4 board-style questions on carpal tunnel syndrome in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 45-year-old woman who works as a data entry clerk presents with numbness and tingling in her right thumb, index finger, middle finger, and the radial half of the ring finger for the past 3 months. Symptoms are worse at night and often wake her from sleep. She reports relief by shaking her hand. On examination, Tinel sign (tapping over the volar wrist) and Phalen test (wrist flexion for 60 seconds) are both positive on the right. Grip strength is mildly reduced. What is the most likely diagnosis?
A 52-year-old woman with known carpal tunnel syndrome has used a nocturnal wrist splint and taken ibuprofen for 10 weeks with minimal improvement. She now reports constant numbness in her thumb and index finger, dropping objects frequently, and difficulty buttoning her shirt. On examination, she has thenar muscle atrophy and weakness of thumb opposition (3/5) on the right. Two-point discrimination is diminished at 8 mm in the index finger (normal <6 mm). Nerve conduction studies show severely prolonged distal motor and sensory latencies of the median nerve. What is the most appropriate next step?
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