Rheumatology Flashcards
A 41-YEAR-OLD FEMALE PRESENTS TO HER GP WITH A 3-WEEK HISTORY OF PAIN IN HER HANDS AND FEET. SHE ALSO COMPLAINS OF STIFFNESS IN THE JOINTS LASTING OVER AN HOUR IN THE MORNINGS. O/E THERE IS SYMMETRICAL SWELLING, TENDERNESS AND REDNESS OVER THE MAJORITY OF HER METACARPOPHALANGEAL, METATARSOPHALANGEAL AND PROXIMAL INTERPHALANGEAL JOINTS. SHE HAS NO RASHES OR NAIL CHANGES.
WHAT IS THE MOST LIKELY DIAGNOSIS?
a. Reactive Arthritis
b. Enteropathic Arthritis
c. Psoriatic Arthritis
d. Rheumatoid Arthritis
e. Osteoarthritis
d. Rheumatoid Arthritis
A 74 YEAR OLD MAN PRESENTS TO THE EMERGENCY DEPARTMENT WITH A SHORT HISTORY OF RIGHT KNEE SWELLING FOLLOWING TRAUMA.
O/E HE IS HAEMODYNAMICALLY STABLE AND AFEBRILE. AN EFFUSION OF THE RIGHT KNEE IS NOTED WHICH IS SLIGHTLY WARM TO TOUCH. THERE IS, HOWEVER NO ERYTHEMA, AND THE PATIENT IS ABLE TO WEIGHT-BEAR WITH ONLY A SLIGHT RESTRICTION OF ACTIVE AND PASSIVE MOVEMENT.
A ROUTINE PANEL OF BLOOD TESTS INCLUDING THE BLOOD COUNT, RENAL FUNCTION AND CRP ARE WITHIN NORMAL LIMITS. X-RAY OF THE KNEE SHOW LOSS OF JOINT SPACE, WITH BONY SPURS SEEN ON THE MEDIAL SIDE.
WHAT IS THE MOST LIKELY DIAGNOSIS?
a. Reactive Arthritis
b. Enteropathic Arthritis
c. Psoriatic Arthritis
d. Rheumatoid Arthritis
e. Osteoarthritis
e. Osteoarthritis
A 62 YEAR OLD WOMAN PRESENTS WITH A NINE WEEK HISTORY OF PAIN, SWELLING AND MORNING STIFFNESS IN HER HANDS AND FEET. SHE HAS A PMHX OF IBD. SHE DENIES ANY FACIAL RASH BUT SHE IS CONCERNED ABOUT HER NAILS WHICH SHE DESCRIBES AS ‘PEELING’. THERE ARE ALSO HORIZONTAL RIDGES ACROSS HER NAILS. HER HAND X-RAYS SHOW A ‘PENCIL-IN-CUP’ DEFORMITY.
WHAT IS THE MOST LIKELY DIAGNOSIS?
a. Reactive Arthritis
b. Enteropathic Arthritis
c. Psoriatic Arthritis
d. Rheumatoid Arthritis
e. Osteoarthritis
c. Psoriatic Arthritis
