A 42-year-old man comes to the NP’s office for evaluation of right knee pain, red eyes, and lesions on soles of his feet. The patient tells the NP he was diagnosed with a urinary tract infection that was treated with antibiotics about 3 weeks ago, and shortly after all these symptoms started. He has multiple sexual partners but states “I use condoms.” Vital signs are in normal ranges. Physical exam show bilateral  conjunctival injection with scant purulent discharge at the lid margins. The right knee is mildly swollen with associate tenderness to palpation. Examination of the soles of feet show multiple erythematous scaly lesions.  The NP would suspect:

The NP is seeing a 8-year-old patient that has severe pain & swelling of their ankle and lower leg, with the inability to bear any weight on the extremity following a soccer sports injury earlier in the day. The NP is MOST worried about which of the following injuries?

A friend asks you to check on their 85-year-old grandmother who resides in a nursing home. Your friend tells you that she rarely gets outside, eats hardly any dairy products, and has aching bones. It is likely that their grandmother has a specific vitamin deficiency. Synthesis of the vitamin in question is dependent on ultraviolet radiation. The actual step in the activation of this vitamin occurs in what tissues?

Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman’s situation?

Following genetic testing and a thorough history from the child’s mother and father, a 5-month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father?

 A 56-year-old woman comes to her NP for evaluation for acid-reflux & swallowing difficulties not improving with H2-blocker or proton pump inhibitors.  Review of symptoms endorses fatigue and dryness and “tightness” of the skin. The NP notices during her physical exam that the patient has skin tightening over the face, hands, and forearms. Telangiectasia is noted of the cheeks. Which of the following is the most likely presentation of the patient’s presentation? 

You patient has been diagnosed with SLE (systemic lupus erythematosus). This disease is theorized to be due to: 

Hilda, age 73, presents with a complaint of low back pain. Red flags in her history include: minor fall, osteopenia, and prolonged steroid use for systemic lupus erythematosus suggest the possibility of which of the following serious underlying conditions might be the cause of her low back pain?

During a well-child exam, the PNP observes the child’s bilateral feet are rotated internally at the ankle. She diagnoses the child with:

A 50-year-old woman comes to her primary care NP because of progressively worsening pain, stiffness, and swelling in her joints. The patient endorses morning stiffness that improves after about 2 hours. In addition, she reports generalized fatigue despite getting adequate rest each night. Serology testing is positive for antinuclear and anti-cyclic citrullinated peptide antibodies. Which of the following joint will likely be affected in this patient?