weeks, when she bends over the baby's crib and feels something give in her back. The next day and the following week, the pain becomes unbearable in her back. She is breast feeding and does not want to take any medication, so she lives with the intense and continuing pain. Within a few weeks, she can no longer stand it, so she goes to see her primary care provider, who orders blood work, does a complete physical, and as a result sends her to an orthopedist who takes x-rays and does a bone density test. The diagnosis comes back as "severe idiopathic osteoporosis." She has fractured three of her lumbar and four of her cervical vertebra.
What is unusual about this diagnosis at this time

Question 20

Match each of the following definitions with its correct term:

Question 21

Leon Best, a mail carrier in the middle of his daily 5-mile delivery route, suddenly experiences excruciating pain in his great left toe. As soon as his route is done, he calls his primary care provider.
What additional information might the primary care provider look for in making a diagnosis

Question 22

Dennis had been a surgical nurse for 20 years, working 8-hour shifts in his local hospital. Some shifts found Dennis on his feet for close to 5 hours before there was any break and the opportunity to sit down. After suffering from a great deal of foot and heel pain, Dennis consulted a specialist, who diagnosed plantar fasciitis.
Will Dennis be able to continue his chosen profession Explain your response.

Question 23

Thirty-five-year-old Donna Duckworth is learning how to care for her newborn of 5 weeks, when she bends over the baby's crib and feels something give in her back. The next day and the following week, the pain becomes unbearable in her back. She is breast feeding and does not want to take any medication, so she lives with the intense and continuing pain. Within a few weeks, she can no longer stand it, so she goes to see her primary care provider, who orders blood work, does a complete physical, and as a result sends her to an orthopedist who takes x-rays and does a bone density test. The diagnosis comes back as "severe idiopathic osteoporosis." She has fractured three of her lumbar and four of her cervical vertebra.
What will Donna's future hold What is the prognosis

Question 24

Leon Best, a mail carrier in the middle of his daily 5-mile delivery route, suddenly experiences excruciating pain in his great left toe. As soon as his route is done, he calls his primary care provider.
Is Leon's profession connected with his complaint Explain.

Question 25

Thirty-five-year-old Donna Duckworth is learning how to care for her newborn of 5 weeks, when she bends over the baby's crib and feels something give in her back. The next day and the following week, the pain becomes unbearable in her back. She is breast feeding and does not want to take any medication, so she lives with the intense and continuing pain. Within a few weeks, she can no longer stand it, so she goes to see her primary care provider, who orders blood work, does a complete physical, and as a result sends her to an orthopedist who takes x-rays and does a bone density test. The diagnosis comes back as "severe idiopathic osteoporosis." She has fractured three of her lumbar and four of her cervical vertebra.
As a health-care practitioner, what teaching tips would you offer Donna