Question Easy:
A 30-year-old woman presents with pain in her right wrist after slipping on ice and landing on her outstretched hand. She has tenderness in the anatomical snuffbox. What is the most likely injury?
A) Scaphoid fracture
B) Colles’ fracture
C) Wrist sprain
D) Smith’s fracture
E) Radial head fracture
Question Medium:
A 55-year-old man presents with knee pain that worsens with activity and is relieved by rest. Physical examination reveals crepitus but no joint effusion. An X-ray of the knee shows joint space narrowing and osteophytes. What is the most appropriate initial management?
A) Arthroscopic surgery
B) Oral morphine
C) Weight loss and exercise
D) Intra-articular steroid injection
E) Knee replacement surgery
Question Hard:
A 70-year-old woman presents with a 3-month history of progressive back pain, especially at night. She also reports unintentional weight loss and fatigue. Examination reveals tenderness over the thoracic vertebrae. An X-ray shows lytic lesions in the thoracic spine. What is the most likely diagnosis?
A) Degenerative disc disease
B) Osteoporosis
C) Multiple myeloma
D) Spinal osteoarthritis
E) Spinal metastasis
Explanations & Answers:
Question Easy Answer: A) Scaphoid fracture
Question Easy Explanation: The tenderness in the anatomical snuffbox is characteristic of a scaphoid fracture, often due to a fall on an outstretched hand (FOOSH). Early diagnosis is critical to prevent complications such as avascular necrosis of the proximal segment.
Question Medium Answer: C) Weight loss and exercise
Question Medium Explanation: For osteoarthritis, NICE guidelines recommend weight loss and exercise as a part of initial management to reduce symptoms and improve joint function. Surgery is reserved for advanced cases not responding to conservative measures.
Question Hard Answer: C) Multiple myeloma
Question Hard Explanation: The combination of bone pain, particularly at night, and lytic lesions on X-ray is suggestive of multiple myeloma, a malignant plasma cell disorder. The patient’s symptoms of weight loss and fatigue also align with this diagnosis.
Medical fact of the day: Did you know that osteoarthritis affects approximately 8.5 million people in the UK? It’s the most common form of arthritis and is a leading cause of disability among older adults.
Quote of the day: “Healing is an art that takes patience and compassion; remember that every small act of care makes a big difference.”