Peripheral end plate fractures typically occur with:
a. degenerative disc
b. shearing loads
c. ligamentous laxity
d. none of the above
Answer: a
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Biomechanics
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- A 54-year-old male construction worker has had low back pain for about two months. He has had previous episodes of low back pain. Now, the pain is more intense than it was on prior episodes and seems to be getting worse rather than improving over time. He does remember lifting very heavy steel beams and the pain is now unbearable. He complains of numbness in both legs and across his buttocks. He is embarrassed to report that he was incontinent of urine and stool this morning. You should plan on:
- A 35-year-old male presents to your office with complaints of back pain and some weakness in his left leg. It has been present for a few weeks and the back and leg pains have been increasing in intensity. You are concerned about a herniated lumbar disc. His left ankle jerk reflex (achilles tendon reflex) is absent and you find numbness on the lateral aspect of the lower leg and sole of his left foot. This is most commonly caused by a:
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- A 64-year-old school superintendent with known rheumatoid arthritis presents to the office with a recurrent episode of significant hand and wrist pain after having been virtually pain-free for about eight months on DMARD therapy as closely monitored by her rheumatologist. She questions the doctor as to how it could be that she has these painful chronic-recurrent flare-ups alternating with pain-free periods, all the while it seems that the "arthritis is getting better" with the medications. What would be the best explanation, based on the article by D. Marcus: "Treatment of Nonmalignant Chronic Pain?"
- A 56-year-old female with a known history of seropositive rheumatoid arthritis maintained on etanercept injections presents complaining of right knee pain and swelling for two days. She has been in good health otherwise and denies fevers and chills. She reports stiffness in the right knee that lasts for longer than 1 hour. Her other joints are doing well. You perform an arthrocentesis and remove 30cc of clear fluid. You send the sample to the lab, and 24 hours later no organisms are seen. The patient follows up later that day. The best course of management for this patient is:
- A 64-year-old woman diagnosed with gout has been taking chronic treatment for over one year. The prescribed medication enhances the excretion of uric acid. Her physician cautions her to contact him before starting any prescription or nonprescription medication. The antigout medication and many other drugs can compete for tubular transport. Examples include aspirin and other nonsteroidal anti-inflammatory drugs, loop and thiazide diuretics, certain anti-infective medications, and certain diabetes drugs. The chronic antigout medication prescribed for this patient is most likely:
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