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Basal Cell Carcinoma - Correct Answer--painless, pearly, ulcerated nodule with overlying telangiectasis -found on sun areas Actinic Keratoses - Correct Answer--slightly rough, pink or flesh-colored lesion in sunexposed area -pharmacological treatment: 5-fluorouracil (topical chemotherapy) -non-pharmacological treatment: chemical peel, cryotherapy, laser resurfacing Tuberculosis - Correct Answer-I. Transmission A. Mycobacterium tuberculosis carried in airborne droplets B. Active Pulmonary or Laryngeal Tuberculosis transmitted 1. Sneeze, cough, speak, or sing II. Symptoms A. Latent Tuberculosis is asymptomatic B. Active Tuberculosis presentation often mimics cancer presentation 1. Non-specific presentation (most common) a. Fatigue b. Weight loss c. Cachexia d. Night Sweats C. Pulmonary Tuberculosis symptoms 1. Productive cough (typically 2-3 weeks) 2. Hemoptysis (uncommon) 3. Pleuritic Chest Pain 4. Dyspnea III. Signs A. Sites of Involvement 1. Primary infection: lung involvement B. Disseminated Disease IV. Management A. Latent Tuberculosis 1. Positive PPD without signs of Active Tb 2. Treatment indicated if risk of Tb Progression from latent to active disease B. Active Tuberculosis Gout - Correct Answer-I. Pathophysiology A. *Gout occurs when Uric Acid levels exceed solubility limits* 1. Monosodium urate crystals deposit in joints, Kidney, and soft tissues 2. Crystal deposition triggers a inflammatory response from cytokines and Neutrophils3. Joint space is irreversibly injured with ongoing attacks II. Risk Factors A. Most common 1. Obesity 2. Alcohol use (especially beer) 3. High purine diet (red meats, turkey and wild game, organ meats, seafood) 4. Drinks sweetened with high fructose corn syrup 5. Diuretic therapy including Thiazide Diuretics 6. Other risks a. Diabetes Mellitus b. Hyperlipidemia c. Hypertension d. Atherosclerosis e. Renal Insufficiency f. Myeloproliferative disease III. Symptoms A. Associated Symptoms 1. Chills 2. Fever as high as 104 F (40 C) 3. Severity: Very severe pain a. Unable to bear weight b. Too painful to put on socks c. Intollerant to light touch from blankets B. Regions Lower extremities 1. *First Metatarsophalangeal joint of great toe* (most common) a. Known as *Podagra* i. Affected in 50% of first gout attacks Mid-tarsal joints 2. Ankle Joints 3. Knee Joints C. Regions upper extremities 1. Fingers 2. Wrists 3. Elbows D. Characteristics: Joint Pain 1. Excruciating, crushing type pain 2. Timing: Joint Pain 3. Acute onset of lower extremity Joint Pain 4. Wakens patient from sleep IV. Signs A. Acute 1. Joint Inflammation 2. Erythema, tenderness and swelling at affected jointa. Pain extends well beyond j