A 66-Year-Old Woman Comes to the Physician Because of Progressively

question 615

Multiple Choice

A 66-year-old woman comes to the physician because of progressively worsening hip pain over the last several weeks.  The pain is localized to the lateral aspect of her left hip over the outer thigh, but sometimes extends to her left buttock and knee.  Her pain increases when she climbs stairs, gets out of the car, and stands up from sitting in a deep chair.  She also notes that the pain sometimes occurs with walking or prolonged standing.  On occasion, the pain awakens her from sleep when she rolls onto her left side.
She denies fever, chills, or constitutional symptoms.  She cannot recall any trauma to the area and has had no falls.  Her medical problems include obesity (BMI 30 kg/m²) , type 2 diabetes mellitus, hypertension, hyperlipidemia, chronic low back pain, and depression.
Which of the following is the most likely cause of this patient's current complaints?

• A)Intermittent claudication
• B)Lumbar spinal stenosis
• C)Meralgia paresthetica
• D)Osteoarthritis of the hip
• E)Trochanteric bursitis

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Definitions:

Antibody-Mediated Immunity

A aspect of the immune response where B cells produce antibodies that are specific to antigens of pathogens, leading to their neutralization or destruction.

Cell-Mediated Immunity

An immune response that does not involve antibodies but rather involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen.

Neutrophils

A type of white blood cell that plays a key role in the immune system by defending the body against infection.

Macrophages

Immune cells that engulf and digest cellular debris, foreign substances, microbes, and cancer cells in a process called phagocytosis.