USMLE Forum Archives - USMLE Step 3 - Rheum- diffuse pain and aches
Rheum- diffuse pain and aches
harry206 - 05-10-09 12:40
A 76-year-old white female presents with diffuse pain and aches. The pain is more pronounced around her shoulder and pelvic girdle muscles. She denies any headaches, visual symptoms, fever, rash, muscle weakness or urinary symptoms. She has a history of hypertension, hypercholesterolemia, and osteoporosis. Her current medications include enalapril, simvastatin, alendronate, and hydrochlorothiazide. Her family history is unremarkable. She does not smoke or drink. Her physical examination reveals tenderness in the muscles of the pelvic girdle. The rest of the physical examination is unrevealing. Routine labs are normal, including serum creatine kinase (CPK) levels. What is the next best step in the management of this patient?
harry206 - 05-10-09 12:40
A 76-year-old white female presents with diffuse pain and aches. The pain is more pronounced around her shoulder and pelvic girdle muscles. She denies any headaches, visual symptoms, fever, rash, muscle weakness or urinary symptoms. She has a history of hypertension, hypercholesterolemia, and osteoporosis. Her current medications include enalapril, simvastatin, alendronate, and hydrochlorothiazide. Her family history is unremarkable. She does not smoke or drink. Her physical examination reveals tenderness in the muscles of the pelvic girdle. The rest of the physical examination is unrevealing. Routine labs are normal, including serum creatine kinase (CPK) levels. What is the next best step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#2
Re: Rheum- diffuse pain and aches usmlefever3 - 05-10-09 14:05 My answer is: e.
since normal CK - rules out polymyositis(requires muscle biopsy) ,simvastatin
no headche or visual disturbance - can't be temporal arteritis ( ESR needed)
#11
Re: Rheum- diffuse pain and aches mtniharika - 09-15-09 13:07 can someone give a better explanation?
#19
Re: Rheum- diffuse pain and aches babbu5508 - 07-28-10 05:27 My answer is: e.
i doubt between a and e ...whether it is statin induced myalgia which tends o reduce with time or musculoskeletal
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