A 62-year-old male presents with a 3-month history of fatigue, arthralgia, and intermittent abdominal pain. On examination, the patient has bilateral ankle edema and palpable purpura on the lower legs. The patient has a history of chronic hepatitis C infection, which was diagnosed 10 years ago. He was treated with interferon and ribavirin therapy and achieved sustained virologic response. The patient also has a history of hypertension, which is well-controlled with Ramipril. Laboratory findings:

Serum creatinine……………………………………....….89 µmol/L (49–93)

Aspartate aminotransferase (AST)……………..52 IU/L (15–37)

Alanine aminotransferase (ALT)………………...44 IU/L (17–63)

Total bilirubin………………………………………......….24 µmol/L (3–17)

Hepatitis C viral load…………………….…..………..Undetectable

Rheumatoid factor…………………………..…….……Positive

Cryoglobulins………………………………….…...….….Present

Which of the following is the correct diagnosis?

Real-Life cases to ensure you are ready for your MCCQE1 Exam!

Ace Qbank Clinical Edge

REAL-LIFE CASES TO ENSURE YOU ARE READY FOR YOUR MCCQE1 EXAM!

Ace Qbank Clinical Edge

Making the proper diagnosis is one of the most important aspects of any medical student’s or junior doctor’s clinical training and hence we created Clinical Edge Cases.

Ace Qbank Clinical Edge helps our students put their knowledge of symptoms and physical findings to test by applying clinical reasoning and assessment concepts to a series of common clinical vignettes. Problem-based learning is being used to focus on the cause behind the presentation of a simulated clinical case.

Each simulated Clinical Edge case contains a list of common causes of the presented condition, offers abundant references to the presented case, making additional information easy to find

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