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 EMQ 5

 

   

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EMQ: 5

Arthritis

a)      Rheumatoid arthritis

b)      Osteoarthritis

c)      Gout

d)      Ankylosing spondylitis

e)      Psoriatic arthropathy

f)        Reiterís syndrome

g)      Septic arthritis

h)      Rheumatic fever

i)        Systemic lupus erythematosus

j)        Pseudogout

Select the most likely cause of arthropathy from the list above to match each of the scenarios given below:

1) A 24-year-old male presents with a gradual onset of backache and morning stiffness that is improved by exercise. On examination of his spine there is decreased spinal mobility and when he stands with his back to a wall, the occiput does not touch the wall.

2) A 50-year-old female presents with pain and stiffness of her hands and wrists. The stiffness is worse in the morning and gets better as the day progresses. On examination she has swelling of her metacarpophalangeal joints and there is ulnar deviation at the metacarpophalangeal joints. Joint movement is impaired.

3) A 45-year-old man presents with pain and deformity of the joints of his hands. On examination the nails show pitting and the distal interphalangeal joints are painful and deformed on both sides.

4) A 70-year-old male presents with severe pain in the right first metatarsophalangeal joint. The pain woke him up from his sleep. On examination the joint is swollen red and painful and tender.

5) A 75-year-old man who has had long-standing problems with his joints presents with pain and swelling of his right knee. On examination he is febrile, the skin overlying the knee looks red, it is hot and there is evidence of fluid within the joint.

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