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Family Medicine II Aquifer Questions with 100% Actual correct answers | verified | latest update | Graded A+ | Already Passed | Complete Solution $7.99
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Family Medicine II Aquifer
Name the six signs of limb threatening injury. - ✅✅-Pain (especially disproportionate)
Pallor
Pulselessness
Paresthesia
Perishing cold
Paralysis
✅✅
What action occurs to cause a medial ankle sprain? What is normally injured? -
-Eversion; deltoid ligament
What is normally involved in a syndesmotic sprain? - ✅✅-Interosseous membrane
and anterior inferior tibiofibular ligament
Physical exam findings with syndesmotic sprain? - ✅✅-Pain and disability out of
proportion to injury; positive ankle squeeze test
What can occur with ankle inversion? - ✅✅-Lateral ankle sprain +/- peroneal tendon
tear
Physical exam finding of a peroneal tendon tear? - ✅✅-Persistent pain posterior to the
lateral malleolus
What action is impaired with an Achilles tendon rupture? - ✅✅-Plantarflexion
What acute ankle injury can result in avascular necrosis? - ✅✅-Talar dome fracture
What is the most common mechanism of ankle sprains? - ✅✅-Plantar flexion and
inversion --> impacts the lateral stabilizing ligaments
✅✅
What ankle ligament is most easily injured?
How can we assess it? - -Anterior talofibular ligament
Anterior drawer test
✅✅
What ligament can be injured with the anterior talofibular ligament?
How can we assess it? - -Calcaneofibular ligament
Inversion stress test
,What is the mechanism of a medial ankle sprain? - ✅✅-Excessive eversion and
dorsiflexion
What provides medial ankle stability? - ✅✅-Deltoid ligament, anterior tibiofibular
ligament, and bony mortise
Describe a Grade I ankle sprain. - ✅✅-Stretching and/or small tear of a ligament
Describe a Grade II ankle sprain. - ✅✅-Incomplete tear and moderate functional
impairment
✅✅-Complete tear and loss of integrity of the ligament
Describe a Grade III sprain. -
Describe the Ottawa ankle rules. - ✅✅-Pain in the malleolar zone AND either bony
tenderness along the distal 6 cm of the posterior edge of either malleolus OR inability to
bear weight 4 steps both immediately after the injury and in the ED
Describe the Ottawa foot rules. - ✅✅ -Pain in the midfoot region AND one of the
following: (a) bony tenderness at either the navicular bone or base of the fifth metatarsal
OR (b) inability to bear weight four steps immediately after the injury and in the ED
What is indicated by a painful crossed-leg test? - ✅✅-High ankle sprain (syndesmotic
injury between the tibia and fibula)
How long should one rest after an ankle sprain? - ✅✅-72 hours
What leads to a quicker return and less instability in an ankle injury? - ✅✅-Semi-rigid
ankle support
A 41-year-old male with no significant past medical history is brought to the Emergency
Department after falling to the ground in the middle of a pick-up basketball game with
friends. He did not lose consciousness nor hit his head when he fell. As he landed on
the ball of his foot after having taken a shot, he recalls hearing a popping sound
followed by immediate pain in the posterior right ankle. On physical exam, the posterior
✅✅
right ankle is edematous and tender to palpation. He is unable to plantarflex his right
foot. What is the most likely diagnosis of his current condition? - -Achilles tendon
rupture
A 19-year-old female with no significant past medical history is the driver in a motor
vehicle accident and is brought to the Emergency Department by EMS. She is
,complaining of severe pain in her right lower extremity that has worsened since the
accident. In addition, she has started to notice what she describes as "burning and
tingling" in her right foot. On physical exam, her right calf is edematous and tender with
tense overlying skin. There is no swelling or tenderness of the right foot or ankle but the
right dorsalis pedis and posterior tibial artery pulses are barely palpable. She cannot
✅✅
confirm light touch of the foot and cannot wiggle her toes on command. What is the next
best step in the management of this patient? - -Emergent surgical consultation
A 21-year-old female with no significant past medical history experienced an
inversion-type injury to her right ankle while playing soccer a day prior to presentation to
the family medicine ambulatory practice. She remembers immediate pain and swelling
but was able to weight bear and limp off the field. She has noticed some significant
swelling which is mostly still present. She has been icing the ankle since the injury as
her coach recommended. Pain is still present near the lateral malleolus. Physical
examination reveals an edematous lateral right ankle with purplish hue and intact
bilateral pulses. Sensation of the bilateral lower extremities is intact and symmetric
motor function is preserved. Palpation of the posterior edge of the lateral malleolus
elicits significant pain from the patient. There is mild tenderness to palpation of the
✅✅
anterior talofibular ligament and the calcaneofibular ligament. The anterior d -
-X-ray imaging of right ankle
A 22-year-old female with no significant past medical history experienced an
inversion-type injury to her right ankle while playing volleyball. The ankle quickly
became edematous, but she used ice and was able to bear weight on the foot. When
the patient presents at the family medicine ambulatory practice two days following her
injury, minimal swelling is noted and motor functions and sensation are preserved. She
has tenderness at the anterior lower lateral malleolus but not inferiorly or posteriorly.
You diagnose her with an ankle sprain. You recommend continued relative rest and also
tell the patient to keep it elevated and ice it several times during the day to help with the
pain and swelling. You inform the patient that immobilization and compression is good
✅✅
for the conservative management of her condition. What is the best compression device
to use in this situation? - -Semi-rigid ankle support
A 20-year-old healthy female with no significant past history presents to your clinic with
dysuria, lower abdominal discomfort, frequency, and urgency for one day. She notes an
odor to her urine but denies any change in its appearance. She reports no vaginal
discharge or fever. Review of systems is otherwise negative. The patient denies sexual
activity and reports normal menses. There are no known allergies. Her examination is
remarkable for mild suprapubic tenderness. Urinalysis: negative; urine HCG: negative.
, ✅✅
Which of the following would be the next best step in her clinical management? -
-Initiate antibiotic treatment while awaiting urine culture results
Name common signs and symptoms of hyperthyroidism. - ✅✅ -Fatigue, heat
intolerance, increased sweating, tachycardia, tremor, weight loss, and exertional
dyspnea
✅✅
Describe lid lag. - -The upper eyelid lags behind the upper edge of the iris as the
eye moves downward
What is the most common cause of goiter worldwide? - ✅✅-Lack of iodine
Describe clonus in hyperthyroidism. - ✅✅-Unstained (2-4 beats)
Diagnose: antibody that acts at the TSH receptor. - ✅✅-Toxic diffuse goiter (Graves
disease)
When does thyroiditis occur? -✅✅-After a viral illness or pregnancy
What is a normal RAIU uptake when evaluating the thyroid? - ✅✅-15-30%
What antibodies are seen in Graves disease? - ✅✅-Anti-thyrotropin receptor
antibodies (TRAb)
What is the mechanism of eye symptoms in Graves disease? - ✅✅-Corneal irritation
from eyelid retraction
✅✅
Name a side effect of methimazole (first line for Graves disease). -
-Agranulocytosis
What is the second line treatment for Graves disease? - ✅✅ -Oral dose of radioactive
iodine
(Requires less blood work; obtain pregnancy test beforehand)
What is the typical starting dose for replacement in primary hypothyroidism? - ✅✅-75
mcg --> increase slowly
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