USMLE Step 1 Question of the Day
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Question:
A 65-year-old woman presents with a one month history of fever, malaise, and weight loss. She also complains of pain and stiffness in her shoulders and hips, and a unilateral headache with worsening vision. She has no history of trauma. What drug should she be treated with first?
Correct Answer: E. Prednisone
This woman has clinical signs suggesting polymyalgia rheumatica and temporal arteritis. The two diseases often present together.
Although biopsy is needed to confirm temporal arteritis, prednisone (choice E) should be started because both diseases are steroid responsive, and prompt treatment is needed to prevent blindness due to occlusion of the ophthalmic artery.
Acetaminophen (choice A) and ibuprofen (choice C) are both cyclo-oxygenase inhibitors, and will relieve some of the muscle pain, but will not resolve the inflammation causing both of these conditions. Allopurinol (choice B) is a xanthine oxidase inhibitor used for the chronic treatment of gout. Infliximab (choice D) is a TNF-alpha antibody used to treat Crohn’s disease, rheumatoid arthritis, and ankylosing spondylitis.
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Category: PharmacologyA 65-year-old woman presents with a one month history of fever, malaise, and weight loss. She also complains of pain and stiffness in her shoulders and hips, and a unilateral headache with worsening vision. She has no history of trauma. What drug should she be treated with first?
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