MSK Quiz#26, Gout and Septic Arthritis  

1. A 50-year-old male presents with sudden onset of severe pain, swelling, and redness in his right big toe. He admits to consuming a large amount of red meat and alcohol over the weekend. Aspiration of the joint reveals needle-shaped, negatively birefringent crystals under polarized light microscopy. Which of the following is the most likely diagnosis? 

Question 1 of 5

2. A 70-year-old woman with a history of osteoarthritis presents with a swollen left knee. The joint is warm, tender, and has decreased range of motion. Joint aspiration yields a white blood cell count of 50,000/µL with predominantly neutrophils. Gram stain shows no organisms, but culture grows Staphylococcus aureus. Which of the following is the most appropriate initial treatment? 

Question 2 of 5

3. A patient presents with acute knee pain and swelling. His medical history is significant for multiple episodes of similar symptoms in the same joint, which resolve with NSAIDs. The joint fluid analysis reveals calcium pyrophosphate crystals. Which of the following is the most likely diagnosis? 

Question 3 of 5

4. A 45-year-old male with a history of intravenous drug use presents with fever, chills, and severe pain in his right hip that worsens with movement. Laboratory tests reveal elevated WBC count and ESR. Joint aspiration is performed, showing a leukocyte count of >50,000/µL with 90% neutrophils. Which of the following organisms is most commonly responsible for this condition? 

Question 4 of 5

5. A 60-year-old male with a history of chronic tophaceous gout presents with acute onset of left knee pain and swelling. He denies fever or recent illness. Joint aspiration reveals negatively birefringent needle-shaped crystals and a white blood cell count of 20,000/µL. Which of the following is the most appropriate treatment at this time? 

Question 5 of 5


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