MRCP2-4575

MRCP2-4575

A 45-year-old patient presents to the emergency department with one day of fever, abdominal pain, joint pain and chest pain. This is the third time this has occurred. He has no past medical history and does not take any regular medications. He is of Turkish descent.

Observations:

Temperature 38.4
Blood pressure 120/66 mmHg
Respiratory rate 18/minute
Oxygen saturations 96% on room air
Heart rate 88 beats per minute

On examination, there is generalized abdominal tenderness. Synovitis is detectable at the left ankle. There is a pericardial rub.

Blood tests:

Hb 138 g/L Male: (135-180)
Female: (115 – 160)
Platelets 189 * 109/L (150 – 400)
WBC 4.5 * 109/L (4.0 – 11.0)
Na+ 137 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 5.2 mmol/L (2.0 – 7.0)
Creatinine 88 µmol/L (55 – 120)
CRP 52 mg/L (< 5)
Antinuclear antibody negative (negative)

What is the most appropriate medication to administer in this case?