18 Oct Which laboratory test result is diagnostic for hypoglycemia?

Which laboratory test result is diagnostic for hypoglycemia?

 

A1c 7.0%

 

Fasting blood sugar of 75 mg/dL

 

Glucose level 43 mg/dL Random glucose level 64 mg/dL

 

Which of the following statements concerning the musculoskeletal examination is true?

 

The uninvolved side should be examined initially and then compared to the involved side.

 

 The part of the body that is causing the patient pain should be examined first.

 

When possible, the patient should not be asked to perform active ROM exercises to avoid causing pain.

 

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

 

Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout.

 

 Which of the following should the clinician expect in the initial test results for this patient?

 

Elevated uric acid level Elevated blood urea nitrogen

 

Decreased urine pH

 

Decreased C-reactive protein

 

Felice is a 64-year-old female who complains that walking and prolonged standing causes pain and weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on the shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which of the following diagnoses is most likely?

 

Multiple sclerosis

 

Herniated lumbar disc

 

Lumbar spinal stenosis Cervical spondylosis

 

Which of the following tests is considered the gold standard for definitively diagnosing osteoporosis?

 

 Bone alkaline phosphatase levels

 

Urinary N-telopeptide assay

 

Bone mass density measurement by densitometry Magnetic resonance imaging

 

Which blood test would confirm a diagnosis of diabetes mellitus?

 

A1c 5.5%

 

Fasting plasma glucose level of 120 mg/dL

 

Oral glucose tolerance test 250 mg/dL (2-hour level) Random plasma glucose level 175 mg/dL

 

Fred has been diagnosed with a trigger finger of the ring finger. Which of the following management strategies is appropriate?

 

Surgical removal of the tendon sheath

 

NSAIDs

 

Local anesthetic injection into the tendon sheath

 

 Splinting

 

The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as:

 

Apprehension sign Bulge sign

 

Thumb sign

 

Lachman sign

 

Chris is a 28-year-old male who complains of lower back pain that began 3 days ago. The pain is worse when he stands or bends, and it is somewhat relieved when he sits. The clinician performs the straight-leg raise test and it is negative. Plain film x-ray is positive. Which diagnosis is most likely?

 

Osteoarthritis

 

Spinal stenosis

 

 Scoliosis

 

 Muscle strain

 

The clinician should question the patient with suspected gout about use of which of these medications?

 

Antihypertensives

 

Thiazide diuretics Cardiac glycosides

 

Potassium supplements

 

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

 

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

 

Hyperalbuminemia

 

Morning stiffness Weight gain

 

A nondiabetic patient has idiopathic hypoglycemia. Which dietary instruction should the clinician share with the patient?

 

Follow a low-protein, high-carbohydrate diet

 

Allow caffeine at each meal

 

Avoid nuts and seeds

 

Eat six small meals a day

 

Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?

 

Allen’s test

 

Phalen’s test Tinel’s sign

 

Finkelstein’s test

 

Which of the following is a common sign of type 2 DM? Anorexia

 

 Recurrent yeast infection Fluid overload

 

Elevated high-density lipoprotein cholesterol

 

Which of the following is essential for diagnosing thyroid cancer?

 

Fine needle aspiration biopsy Thyroid ultrasound

 

Computed tomography scan

 

Magnetic resonance imaging

 

After 6 months of Synthroid therapy, the clinician should expect which result in the repeat thyroid-stimulating hormone studies?

 

Elevated

 

Normal Low

 

Undetectable

 

How often should the clinician examine the feet of a person with diabetes?

 

Every year

 

Every 6 months

 

Every 3 months

 

Every visit

 

Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

 

Morning stiffness and limited mobility of the lumbar spine

 

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

 

 Fever, chills, and elevated erythrocyte sedimentation rate

 

Pathologic fractures, severe night pain, weight loss, and fatigue

 

Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening 1 week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

 

Ecchymosis, edema, and erythema over the lateral epicondyle

 

Pain at the elbow that radiates into the forearm and pain and weakness with gripping objects

 

 Inability to supinate and pronate the arm

 

Inability to flex or extend the elbow against resistance

 

A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which condition that the patient also has would be a contraindication to taking metformin?

 

Ulcerative colitis

 

Inflammatory bowel disease

 

Chronic obstructive pulmonary disease

 

Renal disease  

 

Connie is a 63-year-old seamstress who presents with pain at the base of her right thumb on abduction and extension of her right thumb. She also complains of pain on the radial side of her right wrist with lifting. Which of these diagnostic tests will help to determine if she has de Quervain’s tenosynovitis?

 

Allen’s test

 

Phalen’s maneuver

 

Tinel’s sign

 

Finkelstein’s test

 

The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate teaching has been effective?

 

“I’ll take my pill before breakfast.”

 

 “I know to take my Glucotrol at bedtime.”

 

“It is important to take my medication right after I eat.”

 

“Since I only like to eat two meals a day, I can take the pill between my meals.”

 

A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes.

 

Which test should be ordered next?

 

Serum calcium

 

Thyroid-stimulating hormone Electrolytes

 

Urine specific gravity

 

 Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

 

Gastrocnemius weakness

 

A reduced or absent ankle reflex

 

Numbness in the lateral foot

 

Saddle area anesthesia  

 

The clinician suspects a patient has Addison’s disease. Which clinical manifestation would the clinician observe upon a physical examination?

 

Moon face

 

Central obesity

 

Hyperpigmentation

 

Myxedema coma

 

After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

 

Suggest the patient use a heating pad to improve circulation.

 

Refer to a podiatrist for a foot-care treatment plan. Send the patient for acupuncture treatments.

 

Recommend increased intake of vitamin B12.

 

 The clinician sees a patient who has a body mass index (BMI) of 32.4 kg/m2. How would the clinician classify this patient?

 

Overweight

 

Obesity Class 1

 

Obesity Class 2

 

Obesity Class 1

 

Obesity Class 3

 

 Which of the following statements concerning fibromyalgia is true?

 

Muscle pain that is caused by the development of trigger points within the muscle cannot occur concurrently with fibromyalgia.

 

A cause of myalgia can be fibromyalgia.

 

Bursitis cannot coexist with pain from fibromyalgia.

 

Fibromyalgia is an inflammatory musculoskeletal disorder.

 

A cause of myalgia can be fibromyalgia.

 

You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM but cannot move it above gravity. Which numeric grade of muscle strength would you give this patient?

 

1

 

2

 

3

 

4

 

A clinician is examining a vertebral fracture, and the examination and diagnostic findings have shown a compression of the anterior column that includes both endplates. What type and subtype are these?

 

Compression fracture, type A Burst fracture, type B

 

Seat-belt type injury, level two

 

Fracture-dislocation, shear

 

A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which condition should be included in the differential diagnosis?

 

Peripheral vascular disease

 

Pheochromocytoma Cushing’s disease

 

Acromegaly

 

Willow is a post- menopausal female and her bone mineral density is more than 1 SD below the young adult reference mean. What is her diagnosis?

 

Normal bone mineral density

 

Osteopenia Osteoporosis

 

Severe osteoporosis

 

 A male patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first?

 

Administer glucagon subcutaneously.

 

Have him drink 4 ounces of juice. Call 911.

 

Ask him about his usual eating habits.

 

Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

 

Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

 

People with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

 

People with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

 

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

 

Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

 

 You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

 

Articular

 

 Inflammatory

 

Nonarticular

 

Noninflammatory

 

What is the recommended daily calcium intake for a 60 year old male?

 

500 mg/day

 

750 mg/day

 

1,000 mg/day

 

 1,500 mg/day

 

A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment?

 

No treatment at this time

 

Diet and exercise

 

Diet, exercise, and metformin

 

 Diet, exercise, and metformin

 

Diet, exercise, and exogenous insulin

 

The patient with type 1 diabetes is exhibiting Kussmaul respirations, anorexia, fatigue, and increased thirst. Which condition is occurring?

 

Hypoglycemia

 

Somogyi effect

 

Diabetic ketoacidosis

 

 Hyperosmolar hyperglycemic syndrome

 

 The patient has metabolic syndrome. The patient is at increased risk for which condition?

 

Anxiety disorder

 

Gallbladder disease

 

Diabetes mellitus Hyperparathyroidism

 

Which of the following is a risk factor for overuse syndrome with tendonitis?

 

Body mass index <18

 

Hypothyroidism

 

 Rheumatoid arthritis Cardiac disease