Question Easy:
A 28-year-old woman trips and falls while jogging, landing awkwardly on her right wrist. She complains of pain and swelling around the wrist, and finds it difficult to move. What is the most likely diagnosis?
A) Carpal tunnel syndrome
B) Scaphoid fracture
C) Colles’ fracture
D) Smith’s fracture
E) Wrist sprain
Explanations & Answers:
Question Easy Answer: C) Colles’ fracture
Question Easy Explanation: A Colles’ fracture is a common injury caused by falling onto an outstretched hand, leading to a distal radius fracture with dorsal angulation. This is often seen in “FOOSH” (fall on outstretched hand) injuries, fitting the scenario described.
Question Medium:
A 45-year-old man presents to the clinic with heel pain that is worst in the morning and improves throughout the day. He has recently started training for a marathon. What is the most likely diagnosis?
A) Achilles tendinopathy
B) Plantar fasciitis
C) Calcaneal stress fracture
D) Retrocalcaneal bursitis
E) Tarsal tunnel syndrome
Question Medium Answer: B) Plantar fasciitis
Question Medium Explanation: The characteristic symptom of plantar fasciitis is heel pain that is typically worse in the morning or after rest and improves with activity. This condition is common in runners or those who increase their physical activities suddenly. Management includes stretching exercises, pain relief with NSAIDs, and advice on appropriate footwear.
Question Hard:
A 64-year-old male presents with bilateral hip pain and morning stiffness that lasts more than an hour. He has a past medical history significant for Barrett’s oesophagus and hypertension. X-rays reveal joint space narrowing and osteophytes in both hip joints. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Ankylosing spondylitis
D) Psoriatic arthritis
E) Gout
Question Hard Answer: A) Rheumatoid arthritis
Question Hard Explanation: Bilateral hip pain with prolonged morning stiffness of more than an hour is characteristic of an inflammatory arthritis, such as rheumatoid arthritis. Osteophytes and joint space narrowing are not exclusive to osteoarthritis and can also be seen in long-standing inflammatory arthritis. The patient’s age and clinical presentation make rheumatoid arthritis the more likely diagnosis given symmetric symptoms and duration of stiffness.
Medical fact of the day: Did you know that osteoporosis affects around 3 million people in the UK? The condition causes approximately 500,000 fractures every year, highlighting the importance of prevention and management strategies.
Quote of the day: “In the rhythm of caring for others, remember to pause and care for yourself. Only with a full heart can you give to others.”