Rosh LTC MSK exam questions with complete solutions A 73 -year-old woman with a past medical history of osteoporosis, degenerative disc disease, and knee pain presents with a chief complaint of worsening dyspnea and recent falls. Upon physical examination you notice an excessive curve of her thoracic spine a long with forward -head posture. What is the most likely diagnosis? ✔️✔️Spinal kyphosis A 65 -year-old woman presents to your office to follow up on her recent osteoporosis screening. Her dual -energy X -ray absorptiometry scan results reveal a diagnosis of osteoporosis. Which of the following is the most appropriate therapy? ✔️✔️Alendronate A 67 -year-old woman has a bone mineral density T -score of -2.8 standard deviations. Which of the following is the most likely diagnosis? ✔️✔️Osteoporosis Which of the following biomarkers is the most specific for rheumatoid arthritis? ✔️✔️Anti-
cyclic citrullinated peptide antibodies In which setting is allopurinol contraindicated for the treatment of gout? ✔️✔️Acute attack of gout A 63 -year-old man with hypertension and dyslipidemia presents with pain and swelling of his left great toe. He denies trauma or fever. Examination reveals an exquisitely tender and swollen first metatarsophalangeal joint on his left foot. Arthrocentesis yi elds fluid, as shown above. What is the first -line therapy for this patient? ✔️✔️Ibuprofen Which of the following causes secondary osteoporosis in women? ✔️✔️Corticosteroid use A 73 -year-old woman with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and chronic systolic heart failure presents to the clinic complaining of acute onset of pain in her first metatarsophalangeal joint. She denies recent trauma. Her medications include metoprolol succinate, atorvastatin, aspirin, lisinopril, furosemide and potassium. Which of the following medications is most likely contributing to her acute joint pain? ✔️✔️Furosemide A 57 -year-old man presents to the emergency room after awakening with severe pain in his left big toe. He ate at steakhouse and had several bottles of beer the night before. He has a past medical history of chronic kidney disease. His latest creatinine cle arance was 25 mL/min. Joint aspiration reveals negatively birefringent crystals. Which of the following is the most appropriate treatment? ✔️✔️Prednisone A 42 -year-old man presents with foot complaints. Last night, he was awakened with severe pain in his right great toe. He denies a history of recent injury. Examination reveals significant edema and erythema of the first metatarsophalangeal joint. The overl ying skin is intact but warm. Range
cyclic citrullinated peptide antibodies In which setting is allopurinol contraindicated for the treatment of gout? ✔️✔️Acute attack of gout A 63 -year-old man with hypertension and dyslipidemia presents with pain and swelling of his left great toe. He denies trauma or fever. Examination reveals an exquisitely tender and swollen first metatarsophalangeal joint on his left foot. Arthrocentesis yi elds fluid, as shown above. What is the first -line therapy for this patient? ✔️✔️Ibuprofen Which of the following causes secondary osteoporosis in women? ✔️✔️Corticosteroid use A 73 -year-old woman with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and chronic systolic heart failure presents to the clinic complaining of acute onset of pain in her first metatarsophalangeal joint. She denies recent trauma. Her medications include metoprolol succinate, atorvastatin, aspirin, lisinopril, furosemide and potassium. Which of the following medications is most likely contributing to her acute joint pain? ✔️✔️Furosemide A 57 -year-old man presents to the emergency room after awakening with severe pain in his left big toe. He ate at steakhouse and had several bottles of beer the night before. He has a past medical history of chronic kidney disease. His latest creatinine cle arance was 25 mL/min. Joint aspiration reveals negatively birefringent crystals. Which of the following is the most appropriate treatment? ✔️✔️Prednisone A 42 -year-old man presents with foot complaints. Last night, he was awakened with severe pain in his right great toe. He denies a history of recent injury. Examination reveals significant edema and erythema of the first metatarsophalangeal joint. The overl ying skin is intact but warm. Range
