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Block 3 Round Up

Total questions: 15

Worksheet time: 30mins

Name
Class
Date
1.

Brian is a 79 year-old who has recently moved into a care home due to Alzheimer's Dementia. He is complaining of pain on passing urine and has had more episodes of incontinence than normal. Examination is unremarkable, with Temp=36.7, SpO2=96%, HR=85, BP=145/86, RR=16


What would be the most appropriate investigation to confirm a urinary tract infection?

a)

Mid-stream urine specimen for culture

b)

Bladder scan

c)

Urine dipstick

d)

Renal tract ultrasound

2.

Which joint disease is associated with morning stiffness that improves with activity?

a)

Septic Arthritis

b)

Gout

c)

Rheumatoid Arthritis

d)

Psuedogout

3.

What does this picture show?

a)

Plaque Psoriasis

b)

Eczema

c)

Cellulitis

d)

Guttate Psoriasis

e)

Acne

4.

A 72 year old male presents with severe pain in his knee. On examination the joint is swollen, red and tender. There is pain on active and passive movement.

Pulse 88, Sats 99%, Temp 38.2, BP 156/94.


What is the likely diagnosis?

a)

Gout

b)

Rheumatoid arthritis

c)

Osteoarthritis

d)

Polymyalgia rheumatica

e)

Septic Arthritis

5.

What does this picture show?

a)

Plaque Psoriasis

b)

Eczema

c)

Cellulitis

d)

Acne

e)

Guttate Psoriasis

6.

A patient presents as swelling at the distal interphalangeal joints. What sign is this?

a)

Heberden's nodes

b)

Bouchard's nodes

c)

Swan neck deformity

d)

Z-thumb deformity

7.

A patient presents with swelling at the proximal interphalangeal joints. What sign is this?

a)

Heberden's nodes

b)

Bouchard's nodes

c)

Swan neck deformity

d)

Z-thumb deformity

8.

Nadia, an 86 year-old female, presents to frailty assessment with new confusion. Her AMTS score is 6/10 (previously 9/10) with GP. She has recently started antibiotics for a urinary tract infection.


Which of the following are possible causes of her delirium? Choose 3.

a)

Pain due to T4 wedge fracture

b)

Urinary tract infection

c)

Generalised cerebral atrophy

d)

Undiagnosed lung cancer

e)

Blood sugar 14mmol/L

9.

What is the condition?

a)

Plaque Psoriasis

b)

Eczema

c)

Cellulitis

d)

Guttate Psoriasis

e)

Acne

10.

What condition are Heberden's nodes and Bouchard's nodes commonly seen in?

a)

Gout

b)

Rheumatoid arthritis

c)

Septic arthritis

d)

Osteoarthritis

e)

Ankylosing spondylitis

11.

A 74 year old presents with unilateral knee pain. She describes morning stiffness and pain which worsens on exercise. On examination she has crepitus on knee flexion. What is the likely diagnosis?

a)

Osteoporosis

b)

Rheumatoid arthritis

c)

Osteoarthritis

d)

Gout

e)

Septic arthritis

12.

Which defines osteoporosis?

a)

hip BMD greater than the lower limit of normal which is taken as 1 SD below the young adult reference mean (T score ≥-1).

b)

hip BMD between 1 and 2.5 SD below the young adult reference mean (T score less than -1 but above -2.5).

c)

hip BMD 2.5 SD or more below the young adult reference mean (T score ≤-2.5).

d)

hip BMD 2.5 SD or more below the age related reference mean (Z score ≤-2.5).

e)

hip BMD between 1 and 2.5 SD below the age related reference mean (Z score less than -1 but above -2.5).

13.

How does osteoporosis usually present?

a)

Joint pain

b)

Fragility fracture

c)

Pain on movement

d)

Night sweats

14.

Tomas is a 54 year-old man who takes methotrexate for rheumatoid arthritis. He presents with fever, pain on passing urine and worsening right flank pain for 24hrs. Examination reveals a tender right flank, Temp 38.4, RR 26, SpO2= 96% on air, HR= 125, BP=100/67.


Which 3 of the following are key components of immediate management?

a)

Blood cultures

b)

Arterial/venous blood gas

c)

Renal ultrasound scan

d)

500ml 0.9% Sodium Chloride IV fluid bolus

e)

500ml 5% Dextrose IV fluid bolus

15.

Aileen is a 76 year-old lady with mild Alzheimer's dementia who has been admitted following a 'mechancal fall'.


Which of the following may have interacted with ramipril to increase her falls risk?

a)

Indapamide

b)

Salbutamol Inhaler

c)

Paracetamol

d)

Alcohol