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? 

A 64-year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which of the following statements by the client would necessitate further teaching? (i.e. which state is incorrect?)

You have a 26 year old with a tender, palpable mass about 10 cm in diameter on his right distal femur. In this age group & this physical location, you are most concerned this represents:

Which hormone exerts antiapoptotic effects on osteoblasts (i.e. inhibits apoptosis of osteoblasts) but proapoptotic effects on osteoclasts (i.e. promotes apoptosis of osteoclasts)?

A 45-year-old female comes to your primary care office to establish care. She reports that over the past year, she has been tired a lot and has gained 10 pounds. She states that she has near-constant pain “all over” that is worst in her shoulders, low back, and buttocks. She cannot pinpoint any specific joints that are involved. She has not been sleeping well. She has missed several days of work for her symptoms this year. Her past medical history includes type 2 diabetes mellitus (DM) and hypercholesterolemia, although previous labs show these conditions are controlled, and she has a normal CBC, CMP and sed rate. Her medications are metformin and simvastatin.  You diagnose her with [answer1]. Treatments for her condition will include [answer2]

The patient has weakness and pain in his shoulder, with no history of trauma. The NP is concerned the patient has a rotator cuff tear. Which of the following imaging modalities should be used to assess for rotator cuff tears?