What causes Boutonnière deformity?

Correct Answer: D

Rationale: Boutonnière deformity is characterized by the rupture of the central slip and volar migration of lateral bands. This leads to hyperextension of the PIP joint and flexion of the DIP joint. This deformity is due to the disruption of the extensor mechanism, specifically the central slip. Rupture of the central slip allows the lateral bands to migrate volarly, causing the characteristic deformity. Options A, B, and C do not accurately describe the mechanism of Boutonnière deformity, making them incorrect choices. Option A describes mallet finger deformity, option B refers to trigger finger, and option C relates to carpal tunnel syndrome.

Correct Answer: D

Rationale: The correct answer is D: Smoking. Smoking is considered the greatest single modifiable risk factor for cardiac disease due to its direct negative impact on cardiovascular health. Smoking increases the risk of heart disease by damaging blood vessels, raising blood pressure, increasing heart rate, and promoting the buildup of fatty deposits in the arteries. Quitting smoking has been shown to significantly reduce the risk of developing heart disease. A: Obesity is a significant risk factor for heart disease, but smoking has a greater impact on cardiovascular health. B: Hypertension is a major risk factor for heart disease, but smoking has a more significant impact on cardiovascular health. C: Hyperlipidemia (high cholesterol) is a significant risk factor for heart disease, but smoking is considered the greatest single modifiable risk factor for cardiac disease.

Correct Answer: C

Rationale: The correct answer is C: Sarcoidosis. Sarcoidosis is a respiratory disease that causes a restrictive, parenchymal pattern of illness characterized by granulomatous inflammation in the lung tissue. This results in fibrosis and scarring, leading to reduced lung capacity and difficulty in expanding the lungs fully. Myasthenia gravis (A) is an autoimmune neuromuscular disorder affecting muscle function, not the respiratory system. Asthma (B) is an obstructive lung disease characterized by airway inflammation and bronchoconstriction, leading to airflow limitation. Ankylosing spondylitis (D) is a systemic inflammatory condition primarily affecting the spine and joints, not the lungs.

Correct Answer: C

Rationale: The correct answer is C: Osteopenia. Osteopenia is a contraindication for spinal traction due to decreased bone density, which increases the risk of fractures during traction. Bursitis (A) is not a contraindication, as it affects the soft tissues around the joints. Cervical radiculopathy (B) can benefit from spinal traction to relieve nerve compression. Muscle spasm (D) is not a contraindication but can actually be a reason for using traction to alleviate muscle tension.

Correct Answer: B

Rationale: The correct answer is B: Inspection. Inspection is the first technique used in a physical assessment as it involves observing the patient's overall appearance, skin color, posture, and any obvious abnormalities. This step provides valuable initial information before moving on to other techniques. Palpation, percussion, and auscultation are typically used after inspection to gather more detailed data. Palpation involves touching and feeling for abnormalities, percussion involves tapping to assess underlying structures, and auscultation involves listening to internal sounds. These techniques are important in a comprehensive assessment, but inspection is the initial step to guide the assessment process.