4/3/2023 0 Comments Usmle practice test freeHe is also put on chronic therapy to prevent the recurrence of future attacks. Ibuprofen is prescribed for the acute treatment of this patient’s symptoms. HDL: high-density lipoprotein LDL: low-density lipoprotein Laboratory studies show: Serum glucose (random) Joint arthrocentesis of the inflamed toe reveals urate crystals. A plain radiograph of the right foot reveals no abnormalities. The remainder of the examination is unremarkable. On physical examination, there is significant erythema, swelling, warmth, and moderate pain on palpation of the right 1st toe. The patient is afebrile and the vital signs are within normal limits. He reports similar symptoms in the past and this is his 2nd visit to the emergency department this year with the same complaint. Which of the following would be the most appropriate next step in management?Ī 59-year-old man presents with intense, sharp pain in his toe for the past hour. Arthrocentesis of the 1st left metatarsophalangeal joint reveals sodium urate crystals. The 1st metatarsophalangeal joint of the left foot is erythematous, severely tender to touch, and swollen. On physical examination, the patient is slightly overweight and in obvious distress. The vital signs include: pulse 86/min, respiratory rate 14/min, and blood pressure 130/80 mm Hg. He reports regular drinking and the occasional binge on weekends, but denies any smoking history or recreational drug use. Family history is significant for a mother who has type 2 diabetes mellitus and a father who has hypertension. There is no significant past medical history and he takes no medications. He denies any recent history of trauma or fever. He says he had similar pain a few weeks ago after an evening of heavy drinking with his friends. Students: Educators’ Pro Tips for Tough TopicsĪ 35-year-old man who works in a shipyard presents with a sharp pain in his left big toe for the past 5 hours.Maternity Nursing and Care of the Childbearing Family.
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