Author Question: A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused ... (Read 74 times)

a0266361136 · **on:** Jun 25, 2018

A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused by a fall. On inspection, the femur and tibia are bowed.

There is also a reduced angle of the femoral neck, which gives the patient a waddling gait appearance. The doctor suspects Paget disease. The patient asks how he got that. The nurse will respond,
A)
It's because you don't eat enough calcium-rich foods in your diet.
B)
When you were a child you probably broke you hip, and since it wasn't displaced, you continued to walk on it.
C)
It might be related to a thyroid condition. We will need to run some more blood work.
D)
It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?

Question 2

Although the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82-year-old female has polymyalgia rheumatica.

Which characteristic symptomatology would most likely have led the specialist to suspect this health problem?
A)
Extended periods of walking cause pain that extends from her ankles, knees, and sciatic nerve.
B)
The woman complains of aching and morning stiffness in her neck, shoulder, and pelvis.
C)
Range of motion in the woman's wrists and ankles is greatest in the morning and decreases over the course of a day.
D)
The woman's metatarsal joints are inflamed and sensitive to touch.

CharlieArnold · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Ans:
D

Feedback:

Although the cause of Paget disease remains unclear, there is evidence of both genetic and environmental influences. It has been reported that 15 to 40 of people with the disease have a first-degree relative with Paget disease, and numerous studies have described extended family members with the disease.

Answer to Question 2

Ans:
B

Feedback:

Polymyalgia rheumatica is an inflammatory condition of unknown origin characterized by aching and morning stiffness in the cervical regions and shoulder and pelvic girdle areas. Lower limb pain, wrist and ankle stiffness, and pain in the joints of the foot would not be as clearly suggestive of polymyalgia rheumatica.