A 50-year-old man presents to the office with the complaint of pain in his left great toe. The pain started 2 days ago and has been progressively getting worse to the point that it is difficult to walk even a few steps. He adds that his left big toe is swollen and hot to the touch. He normally drinks 2-3 glasses of red wine each day. Physical examination is notable for an overweight gentleman (BMI of 35) in moderate pain, with an erythematous, swollen, and exquisitely tender left great toe. A complete blood count shows: hemoglobin - 120 g/L, hematocrit - 0.45, platelets - 160*10^9/L, leukocytes 8.0 - 10^9/L, neutrophils - 65%, lymphocytes - 25%, eosinophils - 3%, and monocytes - 7%. Synovial fluid analysis shows cell count of 15,000 cells/mm^3 (80% neutrophils), negatively birefringent crystals present. Elevated concentration of which of the following compounds is the most common laboratory finding in these patients?

Питання КРОК 1 (медицина) · тест з варіантами та поясненням · Medus

EN: A 50-year-old man presents with pain in his left great toe that started 2 days ago and has been progressively worsening. The toe is swollen and hot. He drinks 2–3 glasses of red wine daily. Physical examination: overweight (BMI 35), erythematous, swollen, exquisitely tender left great toe. Synovial fluid: 15,000 cells/mm³ (80% neutrophils), negatively birefringent crystals. Elevated concentration of which compound is the most common laboratory finding in these patients?

Варіанти відповідей

1. Uric acid
2. Urea
3. Cystine
4. Cholesterol
5. Bilirubin

Answer options (EN)

1. Uric acid
2. Urea
3. Cystine
4. Cholesterol
5. Bilirubin

Правильна відповідь

Uric acid

Пояснення

Клініка та негативно подвійнопромінні кристали в синовіальній рідині типови для подагри; підвищений рівень сечової кислоти в крові - найпоширеніша лабораторна ознака. Сечовина, цистин, холестерин та білірубін не є маркерами подагри.

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• 2022 рік, 1 день (English)

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