A 65 year old female presents a painful right knee. An x-ray of the knee shows linear calcification of the articular cartilage and lateral meniscus. Given the likely diagnosis, what would you find on aspiration of the joint?
Positively birefringent crystals
Raised WCC
Pus
Negatively birefringent crystals
No abnormality
A 32 year old female with psoriasis presents with painful swollen fingers with some deformity. What is the most appropriate treatment?
Methotrexate
Azathioprine
Sulfasalazine
Corticosteroids
Etanercept
A 62 year old female with known osteoarthritis and diabetes presents with sudden swelling and pain in her left knee. It is hot, red and tender. What investigation should be performed?
Joint aspiration for gram stain, microscopy and culture
Xray of knee
Joint fluid microscopy
Blood culture
Analgesia
Which of the following is not a long term risk of radiotherapy?
Mucositis
Increased risk of subsequent malignancy
Lymphoedema
Infertility
Sensorineural hearing loss
(May not be long term but acute risk)
A 34 year old female who works in a pet shop presents with a few days history of fever, chills, unproductive cough and shortness of breath. She is also complaining of a sore throat, nose bleeds and severe headache. She is also photophobic. On examination there is a few bibasal crackles. There is evidence of splenomegaly. You notice a few salmon coloured, blanching, papules on her cheeks. Which of the following is the most likely diagnosis?
Psittacosis
Q Fever
Acute form of Extrinsic Allergic Alveolitis
Chronic form of Extrinsic Allergic Alveolitis
Legionella
A patient presents with a nine month history of tingling and weakness in her legs. The patient has bilateral 4/5 power, has loss of ankle reflexes and is hyperreflexic at his knees with upgoing plantars. There is also loss of joint position sense and vibration sensation. What is the likely diagnosis?
Vitamin B12 deficiency
Syringomyelia
Spinal Tumour
Transverse Myelitis
Lumbar Disc Prolapse
(Hint SCD of spnl cord)
A 75 year old gentleman with type 2 diabetes melllitus presents for his retinal screening. On the retinal photograph there is evidence of cotton wool spots and flame haemorrhages. There also appears to be new vessel formation very close to the optic disc. What is the next stage in management?
Referral for laser photocoagulation
Referral for fluorescein angiography
Optimal glycaemic control
Insulin
Fenofibrate
A 32 year old swedish female presents with arthralgia, cough and fever. She has also noticed bruise like lesions on her shins. On examination there is bilateral ankle arthritis and erythema nodosum. A CXR shows bilateral hilar lymphadenopathy. What is the most likely diagnosis?Sarcoidosis
Lofgren syndrome
SLE
Rheumatoid arthritis
Lymphoma
Tuberculosis
(A 32 year old swedish female…enough landmark of the Dx)
A 13 year old boy presents to is GP. He has been generally unwell with a fever for approximately one week. On examination there is evidence of bilateral conjunctivitis, cervical lymphadenopathy, erythema and desquamation and oedema of his hands and feet and his lips appear red and dry. What is the most likely diagnosis?
Kawasaki disease
Infectious mononucleosis
Rubella
Parvovirus
Stills Disease
(red boy,red eye red lips & hands with red signal on heart)