Which treatments may be used to manage bone pain in patients with bone tumors? Select all that apply. a. Bisphosphonates b. Exercise c. External beam radiation d. Massage e. Vertebralplasty Bisphosphonates can decrease pain by preventing growth and development of existing and new bone lesions. Exercise is useful to maintain function and reduce pain. External beam radiation is useful in the majority of patients. Vertebralplasty involves injecting bone cement to stabilize bone. Massage is not recommended.
Which laboratory tests may help distinguish systemic lupus erythematosus (SLE) from other systemic rheumatologic disorders? a. Antinuclear antibody titer b. C-reactive protein c. Rheumatoid factor d. Serum complement levels With SLE, complement levels may decrease because of the activation and deposition of immune complexes in tissues. The other tests are non-specific tests for inflammation and rheumatologic disorders
A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this disorder? Select all that apply. a. Anti-nuclear antibody b. Electromyography c. Erythrocyte sedimentation rate d. Nerve conduction studies e. Plain radiographs While diagnosis may be made on history and physical findings, electromyography and nerve conduction studies can be helpful to confirm or exclude carpal tunnel syndrome. ANA and ESR testing is useful when rheumatoid arthritis is suspected. Plain radiographs are not useful. REF: Diagnostics/Carpal Tunnel Syndrome
A 40-year-old woman reports pain at the thumb base in one hand radiating to the distal radius. The provider learns that the woman knits for a hobby and is able to elicit the pain by asking the patient to pour water from a pitcher. Which condition is suspected in this patient? a. Carpal tunnel syndrome b. Palmar fibrosis c. Tenosynovitis d. Trigger finger Tenosynovitis causes pain as described and occurs more in women between 30 and 59 years who engage in activities requiring excessive repetitive motions, such as knitting. Carpal tunnel syndrome presents with intermittent wrist pain, numbness, and tingling radiating from the palm to the thumb, index finger, middle finger, and medial aspect of the ring finger. Palmar fibrosis causes contractures, usually of the ring finger. Trigger finger causes nodules in tendons that catch on the finger pulley and impede movement
A patient with chronic hip pain cannot take NSAIDs and tells the provider that acetaminophen is minimally helpful. What might the provider recommend initially to improve pain relief? a. A fentanyl patch b. Capsaicin c. Glucosamine d. Lidocaine patches Topical capsaicin has been shown to provide short-term pain relief and has fewer side effects than oral agents. It is an appropriate initial therapy. Fentanyl is a narcotic analgesic and should be reserved for more severe pain. Glucosamine and lidocaine may be helpful for some patients. REF: Pain Management
An adult patient who has been taking high-dose corticosteroids reports a dull, aching pain in the groin and presents with a limp. What condition does the provider suspect, based on this history? a. Avascular necrosis of the femoral head b. Infectious arthritis of the hip c. Osteoarthritis of the hip d. Slipped capital femoral epiphysis Avascular necrosis has the symptoms listed above and is common among patients who have been taking corticosteroids. Infectious arthritis will typically be accompanied by fever and intense pain. Osteoarthritis causes progressively worsening pain with activity and improvement with rest. SCFE is common in adolescents. REF: Clinical Presentation