Question Easy:
A 30-year-old woman presents with diffuse joint pain, stiffness lasting around 30 minutes in the morning, and some swelling of her fingers. What is the most likely diagnosis?
A) Osteoarthritis
B) Gout
C) Rheumatoid arthritis
D) Psoriatic arthritis
E) Septic arthritis
Question Medium:
A 45-year-old man presents with sudden onset of severe pain in his right great toe, redness, and swelling. His medical history includes hypertension and chronic kidney disease. Blood tests reveal raised uric acid levels. What is the most appropriate initial management for his condition? 🦶
A) Allopurinol
B) Colchicine
C) Naproxen
D) Paracetamol
E) Losartan
Question Hard:
A 70-year-old man presents with progressive lower back pain, unintentional weight loss, and night sweats over the past three months. Examination reveals tenderness over the lumbar spine. An MRI shows vertebral bone destruction and a paravertebral mass. Which organism is most likely responsible for this presentation?
A) Mycobacterium tuberculosis
B) Staphylococcus aureus
C) Escherichia coli
D) Streptococcus pneumoniae
E) Pseudomonas aeruginosa
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms of joint pain with morning stiffness and swelling, particularly in the fingers, suggest rheumatoid arthritis. According to NICE guidelines, rheumatoid arthritis typically presents with morning stiffness lasting more than 30 minutes and symmetrical joint symptoms.
Question Medium Answer: C
Question Medium Explanation: Naproxen, a non-steroidal anti-inflammatory drug (NSAID), is the first-line treatment for acute gout attacks according to NICE. It helps reduce inflammation and relieve pain. Colchicine or corticosteroids may be considered if NSAIDs are contraindicated or ineffective.
Question Hard Answer: A
Question Hard Explanation: The symptoms and MRI findings suggest Pott’s disease, which is spinal tuberculosis. Mycobacterium tuberculosis is the most common causative organism for this condition. NICE guidelines recommend consideration of tuberculosis in patients with appropriate risk factors and systemic symptoms.
Medical fact of the day: Did you know that bone is approximately four times stronger than concrete? This natural marvel helps our skeleton withstand immense forces and pressures, a critical factor in modern orthopedic practices.
Quote of the day: “In every challenge faced is an opportunity to learn, heal, and inspire greater care in others.”