EMQs in Clinical Medicine.pdf - Peshawar Medical College

122 Orthopaedics and rheumatology
52 Management of painful joints
A
B
C
D
E
F
G
exercise and physiotherapy
paracetamol
allopurinol
colchicine
high-dose aspirin
oral penicillin
oral prednisolone
H
I
J
K
L
intravenous flucloxacillin, oral
fusidic acid
intravenous hydrocortisone
sulfasalazine (sulphasalazine)
ibuprofen
methotrexate
For each clinical scenario below, suggest the most appropriate management. Each
option may be used only once.
1 A 24-year-old man presented with lower back pain and stiffness that was worse
in the morning. He has a question-mark posture.
2 An 80-year-old man with a 30-year history of rheumatoid arthritis presents to
A&E with fever and pain in the right knee. On examination his right knee is red,
hot and swollen. Aspirated synovial fluid is frankly purulent.
3 A 65-year-old woman recently diagnosed with osteoarthritis requires medication
for joint pain.
4 A 64-year-old woman who has been successfully treated for acute gout requires
prophylactic medication.
5 A 65-year-old woman with polymyalgia rheumatica.
Answers: see page 134.