A 59-year-old man with a known history of gout presents for…
A 59-year-old man with a known history of gout presents for follow-up. He reports swelling around his big toes and elbows. On physical exam, you note firm, irregular nodules over the extensor surfaces of the elbows and at the first metatarsophalangeal joints. The nodules are non-tender, hard, and chalky white in appearance. Which phase of gout is this patient most likely experiencing?
Read DetailsA 30-year-old male is brought to the emergency department by…
A 30-year-old male is brought to the emergency department by police after displaying violent behavior, confusion, and hallucinations. His girlfriend reports he smoked marijuana earlier in the evening but suspects it was laced with another substance, as he became belligerent and agitated shortly afterward. On exam, he is disoriented, has nystagmus, and requires sedation for safety. The clinical team suspects phencyclidine (PCP) toxicity. Which of the following neurotransmitter receptors is primarily affected by phencyclidine (PCP)?
Read DetailsA 45-year-old woman presents with bilateral hand pain and st…
A 45-year-old woman presents with bilateral hand pain and stiffness that is worst in the morning and improves as the day goes on. She reports that the stiffness lasts for over an hour each morning and has been progressively worsening over the past few months. On exam, her metacarpophalangeal (MCP) joints are tender and mildly swollen. Which of the following features is most characteristic of inflammatory joint disease such as rheumatoid arthritis?
Read DetailsA 38-year-old man presents to the emergency department with…
A 38-year-old man presents to the emergency department with muscle pain and weakness. He reports that he recently began an intense workout program after months of inactivity. He denies any history of trauma, drug use, or recent illness. Laboratory findings remarkable for elevated creatine kinase (CK), serum creatinine: 2.0 mg/dL, and potassium: 5.8 mEq/L. In addition to muscle pain and weakness, which of the following symptoms is most likely to be reported by this patient with rhabdomyolysis?
Read DetailsHenry is a 15-year-old athlete who presents with anterior kn…
Henry is a 15-year-old athlete who presents with anterior knee pain that has been intermittent over the past 2 to 3 months. The pain worsens with stair use and improves with rest. He denies systemic symptoms such as fever or weight loss. On examination, there is localized tenderness and swelling over the tibial tuberosity. There is no joint effusion. What is the most likely diagnosis?
Read DetailsA 54-year-old woman presents for a routine wellness visit. S…
A 54-year-old woman presents for a routine wellness visit. She is recently postmenopausal and expresses concern after her sister was diagnosed with osteoporosis. She has no history of fractures but asks about her own risk. Which physiological change during menopause contributes to the increased risk of osteoporosis in postmenopausal women?
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