MODULE 15 EMQs
Match each clinical vignette to the appropriate diagnosis.
Reactive arthritis
Polymyalgia rheumatica
Ankylosing spondylitis
Dermatomyositis
Enteropathic arthritis
Acute gout
Chronic gout
Rheumatoid arthritis
Psoriatic arthritis
Septic arthritis
Pseudogout
Reactive arthritis
Polymyalgia rheumatica
Ankylosing spondylitis
Dermatomyositis
Enteropathic arthritis
Acute gout
Chronic gout
Rheumatoid arthritis
Psoriatic arthritis
Septic arthritis
Pseudogout
EMQ 1.
An 18 year old male presents with a painful left ankle, right foot and right hip. He complains of dry itchy eyes and pain when voiding.
His vital signs are:
HR 92 /min
BP 114/78 mmHg
RR 18
Sats 99% RA
T 37.4 oC
EMQ 2.
A 31 year old female presents with chronic lower back pain. She describes difficulty maintaining her weight and occasional night sweats. On questioning, she describes pain that is worst at night, and at rest, and she is tender with palpation of her sacroiliac joints.
Her vital signs are:
HR 99 /min
BP 124/74 mmHg
RR 19
Sats 99% RA
T 37.1 oC
EMQ 3.
A 71 year old man presents with bilateral pain in his hips and shoulder. He says the pain occurs in the morning, and often lasts for an hour after waking. The symptoms have been occurring for 5 weeks. He has no other major symptoms of systemic illness.
He has a full blood count, ELFT, CRP and ESR performed in the ED. The only abnormality is an ESR of 82mm/h.
EMQ 4.
A 45 year old man with a history of psoriasis presents with painful hands. He has asymmetric swelling of his distal interphalangeal joints on both hands, and swollen sausage shaped fingers (dactylitis). He currently has no active skin lesions.
EMQ 5.
A 38 year old presents with an acutely swollen left knee. He has no history of trauma and no systemic symptoms of infection. Aspiration of the joint shows a count of 10 000 white cells /uL and blue rhomboidal crystals under positively birefringent light.
An 18 year old male presents with a painful left ankle, right foot and right hip. He complains of dry itchy eyes and pain when voiding.
His vital signs are:
HR 92 /min
BP 114/78 mmHg
RR 18
Sats 99% RA
T 37.4 oC
EMQ 2.
A 31 year old female presents with chronic lower back pain. She describes difficulty maintaining her weight and occasional night sweats. On questioning, she describes pain that is worst at night, and at rest, and she is tender with palpation of her sacroiliac joints.
Her vital signs are:
HR 99 /min
BP 124/74 mmHg
RR 19
Sats 99% RA
T 37.1 oC
EMQ 3.
A 71 year old man presents with bilateral pain in his hips and shoulder. He says the pain occurs in the morning, and often lasts for an hour after waking. The symptoms have been occurring for 5 weeks. He has no other major symptoms of systemic illness.
He has a full blood count, ELFT, CRP and ESR performed in the ED. The only abnormality is an ESR of 82mm/h.
EMQ 4.
A 45 year old man with a history of psoriasis presents with painful hands. He has asymmetric swelling of his distal interphalangeal joints on both hands, and swollen sausage shaped fingers (dactylitis). He currently has no active skin lesions.
EMQ 5.
A 38 year old presents with an acutely swollen left knee. He has no history of trauma and no systemic symptoms of infection. Aspiration of the joint shows a count of 10 000 white cells /uL and blue rhomboidal crystals under positively birefringent light.