MSN 620 musculoskeletal module 4 with correct answers

MSN 620 musculoskeletal module 4 with correct answers A 67-year-old female presents with an 18-month history of slowly worsening bilateral knee pain. She complains of moderate pain, particularly after walking or gardening. She has a past medical history of breast cancer, which was treated with primary surgery and radiotherapy 10 years ago. Her medications include letrozole and acetaminophen. The patient's body mass index (BMI) is 30 kg/m2. Examination demonstrates bilateral knee swelling and crepitus with active flexion. Lab results show white blood cell count, C- reactive protein, and erythrocyte sedimentation rate within their normal range, and rheumatoid factor is negative. The x-ray findings of each knee demonstrate joint space narrowing with several osteophytes. Which of the following is essential to prevent the progression of this patient's condition? - Correct Answer️️ -Weight reduction A 65-year-old woman is worried about her inability to perform various activities because of severe lower back pain and pain in both wrist joints. She has a body mass index of 35 kg/m². She has a history of hypertension and takes amlodipine regularly. She has been taking prescribed doses of ibuprofen for the last month but with no relief. Her clinical examination reveals tender wrist joints, palpable swelling at the base of the right thumb, mild tenderness in the lower back, and hip joint pain with movements. Her TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 2/14 lumbar spine hip joint x-ray reveals increased subchondral bone density. What is the best treatment plan for her? - Correct Answer️️ -Weight loss A 74-year-old woman presents with increasing right hip pain over the last 2 months. A review of systems reveals no history of trauma or falls and it has decreased her mobility and made her more dependent on family. Vital signs are blood pressure 130/90 mmHg, heart rate 80 bpm, and body mass index 32 kg/m2. Her physical examination reveals palpable swellings on the proximal interphalangeal joints of her hands and painful restricted movements at the hip joint. Laboratory testing reveals negative rheumatoid factor (RA) and anti-nuclear antibodies (ANA). Her plain x-ray suggests a narrowing of joint space and cartilage erosions. What is the most common hand joint involved in postmenopausal women? - Correct Answer️️ -First carpometacarpal joint A 61-year-old man with a body mass index of 31 kg/m^2 presents for a 6-month history of gradual onset right medial knee pain. Examination reveals a small effusion, stable ligaments, a normally tracking patella, and mild medial joint line tenderness. Standing radiographs show mild medial joint space narrowing. Which of the following is the most appropriate treatment at this stage of the disease? Well done! - Correct Answer️️ -Weight loss and low-impact exercises A 65-year-old woman presents to the clinic for evaluation. She has a history of chronic bilateral knee pain, which has been gradually worsening. She is currently on acetaminophen 1000 mg 3 times daily, naproxen 500 mg twice daily, and tramadol 50 TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 3/14 mg twice daily for knee pain, but these do not seem to help anymore. She has tried physical therapy and intraarticular corticosteroids without much response in the past. She has a past medical history of obesity, diabetes, and hypertension. Her other current medications include insulin and hydrochlorothiazide. Vitals are blood pressure 140/98 mm Hg and heart rate 88 bpm. Exam reveals tenderness in both knees along the medial joint line with swelling, effusion, and decreased range of motion. X-ray shows bone-on-bone and joint space narrowing in the medial compartment bilaterally, along with osteophyte formation. What is the next best step in the treatment of this patient? - Correct Answer️️ -Evaluation for knee replacement A 65-year-old man with a past medical history of hypertension presents to the medical clinic with worsening left knee pain. He has chronic pain in the left knee for 15 years that has recently increased in intensity and is associated with less than 30 minutes of morning stiffness. He participates in aquatic aerobics three times per week. His current medications are lisinopril, duloxetine, and pantoprazole. He cannot tolerate oral nonsteroidal anti-inflammatory drugs (NSAIDs). His physical examination reveals that the right knee is bulky with varus deformity, and crepitus is noted. Knee erythema, effusion, or warmth are absent. He is traveling to Europe next month for a vacation, and he would like to improve his pain in order to tolerate physical activity. What is the best therapeutic option for this patient? - Correct Answer️️ -Corticosteroid injection A 66-year-old man with a history of gastric bypass surgery, a strong f