A 25-year-old man fractured his hand during a street fight and was taken to the Emergency Department where X-rays were taken. A radiologist examined the films and observed a single fracture of the carpal bone that articulates with the majority of the base of the third metacarpal bone.
Which of the following bones was most likely fractured?
What advice would you give Mrs Rose regarding her 3-year-old toddler who she is concerned has ‘flat feet’? She is anxious and distressed and has been advised that her child needs an early operation and expensive orthotics to reverse the condition. However, upon examination, you observe that the toddler is a happy child with full mobility and no pain. The foot only appears flat when standing, but the arch reconstitutes when the child is toe walking or hanging their foot.
A 65-year-old woman who has just been diagnosed with osteoporosis is prescribed oral bisphosphonates. She expresses concern about the potential side-effects of the medication.
What is the most frequent side-effect she may encounter?
De Quervain’s syndrome is a condition that involves the stenosing tenosynovitis of the extensor pollicis brevis and abductor pollicis longus of the thumb. What condition is strongly linked to De Quervain’s syndrome?
An older woman presents to the Emergency Department with severe headache, nausea, vomiting and a painful, red right eye. She has reduced visual acuity in the right eye and normal visual acuity in the left eye. On examination, she had a stony hard eye with marked pericorneal reddening and a hazy corneal reflex. Tonometry revealed raised intraocular pressure.
Which of the following is the most appropriate management plan?
A 28-year-old female patient visits her GP clinic complaining of a painful lump on the border of her left eyelid. She has no medical history and is generally healthy. Upon examination, a small abscess filled with pus is observed in the area. Her visual field is unaffected. What treatment should be recommended for the probable diagnosis?
A 70-year-old man, who has been a diabetic for over 20 years, visits his GP for a routine check-up. During the appointment, he mentions to his doctor that he has been experiencing difficulty with his vision in his right eye for the past few months. He describes it as blurry vision and seeing halos around lights at night. The man has never had any vision problems before. He is currently taking medications for his high blood pressure and cholesterol levels. Other than his vision, his physical examination is unremarkable. What is the most likely diagnosis for the man’s symptoms?
A 62-year-old man comes to the Emergency Department with a suspected hip fracture after falling down the stairs at home. Upon examination, his left leg appears shortened and externally rotated. His vital signs are stable. X-rays are ordered and reveal an intracapsular neck of femur fracture. The patient is also found to have previous fractures, which he was not aware of. A bone mineral densitometry (BMD) scan is requested to determine if the patient has osteoporosis.
What T score value on BMD indicates a diagnosis of osteoporosis?
A 58-year-old woman presents to her General Practitioner (GP) with complaints of severe pain at night due to her osteoarthritis. She has been suffering from this condition for the past 12 years and had a total knee replacement surgery on her right knee last year, which significantly improved her pain. However, for the past two months, she has been experiencing excruciating pain in her left knee. The patient has a medical history of hypertension and peptic ulcer disease and is currently taking 4 g of paracetamol daily. She tried using topical capsaicin last month, which provided some relief, but she is now seeking alternative pain management options. The patient has normal liver function tests and no history of liver disease.
What is the most appropriate course of action for managing this patient’s pain?
A 14-year-old girl attends the Minor Injuries Unit, having ‘twisted’ her left ankle during a hockey match. She played on after the injury and has come to see you after the game ended, as her ankle has become increasingly swollen and painful.
She has walked into the Emergency Department unaided. There is marked swelling around the left ankle. There is some tenderness anterior to the lateral malleolus. Otherwise, there is no bony tenderness on examination of the ankle, foot and knee.
Select the most appropriate management option.