A 35-Year-Old Man with a Known History of Peptic Ulcer

question 221

Multiple Choice

A 35-year-old man with a known history of peptic ulcer disease comes to the physician with sudden onset of pain, swelling, and redness at the base of his great toe.  The patient was awakened in the middle of the night by the pain and was unable to go back to sleep.  He has no history of trauma to the joint.  Physical examination shows swelling, erythema, and exquisite tenderness involving the right first metatarsophalangeal joint.  Fine-needle aspiration of the joint shows needle-shaped, negatively birefringent crystals.  After making the diagnosis, the physician prescribes an appropriate medication.  Shortly after starting the medication, the patient develops nausea, vomiting, and diarrhea.  Which of the following is the most likely mechanism of action of the drug prescribed to this patient?

• A)Decreased renal tubular uric acid reabsorption
• B)Inhibition of cyclooxygenase activity
• C)Inhibition of microtubule formation
• D)Inhibition of phospholipase A₂ activity
• E)Inhibition of xanthine oxidase activity

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Definitions:

Annual Withdrawals

The amount of money taken from an account or investment over the course of a year.

Interest

The expense associated with taking out a loan, usually represented as a yearly percent of the total loan value.

Years

A measurement of time equal to 365 days (or 366 days in a leap year), used to denote the duration or age of something.

Insurance Annuity

An insurance product that pays out income, typically used as a retirement strategy to provide individuals with a steady income in their post-work years.