MSN-FNP Musculoskeletal Disorders Exam Questions with Correct Answers

MSN-FNP Musculoskeletal Disorders Exam Questions with Correct Answers A 42 yo male who plays basketball on the weekends has medial knee pain after landing on the extremity and pivoting sideways to pass. He felt a "pop" and experienced swelling a few minutes later. He has pain with walking. He denies any instability but does feel like it is "catching" with knee flexion. On exam, he has joint effusion, his Lachman's is negative, and he has no pain with patella mobility. What is his most likely injury? A. Anterior cruciate ligament B. Meniscal injury C. Tibial plateau fracture D. Osgood-Schlatter disease - ANSWER B. Meniscal injury A 33 yo female with PMH of DM c/o of pain in her wrist. The pain is located along the radial side of the wrist and has been occurring for a long time. She feels a reduced sensation along the radial side of her hand with occasional numbness and tingling. In addition, she also feels an occasional temperature change in her hand that she describes as a "cool feeling." She does not know exactly when the pain started and cannot recall any trauma or injury to the site. V/S are normal. Exam reveals a well-circumscribed, subcutaneous, soft, mobile wrist mass that is non-tender to palpitation and transilluminates with lighting. The patient has trouble gripping objects. What is the most likely diagnosis? A. Lipoma B. Ganglion cyst C. Radial artery aneurysm D. Osteosarcoma - ANSWER B. Ganglion cyst Explanation: A ganglion cyst is a cystic swelling typically found on the dorsal side of the wrist. These cyst are thought to arise from herniation of synovial tissue from a joint capsule or tendon sheath. They present with chronic wrist pain and may be accompanied by coolness of the hand, numbness/tingling, and possible parethesias. The mass itself is mobile, may be tender to palpation, and transilluminates. (A) Limpoma is a benign tumor of fat that can occur on the hand. Lipomas are soft to the touch and mobile. Unlike Ganglion cyst, lipomas typically do not cause hand symptoms and are not well circumscribed. They do not transilluminate either. (C) Radial artery aneurysms are dilations of the radial artery that extend into the hand. While there is no history of trauma, they present as pulsatile masses without any pain and do not transilluminate either. (D) Osteosarcoma are cancerous tumors occurring in the bone. While they occur typically on the shoulders, elbows, and knees, they can occur in the hand as well. Unlike ganglion cyst, they are not well-circumscribed and are fixed rather than mobile. Gymnast's wrist is associated with which of the following conditions? A. Osteochondritis dissecans of capitellum B. Apophyseal avulsion fracture of the humeral epicondyle C. Subluxation of the radial head D. Injury to the distal radial physis - ANSWER D. Injury to the distal radial physis Explanation: A gymnast wrist refers to injury to the distal radial physis, occurring as a result of repetitive stresses due to weight bearing on the upper extremities. (A) (B) Osteochondritis dissecans of the capitellum and apophyseal avulsion fracture of the medial humeral epicondyle are associated with Leaguer's elbow. (C) Subluxation of the radial head is associated with nursemaids elbow.