11/02/2024
Combined TBL áá˛áˇ ááąá¸áá˝ááşá¸ááąáŹááşá¸ SBA ááąá¸áá˝áąááᯠPulsePoint ááąá¸áááŻáˇáĄáá˝ááş áááşááąá¸áááŻááşááŤáááş
Part-1 (UM-1 and Magaway)
UM1 YGNâď¸
MSS Module
Combined TBL - Painful swelling knee
SBAđŁ
1. What is the major protein component of articular cartilage that is synthesized by chondrocytes?
A. Glycosaminoglycan
B. Keratan
C. Proteoglycan
D. Type I collagen
E. Type II collagen
2. Male, 57-year old, pain right big toe. 2 drinks of alcohol last night, no history of trauma or any other joint pain. Diagnosed as gouty arthritis.
Which of the following is CORRECT regarding precipitation of gout by drinking alcohol?
A. Ethanol activates xanthine oxidase activity in a very short duration.
B. Ethanol increases uric acid formation by providing substrates.
C. Ethanol induced lactic acidosis interferes renal clearance of uric acid.
D. Ethanol metabolism increases purine nucleotide synthesis and breakdown.
E. Ethanol metabolism impairs redox the redox state which favours uric acid load.
3. Which of the following should be considered seriously in acute onset of knee swelling?
A. Bone tumour
B. Elderly patient with osteoporosis
C. History of sports injury
D. Osteoarthritis
E. Septic arthritis
4. 45-year old female, BMI 32 kg/m2, pain and inflammation of right knee following weight-bearing activities, no trauma involved, no systemic symptoms. Which of the following is the most likely provisional diagnosis?
A. Bone malignancy
B. Gouty arthritis
C. Osteoarthritis
D. Osteoporosis
E. Rheumatoid arthritis
5. Arthrocentesis is the procedure performed to aspirate synovial fluid from a swollen joint for both diagnostic and therapeutic purposes. Which of the following condition knee aspiration must NOT be done?
A. Gouty arthritis
B. Haemarthrosis knee
C. Knee cellulitis
D. Knee osteoarthritis
E. Rheumatoid arthritis
6. Pain has an built-in unpleasant effect. Which of the following statememts is TRUE for pain sensation?
A. Joint pains are a type of superficial pain.
B. Pain receptors are encapsulated nerve endings.
C. Pain transmission is along ventral spinothalamic tract.
D. Pain gating occurs in ventral horn of spinal cord.
E. The sensory cortex is not essential for pain perception.
7. 20-year old male, history of drug abuse, injury to forearm and wrist joint while playing football. Wrist joint is inflamed but no fracture seen in X-ray. MO ordered nurse for injection of the drug to relieve pain and inflammation. Which of the following drug should be administered without causing additional problem to him?
A. Acetaminophen
B. Fentanyl
C. Ketorolac
D. Morphine
E. Tramadol
8. 48-year old male, history of ureteric stone, history of gout, consultation for drug treatment for gout, history of allergy to allopurinol. Which of the following agent should be used for long-term management for gout?
A. Dexamethasone
B. Febuxostat
C. Ibuprofen
D. Probenecid
E. Sulfinpyrazone
9. Which of the following is a diagnostic feature of chronic gout?
A. Fever
B. Fracture
C. Alcoholism
D. Joint swelling
E.Tophus
10. The followings are risk factors for gout EXCEPT:
A. Generalised OA
B. High alcohol intake
C. High vitamin C
D. Metabolic syndrome
E. Red meat
Crd to Thet Lin
Musculoskeletal and Skin Module, UM (Magaway)
Combined TBL (Painful swelling of a joint)
8-2-2024
1. Which part of a joint does osteoarthritis usually affect?
A. Bone
B. Bursas
C. Cartilage
D. Ligaments
E. Meniscus
2. Which of these makes it more likely to get osteoarthritis?
A. Back pain
B. Excess body weight
C. Increase uric acid level
D. Too little body weight
E. Young age
3. Chemical agent that causes pain is
A. bradykinin
B. dopamine
C. endorphin
D. enkephalin
E. morphine
4. Production of intense pain by stimuli which normally do not produce pain is called
A. allodynia
B. causalgia
C. hyperpathia
D. primary hyperalgesia
E. secondary hyperalgesia
5. The primary afferent AĂ° fibers in pain pathway release
A. endorphin
glutamate
C. histamine
D. serotonin
E. substance P
6. A 51-year-old man has pain in the right knee, lower back pain and neck. He notices
that the joint feel stiff in the morning. Some joint crepitus is audible on moving the
knee. Serum calcium, phosphorous, ALP and uric acid levels are normal, What is the
most likely diagnosis?
A. Gouty arthritis
B. Multiple myeloma
C. Osteoarthritis
D. Paget disease
E. Rheumatoid arthritis
7. Which of the following one is true for osteoarthritis (0A)?
A. It commonly affects the small joints of hands and feet.
B. Its effects are commonly symmetrical.
C. It is more aggressive than rheumatoid arthritis.
D. OA usually affects weight-bearing joints.
E. Progression ofOA is difficult to predict and can cause widespread symptoms.
8. Which of the following one is true for rheumatoid arthritis (RA)?
A. It affects joints as well as other surrounding tissues, including organs.
B. It is an infectious cause of inflammatory disease.
C. It has many known triggering factors.
D. Pain or aching in one joint is typical.
E. The same symptoms on both sides of the body are uncommon.
9. A 60-year-old man presents to the emergency department with a 3-day history of
gradually worsening pain and swelling in his left knee. He had history of acupuncture one
week ago. On physical examination, temperature is 100 °F and mild edema and erythema and
warmth around the left knee. In this case, the results of the arthrocentesis diagnosed septic
joint. Which of the following is the most likely causal organism for this case?
A. Brucella
Mycobacterium
C. Neisseria
D. Nocardia
E. Staphylococcus
10. The following are the radiological features seen in osteoarthritis of the knee
EXCEPT.
A. Loss of joint space
B. Osteophytes
C. Periosteal reaction
D. Sclerosis
E. Subchondral cysts
Crd to Mya Thet chal
