Joint infection: gonococcal arthritis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Joint infection: gonococcal arthritis

Sample item

A sexually active 22-year-old woman has 3 days of migratory joint pains, tenosynovitis of the wrist and a few pustular lesions on the hands, with a single swollen knee. Which organism is likely, and which antibiotic is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Neisseria gonorrhoeae; ceftriaxone

Disseminated gonococcal infection causes a triad of migratory polyarthralgia, tenosynovitis and pustular skin lesions, sometimes with a purulent monoarthritis. A third-generation cephalosporin such as ceftriaxone is first-line. Joint aspiration and drainage are done for a purulent effusion.

Option by option

  • A. Mycobacterium tuberculosis; isoniazid alone

    Tuberculosis causes an indolent monoarthritis rather than acute migratory polyarthralgia.

  • B. Staphylococcus aureus; amoxicillin alone

    Staphylococcus causes a purulent monoarthritis without this triad, and amoxicillin alone is inadequate.

  • C. Neisseria gonorrhoeae; ceftriaxone (correct)

    Correct. The classic dermatitis-tenosynovitis-arthritis picture needs ceftriaxone.

  • D. Borrelia burgdorferi; metronidazole

    Lyme arthritis follows a tick bite, and metronidazole is not the treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Neisseria gonorrhoeae; ceftriaxone. Disseminated gonococcal infection causes a triad of migratory polyarthralgia, tenosynovitis and pustular skin lesions, sometimes with a purulent monoarthritis.

Why is "Mycobacterium tuberculosis; isoniazid alone" not the answer?

Tuberculosis causes an indolent monoarthritis rather than acute migratory polyarthralgia.

Why is "Staphylococcus aureus; amoxicillin alone" not the answer?

Staphylococcus causes a purulent monoarthritis without this triad, and amoxicillin alone is inadequate.

Why is "Borrelia burgdorferi; metronidazole" not the answer?

Lyme arthritis follows a tick bite, and metronidazole is not the treatment.

What concept does this question test?

It tests Joint infection: gonococcal arthritis in Orthopaedics. A third-generation cephalosporin such as ceftriaxone is first-line. Joint aspiration and drainage are done for a purulent effusion.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Joint infection: gonococcal arthritis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.