Question Easy: A 25-year-old rugby player presents with pain and swelling in his right knee after twisting it during a match. He reports hearing a “pop” at the time of injury and now has difficulty bearing weight. What is the most likely structure injured? 🏉
A) Medial collateral ligament
B) Anterior cruciate ligament
C) Posterior cruciate ligament
D) Lateral collateral ligament
E) Meniscus
Question Medium: A 55-year-old woman presents with worsening pain and stiffness in her hands, particularly in the mornings. She reports difficulty in gripping objects. On examination, there is swelling and tenderness of the metacarpophalangeal and proximal interphalangeal joints. Which investigation is most likely to confirm the diagnosis?
A) Rheumatoid factor
B) Anti-cyclic citrullinated peptide (anti-CCP) antibodies
C) Erythrocyte sedimentation rate (ESR)
D) C-reactive protein (CRP)
E) Plain X-ray of the hands
Question Hard: An 82-year-old man with a known history of osteoporosis falls in his garden. He sustains a fracture of the neck of femur and is awaiting surgery. According to NICE guidelines, which medication should be considered to reduce the risk of further fractures? 💊
A) Vitamin D supplements
B) Bisphosphonates
C) Denosumab
D) Calcitonin
E) Hormone replacement therapy
Explanations & Answers:
Question Easy Answer: B) Anterior cruciate ligament
Question Easy Explanation: The classic “pop” sound and difficulty bearing weight, along with the mechanism of a twisting injury, are characteristic of an anterior cruciate ligament (ACL) tear. This is a common injury in sports involving sudden deceleration or changes in direction, like rugby.
Question Medium Answer: B) Anti-cyclic citrullinated peptide (anti-CCP) antibodies
Question Medium Explanation: Anti-CCP antibodies are highly specific for rheumatoid arthritis and can confirm the diagnosis, especially when clinical features such as morning stiffness and swelling of the specified joints are observed. They are considered more specific than rheumatoid factor and are often used in diagnosis according to NICE guidelines.
Question Hard Answer: B) Bisphosphonates
Question Hard Explanation: In older adults with osteoporosis who sustain a fracture, bisphosphonates are recommended by NICE to reduce the risk of future fractures. These medications help to strengthen bones by inhibiting bone resorption.
Medical fact of the day: The human skeleton is not static; it continually remodels itself. In fact, about 10% of an adult’s skeleton is replaced each year through a process of bone resorption and formation, which is why maintaining bone health is crucial at all stages of life!
Quote of the day: “In the quiet moments of care, we find the strength to heal—not just others, but ourselves. Keep your light shining, for it brightens the path for those in need.”