Question Easy: A 30-year-old office worker presents with pain and tingling in the right hand that is worse at night. This started after working long hours on the computer. On examination, tapping over the wrist leads to tingling in the fingers. What is the most likely diagnosis? 😊
A) De Quervain’s tenosynovitis
B) Carpal tunnel syndrome
C) Lateral epicondylitis
D) Cubital tunnel syndrome
E) Trigger finger
Question Medium: A 50-year-old man presents with a painful, swollen right knee that developed over a few hours. He has a fever and cannot recall any trauma. Synovial fluid analysis shows numerous polymorphonuclear leukocytes and needle-shaped crystals with negative birefringence under polarized light. What is the most appropriate initial treatment? 💉
A) Allopurinol
B) Colchicine
C) Ibuprofen
D) Prednisolone
E) Probenecid
Question Hard: A 70-year-old woman with osteoporosis suffered a vertebral compression fracture following a minor fall. Which medication should be considered first-line for reducing fracture risk in postmenopausal women with osteoporosis according to NICE guidelines? 💊
A) Alendronic acid
B) Denosumab
C) Raloxifene
D) Teriparatide
E) Calcitonin
Explanations & Answers:
Question Easy Answer: B) Carpal tunnel syndrome
Question Easy Explanation: Carpal tunnel syndrome is a common condition caused by compression of the median nerve in the carpal tunnel. The symptoms described, including nocturnal tingling and positive Tinel’s sign, align with this diagnosis. Treatment options may include wrist splints, exercises, or in some cases, surgery.
Question Medium Answer: C) Ibuprofen
Question Medium Explanation: The presentation and synovial fluid findings are classic for an acute gout attack. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often used as first-line treatment to rapidly alleviate pain and inflammation. Colchicine is an alternative, but it can have gastrointestinal side effects. Corticosteroids may be considered if NSAIDs are contraindicated.
Question Hard Answer: A) Alendronic acid
Question Hard Explanation: According to NICE guidelines, alendronic acid, a bisphosphonate, is recommended as the first-line treatment for reducing the risk of osteoporotic fractures in postmenopausal women. It works by inhibiting bone resorption, thereby increasing bone mineral density.
Medical fact of the day: Did you know that vitamin D deficiency is prevalent in the UK, especially during the winter months, and it plays a critical role in bone health maintenance? Adequate levels are essential for calcium absorption and bone mineralisation—key components in preventing osteoporotic fractures.
Quote of the day: “Every ounce of care you give lifts the world a little higher. Keep reaching, keep healing.” 🌟