Question Easy: A 65-year-old woman presents to her GP with pain in her right knee that worsens throughout the day. The knee pain improves with rest and she has noticed some crepitus. What is the most likely diagnosis? 🤔
A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Psoriatic arthritis
E) Septic arthritis
Explanations & Answers:
Question Easy Answer: B) Osteoarthritis
Question Easy Explanation: Osteoarthritis is commonly characterized by joint pain that worsens with activity and improves with rest. The presence of crepitus is also suggestive. According to NICE guidelines, this presentation is typical for osteoarthritis, especially in older patients.
Question Medium: A 35-year-old man has recently been diagnosed with ankylosing spondylitis. He is concerned about managing his pain and mobility. What is the first-line pharmacological treatment recommended? 💊
A) Methotrexate
B) Infliximab
C) Naproxen
D) Paracetamol
E) Sulfasalazine
Question Medium Answer: C) Naproxen
Question Medium Explanation: NICE guidelines recommend NSAIDs, such as naproxen, as the first-line treatment for managing pain in patients with ankylosing spondylitis. They help reduce inflammation and improve mobility. While biological therapies like infliximab may be considered, they are not the first-line treatment.
Question Hard: A 28-year-old female presents with a one-week history of pain and swelling in her left knee. She reports a recent bout of diarrhoea a few weeks ago. On examination, she has conjunctivitis and a painful, swollen knee. What is the most likely diagnosis? 🤨
A) Reactive arthritis
B) Septic arthritis
C) Osteoarthritis
D) Rheumatoid arthritis
E) Psoriatic arthritis
Question Hard Answer: A) Reactive arthritis
Question Hard Explanation: Reactive arthritis is often triggered by a preceding infection, such as a gastrointestinal or genitourinary infection. The classic triad includes arthritis, conjunctivitis, and urethritis, although not all may be present in every case. The timing and symptomatology fit the description of reactive arthritis. According to NHS guidelines, identification of the triggering infection is crucial to guide management.
Medical fact of the day: Did you know that in the UK, osteoarthritis affects at least 8.5 million people? This condition is one of the most common reasons for hip and knee replacement surgery.
Quote of the day: “In the world of care, small acts of kindness can be transformative. Every patient is a person, and every moment is an opportunity.”