Musc

Question 1

Back pain exacerbated by standing and walking; relieved by sitting and hyperflexion of the hips

Answer 1

Spinal stenosis

Question 2

Joints in hand affected in rheumatoid arthritis

Answer 2

MCP & PIP (DIP spared)

Question 3

Joint pain and stiffness that worsen over the course of the day and are relieved by rest

Answer 3

Osteoarthritis

Question 4

Genetic disorder associated with multiple fractures and blue sclerae and is commonly mistaken for child abuse

Answer 4

Osteogenesis imperfecta

Question 5

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest.

Diagnostic test?

Answer 5

Suspect ankylosing spondylitis

Dx test = check HLA B27

Question 6

Arthritis, conjunctivitis, urethritis in young men.

Associated organisms?

Answer 6

Reactive arthritis (Reiter)

```
Org. = chlamydia
Also
- campylobacter
- shigella
- salmonella
- ureaplasma
~~~

Question 7

55 yo man sudden, excruciating first MTP joint pain after a night of drinking red wine. Dx? Work up? Chronic Tx?

Answer 7

Gout

Joint fluid aspirate = needle shaped, negatively birefringent crystals

Chronic Tx: allopurinol or probenecid

Question 8

Rhomboid shaped, positively birefringent crystals on joint fluid aspirate

Answer 8

Pseudogout

Question 9

Elderly woman pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Anaemia and raised ESR

Answer 9

Polymyalgia rheumatica

Question 10

Bone is fractured in a fall on an outstretched hand

Answer 10

Distal radius (Colles) fracture

Question 11

A complication of scaphoid fracture

Answer 11

Avascular necrosis

Question 12

Signs suggesting radial nerve damage with humeral fracture

Answer 12

Wrist drop, loss of thumb abduction

Question 13

Most common primary malignant tumour of bone

Answer 13

Multiple myeloma

Question 14

Headaches, soreness in jaw, pain on scalp, transient monocular blindness

Answer 14

Giant cell arteritis