Wattle Pharmacy Prep

Musculoskeletal
Practice questions with explanations

Musculoskeletal belongs to Therapeutics and patient care, which makes up about 45% of the Overseas Pharmacist Readiness Assessment (OPRA®). Answer each question yourself before opening the explanation.

1. Which principle applies to using a corticosteroid injection for a soft tissue condition such as tendinopathy?

  1. It is the definitive treatment
  2. It provides short-term relief but may impair tendon healing, so it is used selectively alongside a rehabilitation programme
  3. It should be repeated frequently
  4. It cures the condition
Show answer

B. It provides short-term relief but may impair tendon healing, so it is used selectively alongside a rehabilitation programme

Trials in tendinopathy show short-term benefit with worse long-term outcomes than exercise-based rehabilitation, and repeated injections risk tendon rupture. The injection may create a window in which rehabilitation becomes possible, which is a reasonable use, but it does not substitute for the loading programme that heals the tendon.

2. Which treatment is first line for an acute gout attack in a patient with normal renal function?

  1. Paracetamol alone
  2. An antibiotic
  3. An NSAID, colchicine or a corticosteroid, started as early in the attack as possible
  4. Allopurinol started at high dose
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C. An NSAID, colchicine or a corticosteroid, started as early in the attack as possible

All three anti-inflammatory options are effective, and choice depends on comorbidity: NSAIDs are avoided in renal impairment, heart failure and peptic ulcer disease; colchicine is limited by diarrhoea and renal function; corticosteroids suit patients where both are contraindicated. Speed matters more than the choice. Urate-lowering therapy is not started as treatment for the acute attack.

3. Which feature distinguishes inflammatory back pain from mechanical back pain?

  1. Morning stiffness lasting over 30 minutes, improvement with exercise and worsening with rest, often with insidious onset before age 45
  2. Pain worse after activity and relieved by rest
  3. Absence of any morning stiffness
  4. Sudden onset after lifting
Show answer

A. Morning stiffness lasting over 30 minutes, improvement with exercise and worsening with rest, often with insidious onset before age 45

The pattern matters because inflammatory back pain suggests axial spondyloarthritis, which needs rheumatology assessment and responds to NSAIDs and biologics rather than to the reassurance and activity advice appropriate for mechanical pain. Night pain waking the patient in the second half of the night and good response to NSAIDs support the diagnosis.

These are 3 of the 40 questions on musculoskeletal in the app.

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More topics in Therapeutics and patient care

Australian pharmacy practice and law · Cardiovascular therapeutics · CNS and psychiatry · Counselling, OTC and triage · Dermatology · Diabetes and endocrine therapeutics · Eye, ear, nose and throat · Gastrointestinal therapeutics · Infectious diseases · Older people and polypharmacy · Oncology and supportive care · Paediatrics · Pain and palliative care · Pharmaceutical calculations · Renal and urology · Respiratory therapeutics · Vaccines and immunisation · Women's health