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The most common cause of acute bursitis is:A. inactivity.B. joint overuse.C. fibromyalgia.D. bacterial infection.

QuestAn elderly female is diagnosed with tic douloureux. Which assessment finding is related to Type 1?

1. Constant, burning facial pain
2. Shooting pain at the base of the head
3. Shock-like facial pain
4. Severe pain in or around one eye
5. ion 1

What cranial nerve is measured with a “clicking” stimuli?

• CN I
• CN II
• CN VIII
• V

What is cranial nerve is being tested in this scenario? Perform test by lightly touching the forehead area, cheek, and chin. Tell pt to close their eyes while testing; ask if they can feel the sensation

1. Oculomotor
2. Trigeminal
3. Optic
4. hypoglossal

An 18-year-old male presents to the office with right wrist pain and has a history of falling off his skateboard on an outstretched hand. There is pain with palpation at the base of the right thumb. The NP orders an x-ray with suspicion of what type of fracture?

1. Colles Fracture
2. Navicular Fracture
3. Distal Ulnar Fracture
4. Proximal Radius Fracture

A patient experiences tremors, impaired swallowing, and drooling, in addition to testing positive for Myerson's sign. Based on the above symptoms and lab results, you conclude that the patient is exhibiting the initial onset of Parkinson's disease. Which of the following would least likely describe the patient? a.A 50-year-old African American male b.A 55-year-old Caucasian female c. A 65-year-old Hispanic male d. A 70-year-old Asian female

A 48 year old female presents with an “achy” pain located on the medial aspect of her right elbow. What signs or symptoms would suggest Golfer’s elbow?

1. Elbow pain worse with a pulling motion
2. Elbow pain worse with grasping or twisting motions
3. Elbow pain worse with extension
4. Elbow pain worse with flexion

C) Shock-like facial pain. There are two types of tic douloureux (trigeminal neuralgia). Type 1 presents with extreme, shock-like facial pain, which lasts from a few seconds to 2 minutes per event and can last up to 2 hours total. Type 2 is a constant,aching, burning facial pain with less intensity. Type 2 is more common in women and peaks in their 60s. Type 2 can also be related to secondary neurologic disease such as multiple sclerosis or HSV-1. Shooting pain at the base of the head is a symptom of occipital neuralgia. Severe pain in or around one eye is a symptom of cluster headaches.

B. Navicular Fracture: also known as a scaphoid fracture. Common mechanism of injury is a forward fall onto an outstretched hand, hyperextension of the wrist. With palpation to the snuffbox. Initial x-rays may not reveal a fracture; if high suspicion of fracture, splint the wrist and thumb and refer to a hand surgeon. A repeat set of x-rays 2 weeks post injury will often show callus bone formation indicating the presence of a fracture. Scaphoid fractures have a high risk for avascular necrosis and non- unions. -Colles Fracture is the most common type of wrist fracture. It is a distal radius fracture with dorsal displacement of the wrist, referred to as a “dinner fork” deformity. This fracture has the same mechanism of injury as a scaphoid fracture.

C) CN VIII is responsible for the auditory function and is tested by using a clicking stimuli to test the auditory brainstem response (ABR). CN I is the olfactory system (Mnemonic: one nose) CN II (Mnemonic: two eyes). CNV is the trigeminal nerve for chewing and clenching teeth and is the largest cranial nerve.

B. trigeminal Provides the sensory nerves to the face. Perform test by lightly touching the forehead area, cheek, and chin. Trigeminal nerve has 3 branches: ophthalmic (V1), cheek (V2), jaw (V3). Tell pt to close their eyes while testing; ask if they can feel the sensation

1. D As the onset of Parkinson’s disease occurs typically from 45-65 years of age with increased incidence among male and Caucasian patients, a 70-year-old asian woman would be least likely to experience the onset of symptoms. All of the other answer choices contain at least one incidence related factor and are henceforth incorrect.

A. Elbow pain worse with pulling motion. Golfer’s elbow is medial epicondylitis. Pain to the medial aspect of the elbow that is gradual in onset. Pain can be mild to severe and persistent for weeks to months. On physical exam there is localized pain with palpation of the medial epicondyle. Golfer’s elbow is more common in women ages 45- 64 years. Tennis elbow, or lateral epicondylitis. Tennis elbow presents with pain of the lateral aspect of the elbow that can radiate to the forearm. The pain is worse with twisting or grasping motions. Despite their names, these tendinitis injuries often result from overuse, not sports

Correct: B. Joint overuse is the most common cause of acute superficial bursitis Incorrect: Other common risk factors for bursitis include trauma or arthritic conditions such as RA and OA. Bacterial infection is a cause of septic bursitis, which occurs much less frequently than bursitis caused by joint overuse (D). Inactivity is not a risk factor for bursitis (A) while fibromyalgia does not impact the bursa in joints (C).