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Chapter: 1 / Q: 71
A 27-year-old girl presents to her GP with pain and swelling in her joints, particularly the small joints of the hands. She has noticed this discomfort for the past month but has no other symptoms other than a bit of malaise and non-specific feeling of ‘not being herself’. She had put these
Chapter: 1 / Q: 72
A 47-year-old builder complains of pain in his foot. On exami- nation there is evidence of redness and discomfort in the right hallux although there is no evidence of ulceration or skin changes. Social history reveals an intake of alcohol in the region of 40units/week, often in binges
Chapter: 1 / Q: 73
A 63-year-old lady returns to the rheumatology clinic with pain in the joints of the hands and some loss of function. The ring finger on her right hand has become shortened in length, all other fingers are normal although there is a degree of ulnar deviation. Current medications include
Chapter: 1 / Q: 74
A 23-year-old man presents to his GP with an increasing pain in his lower back and stiffness that is worse in the mornings. He has noticed some intermittent pain in his knees and increasing pain in the soles of his feet towards the end of the day. Spine X-ray reveals squaring of the vertebrae
Chapter: 1 / Q: 75
A 74-year-old lady has suffered with increasing pain in her hip for a number of years, which she tolerates with NSAIDs. Recently she has noticed squaring of the thumb joint on her left hand and the pain in her hip is becoming more problematic and more troublesome towards the end of the day
Chapter: 1 / Q: 76
A 34-year-old man presents to hospital with abdominal pain, crampy in nature and associated with loose watery stools. On examination he is pale, tachycardic and sweaty. He denies eating any seafood recently but had been staying at a friend’s farm for the past 2 weeks
Chapter: 1 / Q: 77
A 40-year-old woman presents to hospital with a 3-day history of headache, nausea, lack of appetite. She has been otherwise fit and healthy and describes the headache as not related to any particular time of day but associated with pain on looking at bright lights
Chapter: 1 / Q: 78
A 28-year-old woman presents to her GP with pain on swallow- ing solid food and a strange taste in her mouth. She describes the pain as retrosternal in nature and associated only with swallowing; worse with dry and solid food and less with liquids. She denies any significant weight loss
Chapter: 1 / Q: 79
A 45-year-old man is brought to hospital by his friends who are worried that he has been acting ‘out of character’ recently. Collateral history reveals a gradual change in his behaviour, becoming more confused and agitated over a 2-month period with an episode of shaking of the limbs and arms
Chapter: 1 / Q: 80
A 32-year-old man was found collapsed at home by his partner and brought by ambulance to accident and emergency. On arrival he is struggling to breathe and is on an oxygen mask. History from the partner reveals a gradual onset over the past 2 weeks of increasing shortness of breath
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