You are seeing a 58-year-old male in the clinic today for an acute visit related to joint pain and swelling.

· He has a past medical history of hypertension and hyperlipidemia and is currently taking hydrochlorothiazide 25mg daily and atorvastatin 20mg daily.

· He was seen last in your office for a routine physical 6 months ago and had lab work completed showing a normal CBC, CMP and lipid panel while on his current medications.

· He presents with pain and swelling of the right first metatarsophalangeal joint and he reports the site is red and feels hot to touch. He reports the pain is so bad he can hardly stand to have anything touch the foot and awakens at night with the pain.

· He reports the symptoms started suddenly about 2 days ago and he denies any injury to the foot

· He does not have any similar pain or swelling elsewhere.

· Upon examination today it is observed that the right metatarsophalangeal joint is mildly edematous, erythematous and warm to touch. There is no rash, no bruising, and no laceration on the site. The patient can move the joint through range of motion, but has pain with motion. His physical exam is otherwise unremarkable.

Please develop a discussion post that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion post:

· Provide your diagnosis.

· Discuss how you would manage the patient’s current presentation and provide a rationale supported by scholarly reference for your treatment plan.

· Include your specific prescription(s) for the patient. (This must include the medication name, dose, route, and frequency as well as any special instructions that apply as you would include when writing a prescription).

· Describe the patient education you would provide in relation to your treatment plan.

· Provide your plan for follow-up and/or referral (if indicated)

Please be sure to validate your opinions and ideas with citations and references in APA format.

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