Question Easy: What is the most appropriate initial management for a suspected fracture of the neck of the femur in an elderly patient? 🦵💥
A) MRI scan
B) Hip joint aspiration
C) CT scan
D) Analgesia and immobilisation
E) Antibiotics
Question Medium: A 30-year-old man presents with a painful swollen knee and fever. Joint aspiration reveals cloudy fluid. Which of the following is the most likely diagnosis? 🤒🦵
A) Osteoarthritis
B) Septic arthritis
C) Gout
D) Rheumatoid arthritis
E) Psoriatic arthritis
Question Hard: A 45-year-old woman has worsening low back pain and stiffness for over 3 months, which improves with exercise but not with rest. She also has a history of anterior uveitis. What is the most likely diagnosis? 🏃♀️🌅
A) Fibromyalgia
B) Ankylosing spondylitis
C) Osteoporosis
D) Degenerative disc disease
E) Reactive arthritis
Explanations & Answers:
Question Easy Answer: D) Analgesia and immobilisation
Question Easy Explanation: For an elderly patient with a suspected fracture of the neck of the femur, the most appropriate initial management is to provide pain relief and immobilisation to prevent further injury before definitive imaging can be obtained. This aligns with NHS guidelines on the management of hip fractures.
Question Medium Answer: B) Septic arthritis
Question Medium Explanation: Septic arthritis presents with a painful swollen joint, fever, and cloudy synovial fluid upon aspiration. It’s an emergency due to the risk of joint destruction. NICE guidelines recommend early recognition and treatment with antibiotics.
Question Hard Answer: B) Ankylosing spondylitis
Question Hard Explanation: Ankylosing spondylitis is characterised by chronic back pain and stiffness that improves with exercise. The presence of extra-articular manifestations like anterior uveitis supports this diagnosis. NICE guidelines outline the management of this condition, focusing on exercise and NSAIDs.
Medical fact of the day: Did you know that Vitamin D plays a crucial role in bone health? In the UK, NICE recommends Vitamin D supplementation in individuals at risk of deficiency to prevent conditions like osteomalacia and osteoporosis.
Quote of the day: “In medicine, as in life, the small acts of kindness you show can have the greatest impact. Keep healing with your heart.”