Which of the following laboratory findings is most likely to be reported in this man?

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A 55-year-old, previously healthy man has had episodes of pain and swelling of the right first metatarsophalangeal joint for the past year. These flare-UPS usually occur after consumption of alcohol, typically port wine (six grapes). On physical examination, there is exquisite tenderness with swelling and erythema of the right first metatarsophalangeal joint. A joint aspiration is performed, and laboratory studies of the fluid obtained show needle-shaped crystals and many neutrophils in a small amount of fluid.
1. Increased serum parathyroid hormone level
2. Elevated serum urea nitrogen level
3. Hyperuricemia
4. Markedly elevated levels of serum transaminases
5. Elevated rheumatoid factor titer

Asked by Erin, Last updated: Nov 09, 2024

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John Smith

Answered Sep 09, 2016

Hyperuricemia-(c) acute inflammation of the first metatarsophalangeal joint, caused by precipitation of uric acid crystals in the jointspace, is typical of gout. hyperuricemia is a sine qua non for the development of gout. not all patients with hyperuricemiadevelop gout, however. other, ill-defined factors play a role in pathogenesis. involvement of the big toe is classic, butother joints may be involved. an increased parathyroid hormone level indicates primary hyperparathyroidism, which isunlikely to produce joint disease. elevated serum urea nitrogen is present in renal failure, which may produce secondaryhyperparathyroidism. although attacks of gout are often precipitated by a heavy bout of alcohol consumption, liver damage(marked by elevated transaminases) is not a feature of gouty arthritis. gout is not associated with rheumatoid arthritis.bp7 774777bp8 820822pbd7 13111314pbd8 12431245