Case study questions Flashcards
28YO man, smoker; recent use of ibuprofen. No history of alcohol use. Presents with sudden onset epigastric pain and generalised peritonitis. What is the most likely cause?
Perforated duodenal ulcer
19YO female. Normally fit and well. Short history of pain around umbilicus which has moved to right iliac fossa. Low-grade fever and peritoism. Which part of gut is affected?
- Midgut
- Appendicitis
- Treat via operation
72YO male. History: T2D, smoker. 5-day history of suprapubic pain in left iliac fossa. Associated with fever and tachycardia. What is likely to be the cause?
- Acute diveritculitis
Which is typical of OA?
- Joint stiffness >1 hr
- MCPJ inflammation
- 1st CMCJ inflammation
- Subcutaneous nodules
- 1st CMCJ inflammation
Which of the following is an extra-articular feature of RA?
- Episcleritis
- Peripheral neuropathy
- Pericardial effusion
- Nail fold infarcts
- All the above
- All of the above
Which of these is NOT a classifical finding on XR in OA?
- Subarticular sclerosis
- Osteophytes
- Loss of joint space
- Chondrocalcinosis
- Subchondral cysts
- Chondrocalcinosis (in pseudogout)
- REMEMBER LOSS
Which of the following is NOT a risk factor for gout?
- Family Hx
- High alcohol intake
- NSAID use
- Diuretic use
- High purines
- NSAIDs - treatment not cause
Which of the following is not a fracture associated with OA?
- # NOF
- 1st MTPJ fractures
- Colles’ fracture
- Smith’s fracture
- Vertebral fracture
- 1st MTPJ fracture
Which of these is NOT a side effect of methotrexate?
- GI upset
- Folate deficiency
- Teratogenic
- Peptic ulcer
- Hepatic toxicity
- Oral ulcer
- Peptic ulcer
Geraldine, a 75 year old lady complains of 2 week history of a headache. She has had some tenderness on combing her hair, pain in her jaw while eating and some aching in her shoulders and hips. She mentions that today her vision seemed a little more blurry than usual, but says it’s probably just old age!
What is the most likely diagnosis?
- Giant cell arteritis (GCA)
Claudio, a 67 year old man, presents to your GP surgery complaining of lower back pain that started yesterday while he was sat watching MOTD. Since then, he has noticed some tingling in both his legs and dragging of his right foot. He says he hasn’t passed urine today, despite having the urge to go. How should you further investigate Claudio?
- Full neuro
- PR exam
- Urgent referral to hospital
- MRI spine
Paddy, an 8 year old boy, has been unwell with a fever and sore left knee. On examination, his left knee appears swollen and erythematous, and he is reluctant to move it. What is the most important initial investigation?
- Joint aspiration for MC&S
Which is not a red flag for caudal equine?
- Saddle anaesthesia
- Urinary incontinence
- Areflexia
- Loss of bowel control
- Urinary incontinence
Which is NOT a characteristic of inflammation of the meninges?
- Neck stiffness
- Photophobia
- Headache
- Non-blanching rash
- Non-blanching rash
A child comes into the GP with fever, neck stiffness, non-blanching rash. What is the immediate treatment?
- IM benzylpenicillin
- IV benzylpenicillin
- IV cefiotaxime
- Oral rifampicin
- IM benzylpenicillin
- Meningitis
