Question Easy:
A 45-year-old woman presents with pain and stiffness in her shoulders and hips, particularly in the morning. She describes the stiffness as lasting for more than an hour upon waking. What is the most likely diagnosis? 🤔
A) Osteoarthritis
B) Rheumatoid arthritis
C) Polymyalgia rheumatica
D) Fibromyalgia
E) Ankylosing spondylitis
Explanations & Answers:
Question Easy Answer: C) Polymyalgia rheumatica
Question Easy Explanation: The symptoms of morning stiffness lasting over an hour, especially in the shoulders and hips, are characteristic of polymyalgia rheumatica. According to NICE guidelines, this condition is commonly seen in individuals over 50 and is associated with raised inflammatory markers.
Question Medium:
A 30-year-old male presents with acute knee pain after a football injury. On examination, there is marked swelling and tenderness around the knee joint. The anterior drawer test is positive. What structure is most likely injured? ⚽
A) Medial meniscus
B) Anterior cruciate ligament (ACL)
C) Posterior cruciate ligament (PCL)
D) Medial collateral ligament (MCL)
E) Lateral collateral ligament (LCL)
Question Medium Answer: B) Anterior cruciate ligament (ACL)
Question Medium Explanation: A positive anterior drawer test suggests anterior cruciate ligament (ACL) injury. This test assesses the integrity of the ACL, which prevents forward movement of the tibia relative to the femur.
Question Hard:
A 28-year-old woman presents with low back pain and stiffness that improves with exercise but not with rest. She also reports occasional anterior uveitis. HLA-B27 is positive. Which of the following is the most likely diagnosis? 🔍
A) Rheumatoid arthritis
B) Psoriatic arthritis
C) Ankylosing spondylitis
D) Reactive arthritis
E) Osteoarthritis
Question Hard Answer: C) Ankylosing spondylitis
Question Hard Explanation: Ankylosing spondylitis is indicated by the pattern of low back pain that improves with exercise, positive HLA-B27, and association with anterior uveitis. According to NHS guidelines, this condition commonly affects young adults and has a strong link to the HLA-B27 antigen.
Medical fact of the day: Did you know that hip fractures account for more than 80,000 hospital admissions each year in the UK, with the incidence increasing with age? This emphasizes the importance of osteoporosis screening and falls prevention in the elderly to reduce the risk of fractures.
Quote of the day: “The art of healing comes from nature, not from the physician. Therefore, the physician must start from nature, with an open mind.” 🌿