MSK

Question 1

pain in right shoulder and upper arm for 6 weeks. worsens when elevating arm above head

no deformity, tenderness or reduced range of movement. pain on abduction of right shoulder that is worse with the arm in internal rotation and when abduction is resisted. he is treated with ibuprofen

next step in management?

Answer 1

Refer for physiotherapy.

diagnosis = right supraspinatus tendinopathy. no further inestigations required to confirm. can be managed in primary care. general advise and home exercises or physio

Question 1

Acute Gout. patient has chronic kidney disease stage 4. first line management?

Answer 1

oral prednisolone!!

nsaids would be option but CKD

acute gout treatment: oral steroids, NSAIDS and colchicine

Question 2

classic polymyalgia rhuematica symptoms. management?

Answer 2

prednisolone!

Question 3

Acute Gout first line treatment

Answer 3

Start naproxen

Question 4

70 yo. 6 months increasing pain at base of left thumb. No other joint painful. 1st carpometacarpal joint swollen and tender with reduced opposition of thumb. Most likely diagnosis?

Answer 4

Osteoarthritis!!!

6 months not acute so less likely to be gout.

OA fits with joint affected. Not multiple joints so RA unlikely