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Exam (elaborations)

Fitzgerald Questions with complete solution

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  • Course
  • Musculoskeletal
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  • Musculoskeletal

Fitzgerald Questions with complete solution Fitzgerald- Musculoskeletal Problems Osteoarthritis 55 year old man, BMI 38 kg/m2, roofer, with bilateral knee pain, gradual worsening over 3 yrs Rheumatoid arthritis 31 yr woman, BMI 21 kg/m2, data entry, DM I, complains of joints pain and sti...

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  • August 18, 2024
  • 21
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Musculoskeletal
  • Musculoskeletal
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Fitzgerald- Musculoskeletal Problems
Osteoarthritis
55 year old man, BMI 38 kg/m2, roofer, with bilateral knee pain, gradual
worsening over 3 yrs




Rheumatoid arthritis
31 yr woman, BMI 21 kg/m2, data entry, DM I, complains of joints pain and
stiffness in the morning, unexplained wt loss and fatigue




Redness at the first metatarsophalangeal joint
54 yrs man w/ COPD, presents with an 18 hr hx of sudden onset
monoarticular pain consistent w/ acute gouty arthritis. Drinks alcohol regular




Gout
common wrist and great toe
cooler part of the body




Naproxen Sodium (Aleve, Anaprox)
Preferred medication in treating episodes of acute gouty arthritis?

,Febuxostat (Uloric)
xanthine oxidase inhibitor


preventing gout




When to start preventive therapy for gout?
About 6 months following treatment of an acute gouty attack




Allopurinol
treatment of gout




Advising dietary modification to prevent a future gouty episode, the NP
recommends avoiding?
Organ meats- purine rich food




Gout risk factors include:
- Men ages 40-50
- black
- obese
- diabetes mellitus
- family history

, - persons from countries with abundant lifestyles




Gout treatment
1. acute: NSAID(indomethacin), if not well controlled, steroid, colchicine
2 prevention(chronic): allopurinol for overproduce, probenecid for
underproduce, if on allopurinol but acute, no stop




Gout prevention
Allopurinol




AD
Serum urate levels
foods & drinks that increase: red meat (organ meat specifically, kidney, liver)
sweet breads, sardines, shellfish, high fructose corn syrup, sodas, sports
drinks with high levels, alcohol (especially beer)


target <6 at a minimum and often <5 mg/dL




McMurray Test
Meniscal tear

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