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Following his third episode of gouty arthrits, a 50-year-old man sees you in the clinic. Each case was successfully treated acutely; however, your patient is interested in trying to prevent further episodes. He is not on regular medications and has a normal physical examination today. Blood work reveals an elevated serum uric acid level and otherwise normal renal function and electrolytes. A 24-hour urine collection for uric acid reveals that he is under-excreting uric acid. Suspecting that this is a case of recurrent gout, you place him on probenecid

Clinical Case 8

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A 53-year-old women comes to see you for a consultation. She is scheduled to take a caribbean cruise in 2 weeks but is concerned about sea sickness. She has been on boats before and is very sensitive to motion sickness. A friend mentioned to her that there is a patch that is effective for this problem. She is in good health and takes no medications regularly. Her examination is normal. You prescribe a scopolamine transdermal patch for her.

Clinical Case 3

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A 12-year old girl presents to your office with a sore throat and fever. You diagnose her with pharyngitis caused by group A beta hemolytic streptococcus. She is given an IM injection of penicillin. Approximately 5 minutes later , she is found to be in respiratory distress and audibly wheezing. Her skin is mottled and cool. She is tachycardiac, and her BP has fallen to 70/20 mm hg. You immediately diagnose her as having an anphylactic reaction to the penicillin and give an IM injection of epinephrine.

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