Podcast
Questions and Answers
A 40-year-old man with a history of recurrent painful attacks affecting the right big toe, was diagnosed with gout and started on allopurinol. He is also a known case of psoriasis for several years. He presented to the clinic with recurrent joint pain affecting the right big toe, left ankle, and bilateral knees. He is using allopurinol regularly as prescribed but has no improvement in his joint pain. Examinations revealed he has active arthritis at the left ankle and knee joints bilaterally (see lab results). Which of the following is the most likely cause for his joint pain?
A 40-year-old man with a history of recurrent painful attacks affecting the right big toe, was diagnosed with gout and started on allopurinol. He is also a known case of psoriasis for several years. He presented to the clinic with recurrent joint pain affecting the right big toe, left ankle, and bilateral knees. He is using allopurinol regularly as prescribed but has no improvement in his joint pain. Examinations revealed he has active arthritis at the left ankle and knee joints bilaterally (see lab results). Which of the following is the most likely cause for his joint pain?
A 28-year-old woman with systemic lupus erythematosus for 2 years on hydroxychloroquine 200 mg/day, prednisone 5 mg/day, and azathioprine 100 mg/day presented to the Emergency Room with sudden onset of lower limb weakness and urinary incontinence. Examination revealed she has paraplegia and hyperreflexia (see lab results). Which of the following is the most appropriate test to be done immediately?
A 28-year-old woman with systemic lupus erythematosus for 2 years on hydroxychloroquine 200 mg/day, prednisone 5 mg/day, and azathioprine 100 mg/day presented to the Emergency Room with sudden onset of lower limb weakness and urinary incontinence. Examination revealed she has paraplegia and hyperreflexia (see lab results). Which of the following is the most appropriate test to be done immediately?
A 50-year-old man is complaining of pain affecting the wrist joints bilaterally, second and third proximal interphalangeal joints, and right knee joint for the last 4 months. His examination revealed active arthritis at both wrists and second and third proximal interphalangeal joints (see lab results). Which of the following is the most appropriate treatment?
A 50-year-old man is complaining of pain affecting the wrist joints bilaterally, second and third proximal interphalangeal joints, and right knee joint for the last 4 months. His examination revealed active arthritis at both wrists and second and third proximal interphalangeal joints (see lab results). Which of the following is the most appropriate treatment?
A 30-year-old woman with systemic lupus erythematosus is evaluated for right hip pain that started 3 weeks ago and occurs at night and with walking. Her current medications are azathioprine, hydroxychloroquine, prednisolone, and lisinopril for the last 5 years. Her examination was normal except for pain on internal rotation of the right hip. Laboratory tests including pelvic and left hip radiographs were normal. Which of the following is the most likely cause of hip pain?
A 30-year-old woman with systemic lupus erythematosus is evaluated for right hip pain that started 3 weeks ago and occurs at night and with walking. Her current medications are azathioprine, hydroxychloroquine, prednisolone, and lisinopril for the last 5 years. Her examination was normal except for pain on internal rotation of the right hip. Laboratory tests including pelvic and left hip radiographs were normal. Which of the following is the most likely cause of hip pain?
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A 60-year-old man complaining of right knee pain for several years that has increased over the last few months. He also has noticed frequent knee clicks. A diagnosis of osteoarthritis is suspected. Which of the following is the most appropriate to confirm the diagnosis?
A 60-year-old man complaining of right knee pain for several years that has increased over the last few months. He also has noticed frequent knee clicks. A diagnosis of osteoarthritis is suspected. Which of the following is the most appropriate to confirm the diagnosis?
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A 52-year-old man with rheumatoid arthritis for 12 years. His current treatment consists of methotrexate 15 mg weekly and adalimumab 40 mg/2 weeks. He presented to the clinic complaining of fever and shortness of breath for 1 week. His chest examination revealed coarse crackles over the lower part of the right lung (see lab results). Which of the following is the most appropriate action to be taken on this visit?
A 52-year-old man with rheumatoid arthritis for 12 years. His current treatment consists of methotrexate 15 mg weekly and adalimumab 40 mg/2 weeks. He presented to the clinic complaining of fever and shortness of breath for 1 week. His chest examination revealed coarse crackles over the lower part of the right lung (see lab results). Which of the following is the most appropriate action to be taken on this visit?
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A 30-year-old man presented to the Emergency Department with an acute monoarthritis where joint aspiration was performed. Based on the presence of crystals in the synovial fluid, he was diagnosed with gout. Which of the following is the most likely type of the crystals seen?
A 30-year-old man presented to the Emergency Department with an acute monoarthritis where joint aspiration was performed. Based on the presence of crystals in the synovial fluid, he was diagnosed with gout. Which of the following is the most likely type of the crystals seen?
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A 30-year-old woman with a diagnosis of systemic lupus erythematosus who was maintained on mycophenolate mofetil 1 gm/day, hydroxychloroquine 200 mg/day, and prednisone 5 mg/day for the last 1 year. She has had inactive disease for more than 6 months. She is planning to get pregnant (see lab results). Which of the following is the most appropriate action at this time?
A 30-year-old woman with a diagnosis of systemic lupus erythematosus who was maintained on mycophenolate mofetil 1 gm/day, hydroxychloroquine 200 mg/day, and prednisone 5 mg/day for the last 1 year. She has had inactive disease for more than 6 months. She is planning to get pregnant (see lab results). Which of the following is the most appropriate action at this time?
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A 61-year-old woman is evaluated for a left pulmonary nodule that was discovered incidentally 2 months ago. She is currently asymptomatic and has not had shortness of breath, fever, chills, weight loss, or night sweats. Medical history is otherwise unremarkable, and she takes no medications. She never smoked. Examination revealed no cervical or supraclavicular lymphadenopathy, and the lungs are clear to auscultation (see report). CT scan chest: Showed an 8 mm left lung nodule. Which of the followings is the most appropriate next step in management?
A 61-year-old woman is evaluated for a left pulmonary nodule that was discovered incidentally 2 months ago. She is currently asymptomatic and has not had shortness of breath, fever, chills, weight loss, or night sweats. Medical history is otherwise unremarkable, and she takes no medications. She never smoked. Examination revealed no cervical or supraclavicular lymphadenopathy, and the lungs are clear to auscultation (see report). CT scan chest: Showed an 8 mm left lung nodule. Which of the followings is the most appropriate next step in management?
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A 63-year-old woman presented with exertional dyspnea for 8 months. She was diagnosed with COPD 3 years ago and has had 4 exacerbations in the last year. She completed pulmonary rehabilitation and quit smoking 2 years ago. Medications include long-acting B2 agonist, inhaled glucocorticoid, roflumilast, and albuterol as needed. Examination revealed no jugular venous distention; decreased breath sounds, a loud pulmonary component of S1 (see lab results and reports) Chest radiograph: Normal. Echocardiogram: Ejection fraction of 60%, no valvular or wall motion abnormalities, and estimated mean pulmonary artery pressure is 55 mmHg. Which of the following is the most appropriate treatment?
A 63-year-old woman presented with exertional dyspnea for 8 months. She was diagnosed with COPD 3 years ago and has had 4 exacerbations in the last year. She completed pulmonary rehabilitation and quit smoking 2 years ago. Medications include long-acting B2 agonist, inhaled glucocorticoid, roflumilast, and albuterol as needed. Examination revealed no jugular venous distention; decreased breath sounds, a loud pulmonary component of S1 (see lab results and reports) Chest radiograph: Normal. Echocardiogram: Ejection fraction of 60%, no valvular or wall motion abnormalities, and estimated mean pulmonary artery pressure is 55 mmHg. Which of the following is the most appropriate treatment?
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A 58-year-old woman presented to the medical clinic complaining of daily wheezing and breathlessness during allergy season. These episodes of wheezing have limited her activities several times a week. She has a long history of seasonal allergies in the form of itchy eyes and runny nose. No other medical history. Medications include loratadine as needed, and antihistamine eye drops.
Examination revealed watery eyes with conjunctival irritation, expiratory wheezing, and normal cardiac examination (see reports). Chest radiograph: Unremarkable. Spirometry: FEV1 of 74% of predicted, which improved by 18% with a bronchodilator.
Which of the following is the most appropriate treatment?
A 58-year-old woman presented to the medical clinic complaining of daily wheezing and breathlessness during allergy season. These episodes of wheezing have limited her activities several times a week. She has a long history of seasonal allergies in the form of itchy eyes and runny nose. No other medical history. Medications include loratadine as needed, and antihistamine eye drops. Examination revealed watery eyes with conjunctival irritation, expiratory wheezing, and normal cardiac examination (see reports). Chest radiograph: Unremarkable. Spirometry: FEV1 of 74% of predicted, which improved by 18% with a bronchodilator. Which of the following is the most appropriate treatment?
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A 71-year-old man is evaluated after a recent hospitalization 10 days ago for pneumonia and was discharged with a 10-day course of appropriate antibiotics. For the past 5 days, he has had a low-grade fever and increased shortness of breath. Pulmonary examination reveals decreased fremitus, dullness to percussion, and decreased breath sounds over the lower third of the right hemithorax (see lab results and report). Chest radiograph: Moderate right-sided pleural effusion. Which of the followings is the most appropriate management?
A 71-year-old man is evaluated after a recent hospitalization 10 days ago for pneumonia and was discharged with a 10-day course of appropriate antibiotics. For the past 5 days, he has had a low-grade fever and increased shortness of breath. Pulmonary examination reveals decreased fremitus, dullness to percussion, and decreased breath sounds over the lower third of the right hemithorax (see lab results and report). Chest radiograph: Moderate right-sided pleural effusion. Which of the followings is the most appropriate management?
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A 20-year-old man is evaluated for a 6-month history of chest and throat tightness, acute episodes
of stridor, and a prolonged wheeze that occur during his college basketball practice. He has a history of
moderate persistent asthma, which is controlled. He takes a short-acting B2 agonist inhaler as needed, but
this does not relieve his symptoms. In addition to a low-dose inhaled glucocorticoid and a long-acting
inhaled B2 agonist, he otherwise feels well. Medical history is otherwise unremarkable. Examination
reveals normal vital signs and unremarkable systemic examination (see reports). Chest radiograph:
Normal. Spirometry: No evidence of obstruction. Which of the following is the most appropriate
next step in management?
A 20-year-old man is evaluated for a 6-month history of chest and throat tightness, acute episodes of stridor, and a prolonged wheeze that occur during his college basketball practice. He has a history of moderate persistent asthma, which is controlled. He takes a short-acting B2 agonist inhaler as needed, but this does not relieve his symptoms. In addition to a low-dose inhaled glucocorticoid and a long-acting inhaled B2 agonist, he otherwise feels well. Medical history is otherwise unremarkable. Examination reveals normal vital signs and unremarkable systemic examination (see reports). Chest radiograph: Normal. Spirometry: No evidence of obstruction. Which of the following is the most appropriate next step in management?
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A 33-year-old man presented with shortness of breath, fatigue, and nighttime cough. He has been working
in a car repair shop for the past 1 year and notes that his symptoms began about 8 months ago. He
believes his symptoms are associated with his workdays. He is being evaluated after several days off from
work and currently has no symptoms or medical concerns. He has an unremarkable medical history
and takes no medications. He has never smoked. Physical examination is unremarkable. A chest
radiograph and spirometry results are normal. Which of the following is the most appropriate next step
in management?
A 33-year-old man presented with shortness of breath, fatigue, and nighttime cough. He has been working in a car repair shop for the past 1 year and notes that his symptoms began about 8 months ago. He believes his symptoms are associated with his workdays. He is being evaluated after several days off from work and currently has no symptoms or medical concerns. He has an unremarkable medical history and takes no medications. He has never smoked. Physical examination is unremarkable. A chest radiograph and spirometry results are normal. Which of the following is the most appropriate next step in management?
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A 49-year-old woman is evaluated for a 4-month history of dry cough, which began 4 months ago when she noted a paroxysmal onset of persistent coughing spells that make it difficult to carry on a conversation. She was initially diagnosed with allergic rhinitis and was started on a glucocorticoid nasal inhaler with no improvement. Medical history is otherwise unremarkable except for a history of dust allergies. Examination revealed normal vital signs, slight nasal congestion, and dry cough are noted during the examination. Cardiovascular, pulmonary, and abdominal examination findings are unremarkable (see reports). Chest radiograph: Normal. Spirometry: Slightly reduced FEV/FVC ratio of 70% which increased after bronchodilator challenge by 20%. Which of the following is the most appropriate diagnostic test to perform next?
A 49-year-old woman is evaluated for a 4-month history of dry cough, which began 4 months ago when she noted a paroxysmal onset of persistent coughing spells that make it difficult to carry on a conversation. She was initially diagnosed with allergic rhinitis and was started on a glucocorticoid nasal inhaler with no improvement. Medical history is otherwise unremarkable except for a history of dust allergies. Examination revealed normal vital signs, slight nasal congestion, and dry cough are noted during the examination. Cardiovascular, pulmonary, and abdominal examination findings are unremarkable (see reports). Chest radiograph: Normal. Spirometry: Slightly reduced FEV/FVC ratio of 70% which increased after bronchodilator challenge by 20%. Which of the following is the most appropriate diagnostic test to perform next?
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A 57-year-old man is evaluated for chronic cough, occasional wheezing, and exertional dyspnea while walking. Medical history includes an episode of bronchitis, for which he underwent outpatient treatment 8 months ago. He has a 20-pack-year smoking history. Examination revealed normal vital signs, mildly decreased breath sounds throughout both lungs, and scattered expiratory wheezes bilaterally. Spirometry shows an FEV1 of 75% of predicted and a post-bronchodilator FEV/FVC ratio of 68%. His modified Medical Research Council (mMRC) symptom score is 2. In addition to smoking cessation, which of the following is the most appropriate long-term management plan?
A 57-year-old man is evaluated for chronic cough, occasional wheezing, and exertional dyspnea while walking. Medical history includes an episode of bronchitis, for which he underwent outpatient treatment 8 months ago. He has a 20-pack-year smoking history. Examination revealed normal vital signs, mildly decreased breath sounds throughout both lungs, and scattered expiratory wheezes bilaterally. Spirometry shows an FEV1 of 75% of predicted and a post-bronchodilator FEV/FVC ratio of 68%. His modified Medical Research Council (mMRC) symptom score is 2. In addition to smoking cessation, which of the following is the most appropriate long-term management plan?
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A 42-year-old woman presented to the clinic for follow-up of a 7-month history of chronic, nonproductive cough. She was recently diagnosed with cough-variant asthma after a mechacholine challenge test. She was started on inhaled fluticasone and as-needed albuterol 2 months ago. Her cough initially improved; however, her symptoms have not fully resolved and are worsened at times, most notably when she lies down. She also noted that mild hoarseness occassionally accompanies her cough, especially when she wakes up in the morning. Examination revealed a dry cough with frequent throat clearing. The chest was clear with no wheezing. Which the following is the most appropriate management?
A 42-year-old woman presented to the clinic for follow-up of a 7-month history of chronic, nonproductive cough. She was recently diagnosed with cough-variant asthma after a mechacholine challenge test. She was started on inhaled fluticasone and as-needed albuterol 2 months ago. Her cough initially improved; however, her symptoms have not fully resolved and are worsened at times, most notably when she lies down. She also noted that mild hoarseness occassionally accompanies her cough, especially when she wakes up in the morning. Examination revealed a dry cough with frequent throat clearing. The chest was clear with no wheezing. Which the following is the most appropriate management?
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A 17-year-old man presented to the Emergency Department with a severe asthma exacerbation that began 12 hours ago. He is on an albuterol inhaler and a long-acting glucocorticoid at home without improvement. He was hospitalized and intubated 2 years ago. Examination revealed respiratory distress with diffuse expiratory wheezes. After 1 hour of systemic glucocorticoid and B2 agonist nebulizer, he still appeared in respiratory distress (see lab results and report). Chest X-ray: Hyperinflated lungs. Which of the following is the most appropriate next step in management?
A 17-year-old man presented to the Emergency Department with a severe asthma exacerbation that began 12 hours ago. He is on an albuterol inhaler and a long-acting glucocorticoid at home without improvement. He was hospitalized and intubated 2 years ago. Examination revealed respiratory distress with diffuse expiratory wheezes. After 1 hour of systemic glucocorticoid and B2 agonist nebulizer, he still appeared in respiratory distress (see lab results and report). Chest X-ray: Hyperinflated lungs. Which of the following is the most appropriate next step in management?
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A 63-year-old man was evaluated in the Emergency Room for 1 week of progressive shortness of breath and found to have right pleural effusion on chest X-ray. Aspiration yielded a clear transudative fluid. Which of the following is the most likely cause?
A 63-year-old man was evaluated in the Emergency Room for 1 week of progressive shortness of breath and found to have right pleural effusion on chest X-ray. Aspiration yielded a clear transudative fluid. Which of the following is the most likely cause?
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A 24-year-old woman is reviewed in the Asthma Clinic. She currently uses a salbutamol
A 24-year-old woman is reviewed in the Asthma Clinic. She currently uses a salbutamol
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A 63-year-old woman is in the COPD clinic for frequent exacerbations, despite being
maintained on a salbutamol inhaler as required and a tiotropium inhaler regularly. She was
diagnosed with COPD three years ago and recently quit smoking. Her latest FEV1 was 39% of
predicted.
Which of the following is the most appropriate next step in her management?
A 63-year-old woman is in the COPD clinic for frequent exacerbations, despite being maintained on a salbutamol inhaler as required and a tiotropium inhaler regularly. She was diagnosed with COPD three years ago and recently quit smoking. Her latest FEV1 was 39% of predicted. Which of the following is the most appropriate next step in her management?
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A 69-year-old smoker presents with a 3-week history of worsening breathlessness. Examination revealed normal vital signs and decreased breathing sounds over the lower left zone (see reports). Chest X-ray: Large left-sided pleural effusion. Pleural tapping: Pending result. Which of the following will most likely indicate that it is an exudative effusion?
A 69-year-old smoker presents with a 3-week history of worsening breathlessness. Examination revealed normal vital signs and decreased breathing sounds over the lower left zone (see reports). Chest X-ray: Large left-sided pleural effusion. Pleural tapping: Pending result. Which of the following will most likely indicate that it is an exudative effusion?
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A 33-year-old man with a history of severe asthma is admitted to the Emergency Department with an asthma attack. He received high-flow oxygen and nebulized salbutamol. He is unable to complete sentences, has bilateral expiratory wheeze, and is unable to perform a peak flow reading. He was immediately given intravenous hydrocortisone and nebulized salbutamol continuously. After 10 minutes, there is no improvement, and intravenous magnesium sulfate was given. His condition continues to deteriorate (see lab results). Which of the following is the most appropriate management?
A 33-year-old man with a history of severe asthma is admitted to the Emergency Department with an asthma attack. He received high-flow oxygen and nebulized salbutamol. He is unable to complete sentences, has bilateral expiratory wheeze, and is unable to perform a peak flow reading. He was immediately given intravenous hydrocortisone and nebulized salbutamol continuously. After 10 minutes, there is no improvement, and intravenous magnesium sulfate was given. His condition continues to deteriorate (see lab results). Which of the following is the most appropriate management?
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A 34-year-old woman with a history of asthma and allergic rhinitis has been discharged from the hospital 2 weeks ago following an acute exacerbation of bronchial asthma and reports generally poor control with a persistent nighttime cough and exertional wheeze. Her current asthma therapy is salbutamol inhaler 100 mcg prn, beclometasone dipropionate inhaler 800 mcg bd, and salmeterol 50 mcg bd. Which of the following is the most appropriate next step in outpatient management?
A 34-year-old woman with a history of asthma and allergic rhinitis has been discharged from the hospital 2 weeks ago following an acute exacerbation of bronchial asthma and reports generally poor control with a persistent nighttime cough and exertional wheeze. Her current asthma therapy is salbutamol inhaler 100 mcg prn, beclometasone dipropionate inhaler 800 mcg bd, and salmeterol 50 mcg bd. Which of the following is the most appropriate next step in outpatient management?
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A 33-year-old woman has been assessed in the Emergency Department with an acute exacerbation of asthma. Which of the following features is most likely to indicate a life-threatening attack?
A 33-year-old woman has been assessed in the Emergency Department with an acute exacerbation of asthma. Which of the following features is most likely to indicate a life-threatening attack?
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A 26-year-old man is admitted with acute severe asthma. Treatment is initiated with 100% oxygen, nebulized salbutamol, ipratropium bromide nebulizers, and IV hydrocortisone. Despite initial treatment, there is no improvement. Examination reveals that he is in respiratory distress, cannot complete full sentences, and has bilateral expiratory wheezing. Which of the following is the most appropriate IV emergency treatment?
A 26-year-old man is admitted with acute severe asthma. Treatment is initiated with 100% oxygen, nebulized salbutamol, ipratropium bromide nebulizers, and IV hydrocortisone. Despite initial treatment, there is no improvement. Examination reveals that he is in respiratory distress, cannot complete full sentences, and has bilateral expiratory wheezing. Which of the following is the most appropriate IV emergency treatment?
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A 70-year-old man known to have chronic obstructive pulmonary disease (COPD). Examination revealed evidence of cor pulmonale with a significant degree of lower limb edema. His FEV1 is 40% (see lab result). Which of the following interventions is most associated with increased survival?
A 70-year-old man known to have chronic obstructive pulmonary disease (COPD). Examination revealed evidence of cor pulmonale with a significant degree of lower limb edema. His FEV1 is 40% (see lab result). Which of the following interventions is most associated with increased survival?
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A 55-year-old man is evaluated for an 18-month history of intermittent, nonproductive chronic cough, and dyspnea with exertion. No history of fever, chest pain, heartburn, loss of appetite, or weight loss. He has smoked 1 pack daily for the last 30 years. His medical history is otherwise unremarkable, and he takes no medications. Examination revealed he is comfortable, no jugular venous distention, normal heart sounds, no murmur, clear lungs, and no lower limb edema A chest radiograph and electrocardiogram are normal. Which of the following is the most appropriate next diagnostic test?
A 55-year-old man is evaluated for an 18-month history of intermittent, nonproductive chronic cough, and dyspnea with exertion. No history of fever, chest pain, heartburn, loss of appetite, or weight loss. He has smoked 1 pack daily for the last 30 years. His medical history is otherwise unremarkable, and he takes no medications. Examination revealed he is comfortable, no jugular venous distention, normal heart sounds, no murmur, clear lungs, and no lower limb edema A chest radiograph and electrocardiogram are normal. Which of the following is the most appropriate next diagnostic test?
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A 79-year-old man is evaluated in follow-up for a 2 mm solitary pulmonary nodule, which
was incidentally discovered on imaging for chest pain 4 years ago. Follow-up chest CT was
obtained at 1, 2, and 3-year intervals, and the pulmonary nodule appears unchanged. He feels
well and does not have any respiratory or constitutional symptoms. He never smokes.
Examination revealed normal vital signs and cardiopulmonary examination. Which of the following
is the most appropriate recommendation?
A 79-year-old man is evaluated in follow-up for a 2 mm solitary pulmonary nodule, which was incidentally discovered on imaging for chest pain 4 years ago. Follow-up chest CT was obtained at 1, 2, and 3-year intervals, and the pulmonary nodule appears unchanged. He feels well and does not have any respiratory or constitutional symptoms. He never smokes. Examination revealed normal vital signs and cardiopulmonary examination. Which of the following is the most appropriate recommendation?
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A 68-year-old woman is evaluated in follow-up after a 5 mm pulmonary nodule was
discovered on chest imaging obtained 9 months ago. She feels well and has not had shortness
of breath, cough, hemoptysis, weight loss, or chest pain. She has a 50-pack-year smoking
history and is a recurrent smoker. Examination revealed normal vital signs, no cervical or
supraclavicular lymphadenopathy, and clear lungs to auscultation bilaterally (see report).
Repeated chest CT: Interval increase in the size of the nodule, now measuring 10.5 mm in
diameter, and no evidence of mediastinal or hilar lymphadenopathy. Which of the following is the
most appropriate next step?
A 68-year-old woman is evaluated in follow-up after a 5 mm pulmonary nodule was discovered on chest imaging obtained 9 months ago. She feels well and has not had shortness of breath, cough, hemoptysis, weight loss, or chest pain. She has a 50-pack-year smoking history and is a recurrent smoker. Examination revealed normal vital signs, no cervical or supraclavicular lymphadenopathy, and clear lungs to auscultation bilaterally (see report). Repeated chest CT: Interval increase in the size of the nodule, now measuring 10.5 mm in diameter, and no evidence of mediastinal or hilar lymphadenopathy. Which of the following is the most appropriate next step?
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Flashcards
Gout
Gout
A form of inflammatory arthritis characterized by recurrent painful attacks, often affecting the big toe.
Allopurinol
Allopurinol
A medication used to lower uric acid levels in patients with gout.
Psoriatic arthritis
Psoriatic arthritis
A type of arthritis that affects some people who have psoriasis, characterized by joint pain and swelling.
Systemic lupus erythematosus
Systemic lupus erythematosus
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Hydroxychloroquine
Hydroxychloroquine
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Methotrexate
Methotrexate
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Lupus arthritis diagnosis
Lupus arthritis diagnosis
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Septic arthritis
Septic arthritis
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Osteoarthritis
Osteoarthritis
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Arthrocentesis
Arthrocentesis
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Avascular necrosis
Avascular necrosis
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Pulmonary embolism
Pulmonary embolism
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Pleural effusion
Pleural effusion
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Chronic kidney disease
Chronic kidney disease
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Type 2 diabetes mellitus
Type 2 diabetes mellitus
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Exertional dyspnea
Exertional dyspnea
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D-dimer test
D-dimer test
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Blood cultures
Blood cultures
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Acute respiratory distress syndrome (ARDS)
Acute respiratory distress syndrome (ARDS)
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Asthma
Asthma
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Acute kidney injury
Acute kidney injury
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Nodular lung disease
Nodular lung disease
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Infectious gastroenteritis
Infectious gastroenteritis
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Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD)
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Iron deficiency anemia
Iron deficiency anemia
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Anemia
Anemia
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Study Notes
Medical Case Studies - Study Notes
- General Information: The provided text contains multiple medical case studies, each describing a patient's symptoms, medical history, and the subsequent diagnosis/treatment. No personal information is included.
Case Study 1 (Question 0001)
- Patient: A 40-year-old man with a history of gout and psoriasis.
- Symptoms: Painful attacks affecting his right big toe, left ankle, and bilateral knees, despite regular allopurinol use.
- Diagnosis: Psoriatic arthritis.
Case Study 2 (Question 0002)
- Patient: A 28-year-old woman with systemic lupus erythematosus (SLE).
- Symptoms: Sudden onset of lower limb weakness and urinary incontinence.
- Diagnosis: Presents with paraplegia and hyperreflexia
- Recommended immediate test: Lumbar puncture and MRI of the spinal cord.
Case Study 3 (Question 0003)
- Patient: A 50-year-old man complaining of wrist and knee joint pain.
- Symptoms: Active arthritis in bilateral wrists and the second and third proximal interphalangeal joints.
- Diagnosis: Based on the given findings, a combination of Methotrexate, hydroxychloroquine, and prednisone would be the most appropriate treatment.
Case Study 4 (Question 0004)
- Patient: A 30-year-old woman with systemic lupus erythematosus (SLE).
- Symptoms: Pain in the right hip, occurring at night and with walking.
- Diagnosis: Active lupus arthritis is the most likely cause of the hip pain.
Case Study 5 (Question 0005)
- Patient: A 60-year-old man with osteoarthritis.
- Symptoms: Increasing right knee pain over the last few months, and frequent clicking.
- Diagnostic test: Bilateral Knee X-rays are the most appropriate way to determine the confirmed diagnosis.
Case Study 6 (Question 0006)
- Patient: A 52-year-old man with rheumatoid arthritis.
- Symptoms: Fever and shortness of breath
- Diagnosis: Coarse crackles in the lower part of the right lung are present during the initial chest X-ray assessment.
- Recommended action: Hold current treatment while starting antibiotics.
Case Study 7 (Question 0007)
- Patient: A 30-year-old man with a diagnosis of gout.
- Symptoms: bilateral wrist joints, second and third proximal interphalangeal joints, right knee joint pain affecting for the last 4 months.
- Diagnosis: Needle-shaped, negatively birefringent crystals are present in the synovial fluid.
- Treatment: Based on the presented information, methotrexate, hydroxychloroquine, and prednisone would be the most appropriate treatment
and so on... (Other case studies follow a similar format)
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Description
Analysis of medical case studies including psoriatic arthritis and lupus. Review symptoms, diagnosis, with recommended tests. Focus on patient history and treatment options.
