Physician Assistant Exam Practice Questions about Bones and Joints

Because musculoskeletal conditions affect millions of Americans, you can bet you’ll see questions about them on the PANCE or PANRE. Many of these conditions can be debilitating, whether you’re talking about rheumatologic conditions (such as rheumatoid arthritis or gout), orthopedic problems (such as osteoarthritis), or hip or knee pain. These practice questions are similar to the ones you’ll see on the PANCE about bones and joints.

Example PANCE Questions

  1. Which of the following muscles is not part of the rotator cuff?

    (A) Supraspinatus

    (B) Infraspinatus

    (C) Subscapularis

    (D) Teres minor

    (E) Teres major

  2. You’re evaluating a 40-year-old woman who has a history of worsening morning stiffness and swelling of the fingers and hands. No facial rash is present. Which of the following labs is most specific for diagnosing this rheumatologic condition?

    (A) Erthryocyte sedimentation rate (ESR)

    (B) Rheumatoid factor

    (C) Anticitrullinate cyclic peptide

    (D) Antinuclear antibody (ANA)

    (E) Antiribonucleoprotein P (anti-RNP)

  3. A radiograph showing chondrocalcinosis would be suggestive of which of the following conditions?

    (A) Gout

    (B) Pseudogout

    (C) Rheumatoid arthritis

    (D) Septic arthritis

    (E) Osteoarthritis

  4. Which of the following medications is approved for the treatment of pain associated with fibromyalgia syndrome (FMS)?

    (A) Lyrica (Pregabalin)

    (B) Prednisone (Sterapred)

    (C) Carisoprodol (Soma)

    (D) Cyclobenzaprine (Flexeril)

    (E) Oxycodone (OxyContin)

  5. Boxer’s fracture is caused by an injury to which area of the hand or wrist?

    (A) First metacarpal

    (B) Scaphoid bone

    (C) Third metatarsal

    (D) Third metacarpal

    (E) Navicular bone

  6. Which of the following is a potential side effect of colchicine?

    (A) Constipation

    (B) Edema

    (C) Leukopenia

    (D) Leukocytosis

    (E) Hyponatremia

Example PANCE Answers and Explanations

Use this answer key to score the practice questions about bones and joints. The answer explanations offer some insight into why the correct answer is better than the other choices.

1. E. The supraspinatus, infraspinatus, subscapularis, and teres minor are the four muscles of the rotator cuff. Whereas the teres minor externally rotates the humerus, the teres major, which is not part of the rotator cuff, internally rotates the humerus.

2. C. Anticitrullinate cyclic peptide (anti-CCP) antibodies are specific and sensitive to rheumatoid arthritis. The erthryocyte sedimentation rate (ESR) can be elevated in many conditions, including infection and inflammation. The rheumatoid factor is positive only 50 percent of the time in someone with rheumatoid arthritis. The antinuclear antibody (ANA) test can be positive in many autoimmune conditions, including systemic lupus erythematosus (SLE). Anti-RNP (antiribonucleoprotein) is specific for mixed connective tissue disease. The clinical presentation marks this condition as rheumatoid arthritis.

3. B. Pseudogout is characterized by a “chalk line” on a radiograph. Osteoarthritis causes more joint destruction, and the classic radiograph appearance for rheumatoid arthritis is joint space narrowing and erosive arthritis.

4. A. The FDA approved lyrica (Pregabalin) for the treatment of pain in fibromyalgia syndrome (FMS). The other listed meds aren’t indicated in the treatment for fibromyalgia.

5. D. Injury to the third metacarpel is the classic finding in a boxer’s fracture.

6. C. Colchicine can cause myopathy, diarrhea, and leukopenia. Its dose needs to be adjusted in the setting of kidney disease. It doesn’t cause leukocytosis, which is one of the side effects of steroids like prednisone, nor does it cause hyponatremia, constipation, or edema.

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