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A 65-Year-Old Man Comes to the Physician Due to Attacks

question 750

Multiple Choice

A 65-year-old man comes to the physician due to attacks of joint pain and swelling that affect primarily his hands but sometimes his knees or elbows. He currently has no pain, but the episodes occur once or twice a month.
The patient's other medical problems include type 2 diabetes mellitus and hypertension. He has not seen a physician for 2 years, and he has managed his diabetes with diet. He was diagnosed with arthritis 2 years ago at a different clinic and was prescribed ibuprofen. The patient smokes 1-2 packs of cigarettes a day and drinks 2-3 cans of beer each night.
Temperature is 36.7 C (98 F) , blood pressure is 155/96 mm Hg, pulse is 84/min, and respirations are 16/min. The patient's BMI is 35 kg/m². He has clear lungs and normal first and second heart sounds. His abdomen is obese, nontender, and without hepatosplenomegaly. His fingers are shown in the images below. There is no joint tenderness and no joint effusions are present elsewhere.

Serum creatinine level is normal and fasting blood glucose level is 133 mg/dL.
Which of the following agents is most likely to provide long-term relief for this patient's symptoms?

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Teleological

Pertaining to teleology, the philosophical study of design and purpose, especially as related to the ethical and moral implications of actions and outcomes.

Deontological

An ethical theory based on the principle that the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of the action.

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The ability of the general public to access certain physical or digital areas, documents, or services, often pertaining to government information or media broadcasting.