A 52-Year-Old Man Comes to the Office for Follow-Up After

question 814

Multiple Choice

A 52-year-old man comes to the office for follow-up after recent emergency department evaluation for knee pain.  The patient had sudden-onset, severe pain in the right knee associated with swelling and difficulty walking.  Arthrocentesis was performed; microscopic findings from the synovial fluid are shown in the exhibit.  The patient's symptoms have improved with medical treatment.  Medical history is notable for hypertension treated with amlodipine.  The patient drinks 2 or 3 beers daily but does not use tobacco or illicit drugs.  He works in a warehouse and his job involves lifting heavy boxes.  He is divorced, has had 2 sexual partners in the past 6 months, and rarely uses condoms.
Blood pressure is 130/82 mm Hg and pulse is 80/min.  BMI is 32 kg/m².  Physical examination is normal.
Which of the following is the most appropriate intervention for this patient to decrease the future risk of similar episodes?

• A)Avoid high-impact work activities
• B)Change antihypertensive to a thiazide diuretic
• C)Decrease alcohol intake
• D)Follow safer sex practices
• E)Initiate prophylactic medication

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Definitions:

Utility Function

An illustrative model that shows the way individuals prioritize various combinations of products based on their contentment levels.

Coconuts

The large, brown, hard-shelled seeds of the coconut palm, used for food, oil, and as a source of material.

Fish

Aquatic vertebrates that live in water, breathe with gills, and typically have fins and scales.

Increasing Returns to Scale

A situation in production where an increase in the quantity of inputs leads to a proportionally larger increase in output.