Rosh Internal Medicine Boost Practice Exam

Which treatment is indicated for a patient presenting with symmetrical stiffness and an elevated erythrocyte sedimentation rate?

1. Ibuprofen

2. Methotrexate

3. Physical therapy

4. Prednisone

The correct answer is: Prednisone

The appropriate treatment for a patient presenting with symmetrical stiffness and an elevated erythrocyte sedimentation rate (ESR) suggests an inflammatory condition, such as rheumatoid arthritis, which commonly presents with these symptoms. Prednisone, a corticosteroid, is often used to manage inflammation and suppress the immune response in conditions characterized by significant inflammatory activity. In this context, the use of prednisone is indicated as it can provide quick relief of symptoms and reduce inflammatory markers, making it a suitable choice until a longer-term management strategy is effectively implemented. In contrast, while ibuprofen is an anti-inflammatory medication that may help with mild inflammation and pain, it typically provides symptomatic relief rather than addressing the underlying inflammatory process as effectively as corticosteroids in severe cases. Methotrexate is a disease-modifying antirheumatic drug (DMARD) that is commonly used for chronic management of conditions like rheumatoid arthritis but takes time to exert its effects and is not indicated for acute management of inflammation. Physical therapy might be beneficial for long-term joint function and mobility but does not address acute inflammation directly. Thus, prednisone stands out as the most immediate and appropriate treatment option in this scenario.