Question Easy: A 55-year-old woman presents with pain in her right shoulder, which worsens when she tries to lift her arm above her head. On examination, you notice tenderness over the lateral aspect of the shoulder but no swelling or erythema. X-ray imaging shows no fracture or dislocation. What is the most likely diagnosis? 🤔
A) Osteoarthritis
B) Frozen shoulder
C) Rotator cuff tendinopathy
D) Bursitis
E) Shoulder dislocation
Explanations & Answers:
Question Easy Answer: C) Rotator cuff tendinopathy
Question Easy Explanation: The description suggests rotator cuff tendinopathy, a common cause of shoulder pain, especially when lifting the arm. The absence of swelling and X-ray findings rules out other conditions like arthritis or dislocation. NICE guidelines emphasise managing this condition with physiotherapy and analgesia.
Question Medium: A 45-year-old man presents with a sudden onset of back pain radiating down his left leg after lifting a heavy object. He reports numbness in the left foot and difficulty in dorsiflexing the ankle. 🦵🏻 Which nerve root is most likely affected?
A) L3
B) L4
C) L5
D) S1
E) S2
Question Medium Answer: C) L5
Question Medium Explanation: The symptoms described are typical of sciatica due to an L5 nerve root compression. The inability to dorsiflex the ankle and numbness in the foot are indicative of this nerve root involvement, as per NHS guidelines on lumbar radiculopathy management.
Question Hard: A 70-year-old male presents to the ED with a history of a fall onto his outstretched hand. X-ray of the wrist shows a fracture of the distal radius with dorsal angulation. What type of fracture is this? 🏥
A) Smith’s fracture
B) Galeazzi fracture
C) Bennett’s fracture
D) Colles’ fracture
E) Monteggia fracture
Question Hard Answer: D) Colles’ fracture
Question Hard Explanation: A Colles’ fracture is characterized by a distal radius fracture with dorsal angulation often due to falling onto an outstretched hand. According to the BNF, management may include immobilisation or surgical intervention based on the displacement.
Medical fact of the day: Did you know? The most common joint affected by osteoarthritis is the knee, particularly prevalent in individuals over the age of 45, impacting both the joint’s function and the individual’s quality of life according to UK guidelines.
Quote of the day: “In every consultation, lies the profound opportunity to heal, inspire, and connect. Remember, your compassion is just as important as your clinical acumen.” 😊