PBL Sessions: Musculoskeletal Organ System

Page 5

History of Present Illness:

He is given an injection of glucocorticoids into the affected joint. He is treated with indomethacin for a week, and the pain and swelling subsides. His serum uric acid is 10.2 mg/dL. He is started on allopurinol, but a week later develops a fever and generalized erythematous skin rash.

Figure 5: Appearance of the skin

The patient is concerned about his weight, which is 92 kg, up 5 kg from a year ago. His height is 69 inches (175 cm). His brother died from a myocardial infarction at age 50.

Tasks

• What do these findings indicate?

• What hypotheses explain these findings?

• Explain your reasoning for the hypotheses you choose.

• Is there anything that can tie these findings together?

• What would you do regarding the patient's drug therapy?

Stop !! Complete discussions and tasks before moving to the next page.