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💡 EXPLANATION:
Arthrocentesis is mandatory in acute hot joints to rule out septic arthritis, regardless of gout history. Synovial fluid analysis differentiates crystal-induced from septic arthritis. Serum uric acid is often normal during acute attacks.

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OBSTETRICS AND GYNAECOLOGY

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💡 EXPLANATION:
Septic arthritis is the primary differential for acute monoarthritis in diabetics due to immune suppression. Absence of fever is common in elderly patients and does not rule out infection. Immediate synovial fluid analysis is required to prevent joint destruction.

💡 EXPLANATION:
Mechanical locking (inability to extend) with focal medial joint line tenderness is characteristic of a displaced bucket-handle tear of the medial meniscus. ACL injuries typically present with immediate swelling and instability, not mechanical locking.

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💡 EXPLANATION:
Diagnosis is Patellofemoral Pain Syndrome (PFPS). Key features: young female runner, anterior knee pain, 'theater sign' (pain after sitting), and positive patellar grind test. Absence of joint line tenderness makes meniscal tear unlikely.

💡 EXPLANATION:
The tibial nerve courses posteromedially behind the medial malleolus. Injury causes loss of plantarflexion (tiptoes), inversion, and toe flexion, plus sensory loss on the sole. Common peroneal injury affects dorsiflexion.

💡 EXPLANATION:
CT chest is the gold standard for the initial characterization of a pulmonary nodule detected on X-ray. It provides necessary details on size, margins, and density to guide risk stratification. PET and biopsy are indicated only after CT assessment.

💡 EXPLANATION:
UAE guidelines recommend screening mammography every 2 years for women aged 40–69. Colonoscopy is valid for 10 years (next due at 58). Pap smear is indicated every 3–5 years (not due yet). DEXA screening generally begins at age 65 for average-risk women.

💡 EXPLANATION:
Routine DEXA screening is recommended for women ≥ 65 y/o. Women < 65 require screening only if fracture risk is increased (e.g., low BMI, steroid use, parental hip fracture). Since she has no risk factors, screening is deferred.