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Question:
A 60-year-old male presents with a hot, red, swollen MTP joint of the big toe. The patient complains that onset of pain was sudden and rates the pain as a 7 out of 10. Past medical history is significant for high blood pressure for which he recently began taking a thiazide diuretic. A joint aspiration is likely to reveal the following:
Correct Answer: C. Needle-shaped, negatively birefringent crystals
The patient is experiencing a gout attack, which is commonly brought on by thiazide diuretics (which inhibit uric acid secretion). Gout crystals are needle-shaped and negatively birefringent under polarized light. The other answer choices describe pseudogout (rhomboid-shaped, positively birefringent), osteoarthritis (spherical clumps), calcium oxalate stones (bipyramidal, positively refringent), and hypercholesteremia stones (flat rhomboidal plates).
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Category: PharmacologyA 60-year-old male presents with a hot, red, swollen MTP joint of the big toe. The patient complains that onset of pain was sudden and rates the pain as a 7 out of 10. Past medical history is significant for high blood pressure for which he recently began taking a thiazide diuretic. A joint aspiration is likely to reveal the following:
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