Musculoskeletal

Question 1

Back pain that is exacerbeted by standing and walking and relieved with sitting and hyperflexion of the hips

Answer 1

Spinal stenosis

Question 2

Joints in the hand affected in rheumatoid arthritis

Answer 2

MCP annd PIP joints; DIP joints are 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

A genetic disorder that is 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. Check HLA-B27

Question 6

Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?

Answer 6

Reactive (Reiter) arthritis. Most commonly associated with Chlamydia. Also consider Campylobacter, Shigella, Salmonella, and Ureaplasma

Question 7

A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drining red wine. Diagnosis, workup, and chronic treatment?

Answer 7

Gout? Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopuinol or febuxostat (allebei xantine-oxidaseremmers) 
or probenecid (als allopurinol of febuxostat niet goed verdragen worden of er recidieven optreden onder deze middelen).
Acute behandeling: NSAID, colchicine, corticosteroïden (canakinumab)

Question 8

Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.

Answer 8

Pseudogout

Question 9

An elderly woman presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and elevated ESR

Answer 9

Polymyalgia rheumatica

Question 10

Bone fractured in a fall on a outstretched hand

Answer 10

Distal radius (Colles fracture)

Question 11

A complication of scaphoid fracture

Answer 11

Avascular necrosi

Question 12

Signs suggesting radial nerve damage with humeral fracture

Answer 12

Wrist drop, loss of thumb abduction

Question 13

The most common 1° malignant tumor of bone

Answer 13

Multiple myeloma

Question 14

Headaches, soreness in jaw, pain on scalp, transient monoclar blindness?

Answer 14

Giant cell arteritis