Question Easy:
A 35-year-old woman presents with pain in her right wrist after falling on an outstretched hand. There is swelling and tenderness over the anatomical snuffbox. What is the most likely diagnosis?
A) Scaphoid fracture
B) Colles’ fracture
C) Smith’s fracture
D) Lunate dislocation
E) Ulnar styloid fracture
Question Medium:
A 72-year-old man complains of stiffness and pain in his hip, worse in the morning and after prolonged activity. He has reduced range of motion and crepitus on examination. What is the most likely diagnosis?
A) Septic arthritis
B) Osteoarthritis
C) Rheumatoid arthritis
D) Gout
E) Psoriatic arthritis
Question Hard:
A 28-year-old woman presents with sudden onset of severe back pain. She reports no trauma but mentions that she has a history of ankylosing spondylitis. On examination, there is tenderness over the lumbar vertebrae. Which of the following investigations is the most appropriate next step?
A) MRI of the lumbar spine
B) X-ray of the lumbar spine
C) CT scan of the lumbar spine
D) Bone scintigraphy
E) Ultrasound
Explanations & Answers:
Question Easy Answer:
A) Scaphoid fracture
Question Easy Explanation:
Scaphoid fractures are common in young adults who fall on an outstretched hand. Swelling and tenderness over the anatomical snuffbox are classic signs. Early diagnosis and treatment are crucial as delayed treatment can lead to complications such as avascular necrosis.
Question Medium Answer:
B) Osteoarthritis
Question Medium Explanation:
Osteoarthritis is characterized by joint pain and stiffness, particularly affecting weight-bearing joints like the hips. Morning stiffness that improves with movement and crepitus on examination are typical features. Management includes lifestyle modifications, pharmacological treatment, and in severe cases, surgical intervention.
Question Hard Answer:
A) MRI of the lumbar spine
Question Hard Explanation:
An MRI is the most appropriate next step as it is highly sensitive in detecting subtle pathologies like early vertebral fractures or spinal cord involvement in patients with ankylosing spondylitis. X-rays can miss early changes and are less effective in this scenario.
Medical fact of the day: The scapholunate ligament is the most commonly injured ligament in the wrist and is frequently associated with scaphoid fractures. Delayed or missed diagnosis can lead to chronic wrist instability and arthritis.
Quote of the day: “In the realm of healthcare, passion fuels progress, and empathy fosters healing.” 💙👩⚕️👨⚕️