NMS Q&A Family Medicine

SECTION IXMusculoskeletal andRheumatological Diseasesin Primary Carechapter 23Musculoskeletal Problemsof the Upper ExtremitiesExamination questions : Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 32-year-old female, employed for 2 years in anassembly line, complains to her family doctor of wristand hand pain increasing over 2 weeks. She hasworked with her hands and wrists handling smallpart and feeding them into an automated machine100 times per hour, with 30 minutes for lunch breakand two 15-minute rest periods. She denies numbnessin the extremities. There is no tenderness ventrallyover the radius or between the extensor tendonsof the thumb. However, on further examination, shecomplains of pain when the doctor asks her to makea fist and then to ulnar deviate the wrist. This maneuvercauses pain in the radial aspect of the wrist. Thereis tenderness to palpation over the radial styloid nearthe base of the metacarpal of the thumb. Which ofthe following is the diagnosis?(A) Carpal tunnel syndrome(B) DeQuervain syndrome(C) Occult scaphoid fracture(D) Stress fracture of the distal radius(E) Reflex sympathetic dystrophy2 A 25-year-old woman fell onto her outstretched handand incurred a fracture of the distal radius thatappears to be virtually non-displaced. Which of thefollowing would be appropriate for treating this fractureduring the acute phase in the family doctor’soffice?(A) Volar splint extending from the mid forearm tothe distal palmar crease.143