I Human Case Study Week 9 – 83-Year-Old
Female (Osteoarthritis) (2026) FULL CLINICAL
SUMMARY & SOAP NOTE PRACTICE GUIDE
<LATEST VERSION>
1. What is the most common chief complaint for a patient with symptomatic osteoarthritis
(OA)?
a) Muscle weakness
b) Joint pain that worsens with activity and improves with rest ✓
c) Sudden, sharp, stabbing pain at night
d) Generalized body fatigue
2. How does the patient likely describe the quality of her joint pain?
a) Burning and tingling
b) Sharp and shooting
c) Aching and stiffness ✓
d) Throbbing and pulsating
3. What is a key feature of morning stiffness in osteoarthritis?
a) Lasts for several hours
b) Is improved with activity
c) Is typically brief, lasting less than 30 minutes ✓
d) Is associated with systemic fever
4. Which joint is MOST commonly affected in osteoarthritis?
a) Shoulder
b) Ankle
c) Knee ✓
d) Wrist
5. What aggravating factor will the patient most likely report for her knee pain?
a) Resting in bed
b) Walking down stairs ✓
c) Hot showers
d) Light stretching
,6. What relieving factor will the patient most likely report for her joint pain?
a) Running
b) Rest ✓
c) Cold compression
d) Heavy lifting
7. A history of "crepitus" refers to:
a) Joint swelling
b) A grating sensation or sound with joint movement ✓
c) Joint deformity
d) Skin redness
8. What is a common functional limitation for a patient with advanced knee OA?
a) Inability to brush hair
b) Difficulty rising from a chair or climbing stairs ✓
c) Loss of fine motor skills in the hands
d) Trouble swallowing
9. Which of the following is a "red flag" symptom that suggests something other than
simple OA?
a) Pain that is worse in the evening
b) Joint instability or "giving way"
c) Constitutional symptoms like fever and weight loss ✓
d) Pain with palpation of the joint line
10. What past medical history is a significant risk factor for developing osteoarthritis?
a) Asthma
b) Previous joint injury or surgery ✓
c) Hypertension
d) Migraines
11. The patient's age (83) is a primary risk factor because OA is a disease of:
a) Autoimmunity
b) Wear and tear/degeneration ✓
c) Acute infection
d) Nutritional deficiency
12. What family history is relevant to osteoarthritis?
a) Rheumatoid Arthritis
b) Lupus
, c) Gout
d) A family history of OA, especially Heberden's nodes ✓
13. What social history is critical to assess in this patient's functional status?
a) Tobacco use
b) Alcohol use
c) Living situation and need for assistive devices ✓
d) Sexual activity
14. What review of systems is most pertinent for OA?
a) Neurological (headaches, dizziness)
b) Musculoskeletal (joint pain, swelling, limited ROM) ✓
c) Cardiovascular (chest pain)
d) Gastrointestinal (abdominal pain)
15. What medication is the patient likely using for pain relief?
a) Insulin
b) Acetaminophen or Ibuprofen ✓
c) Antibiotics
d) Antidepressants
16. A key question to assess the impact of pain is to ask about:
a) Their favorite food
b) Effect on activities of daily living (ADLs) ✓
c) Childhood illnesses
d) Travel history
17. What symptom distinguishes inflammatory arthritis (like RA) from OA?
a) Pain
b) Prolonged morning stiffness (>1 hour) and systemic symptoms ✓
c) Joint tenderness
d) History of injury
18. What might the patient report about the appearance of her finger joints?
a) Swan-neck deformities
b) Ulnar deviation
c) Bony enlargements (Heberden's and Bouchard's nodes) ✓
d) Psoriatic plaques
19. Pain that is localized to the medial knee joint line in an older adult is classic for:
a) Gout
, b) Patellofemoral syndrome
c) Osteoarthritis of the knee ✓
d) Septic arthritis
20. What is a common complaint regarding sleep in patients with OA?
a) Sleeping too much
b) Pain disrupting sleep ✓
c) Sleepwalking
d) Night terrors
21. What gait abnormality might be observed in a patient with severe hip OA?
a) Steppage gait
b) Antalgic gait (limping) ✓
c) Ataxic gait
d) Scissoring gait
22. In the history, the patient denies fever and chills. This helps rule out:
a) Osteoporosis
b) Septic arthritis ✓
c) Gout
d) Bursitis
23. What is the most significant modifiable risk factor for OA progression?
a) Age
b) Genetics
c) Obesity ✓
d) Gender
24. The patient reports the pain started insidiously and has worsened over years. This is
typical for:
a) Fracture
b) Gout attack
c) Osteoarthritis ✓
d) Muscle strain
25. Asking about a history of peptic ulcer disease is important before prescribing:
a) Acetaminophen
b) NSAIDs ✓
c) Topical capsaicin
d) Glucosamine
Female (Osteoarthritis) (2026) FULL CLINICAL
SUMMARY & SOAP NOTE PRACTICE GUIDE
<LATEST VERSION>
1. What is the most common chief complaint for a patient with symptomatic osteoarthritis
(OA)?
a) Muscle weakness
b) Joint pain that worsens with activity and improves with rest ✓
c) Sudden, sharp, stabbing pain at night
d) Generalized body fatigue
2. How does the patient likely describe the quality of her joint pain?
a) Burning and tingling
b) Sharp and shooting
c) Aching and stiffness ✓
d) Throbbing and pulsating
3. What is a key feature of morning stiffness in osteoarthritis?
a) Lasts for several hours
b) Is improved with activity
c) Is typically brief, lasting less than 30 minutes ✓
d) Is associated with systemic fever
4. Which joint is MOST commonly affected in osteoarthritis?
a) Shoulder
b) Ankle
c) Knee ✓
d) Wrist
5. What aggravating factor will the patient most likely report for her knee pain?
a) Resting in bed
b) Walking down stairs ✓
c) Hot showers
d) Light stretching
,6. What relieving factor will the patient most likely report for her joint pain?
a) Running
b) Rest ✓
c) Cold compression
d) Heavy lifting
7. A history of "crepitus" refers to:
a) Joint swelling
b) A grating sensation or sound with joint movement ✓
c) Joint deformity
d) Skin redness
8. What is a common functional limitation for a patient with advanced knee OA?
a) Inability to brush hair
b) Difficulty rising from a chair or climbing stairs ✓
c) Loss of fine motor skills in the hands
d) Trouble swallowing
9. Which of the following is a "red flag" symptom that suggests something other than
simple OA?
a) Pain that is worse in the evening
b) Joint instability or "giving way"
c) Constitutional symptoms like fever and weight loss ✓
d) Pain with palpation of the joint line
10. What past medical history is a significant risk factor for developing osteoarthritis?
a) Asthma
b) Previous joint injury or surgery ✓
c) Hypertension
d) Migraines
11. The patient's age (83) is a primary risk factor because OA is a disease of:
a) Autoimmunity
b) Wear and tear/degeneration ✓
c) Acute infection
d) Nutritional deficiency
12. What family history is relevant to osteoarthritis?
a) Rheumatoid Arthritis
b) Lupus
, c) Gout
d) A family history of OA, especially Heberden's nodes ✓
13. What social history is critical to assess in this patient's functional status?
a) Tobacco use
b) Alcohol use
c) Living situation and need for assistive devices ✓
d) Sexual activity
14. What review of systems is most pertinent for OA?
a) Neurological (headaches, dizziness)
b) Musculoskeletal (joint pain, swelling, limited ROM) ✓
c) Cardiovascular (chest pain)
d) Gastrointestinal (abdominal pain)
15. What medication is the patient likely using for pain relief?
a) Insulin
b) Acetaminophen or Ibuprofen ✓
c) Antibiotics
d) Antidepressants
16. A key question to assess the impact of pain is to ask about:
a) Their favorite food
b) Effect on activities of daily living (ADLs) ✓
c) Childhood illnesses
d) Travel history
17. What symptom distinguishes inflammatory arthritis (like RA) from OA?
a) Pain
b) Prolonged morning stiffness (>1 hour) and systemic symptoms ✓
c) Joint tenderness
d) History of injury
18. What might the patient report about the appearance of her finger joints?
a) Swan-neck deformities
b) Ulnar deviation
c) Bony enlargements (Heberden's and Bouchard's nodes) ✓
d) Psoriatic plaques
19. Pain that is localized to the medial knee joint line in an older adult is classic for:
a) Gout
, b) Patellofemoral syndrome
c) Osteoarthritis of the knee ✓
d) Septic arthritis
20. What is a common complaint regarding sleep in patients with OA?
a) Sleeping too much
b) Pain disrupting sleep ✓
c) Sleepwalking
d) Night terrors
21. What gait abnormality might be observed in a patient with severe hip OA?
a) Steppage gait
b) Antalgic gait (limping) ✓
c) Ataxic gait
d) Scissoring gait
22. In the history, the patient denies fever and chills. This helps rule out:
a) Osteoporosis
b) Septic arthritis ✓
c) Gout
d) Bursitis
23. What is the most significant modifiable risk factor for OA progression?
a) Age
b) Genetics
c) Obesity ✓
d) Gender
24. The patient reports the pain started insidiously and has worsened over years. This is
typical for:
a) Fracture
b) Gout attack
c) Osteoarthritis ✓
d) Muscle strain
25. Asking about a history of peptic ulcer disease is important before prescribing:
a) Acetaminophen
b) NSAIDs ✓
c) Topical capsaicin
d) Glucosamine
