guest78-2 ques - stefan78

[ArchivalUser]

A 63-year-old man comes to the clinic complaining of acute left toe pain that began last night while he was lying in bed. He rates the pain at 9 out of 10, on a pain scale, with 10 being the worst pain, and he tells you that it is much worse when his bed sheets rub across the toe. His past medical history is significant for gastroesophageal reflux disease for which he takes omeprazole, and he was recently diagnosed with mild hypertension for which he was started on hydrochlorothiazide. His blood pressure is 125/85 mm Hg, pulse is 82/min, and respirations are 18/min. He has swelling and erythema over the first metatarsophalangeal (MTP) joint of the left foot. The remainder of his examination, including other joints is entirely normal. Laboratory studies show a normal complete blood count, uric acid 12.4 mg/dl, and creatinine 0.9 mg/dl. An arthrocentesis is performed which shows negatively birefringent crystals. The most appropriate management for this patient is

A. allopurinol 100 mg orally once daily then a follow up uric acid level in 1 month


B. ibuprofen 600 mg orally every 8 hours for 4 weeks and start allopurinol 100 mg once daily as soon as symptoms have resolved. Follow up uric acid level in 1 month


C. ibuprofen 600 mg orally every 8 hours until symptoms resolve and change his antihypertensive agent. Follow up uric acid level in 1 month


D. no treatment is necessary for this self-limited condition


E. probenecid 250 mg orally once daily then follow up uric acid level in 1 month

[ArchivalUser]

C.

[ArchivalUser]

love u stefen when u post these Easy Q .. tres facille ... its Cc

[ArchivalUser]

c

[ArchivalUser]

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[ArchivalUser]

ccccc