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unexplained intermittent polyarticular joint pain

30 y/o female, “social smoker”, overweight, complains of intermittent joint “flare ups” in knees, shoulders and elbows, often more than one joint at a time. Pain presents without swelling, but with some warmth around the joint. Was diagnosed with osgood-schlatters as a child (12) when first presented with knee pain, but has remained to this day.

She says nothing in particular brings the pain on, but associates increased pain with low activity. She says the pain starts in one joint and then moves to others, gets more painful and then improves over the course of a few weeks. She has previously been on naproxen with slight improvement but not consistently. Additionally, the pt is slightly hyper mobile in wrists, fingers, and knees.

PMH: tonsillectomy, renal calculi with blood tests showing high levels of urea (both Uric Acid and calcium oxalate stones), perianal abscess which led to sepsis.

Family history of OA.

A 35-year-old woman presents with a one-week history of a slightly raised erythematous lesion on her inner thigh. She has been experiencing fatigue and joint pain since returning from a camping trip in Maine earlier in the month. She is 33-weeks pregnant and is otherwise well. An enzyme-linked immunosorbent assay (ELISA) test comes back negative for Lyme antibodies. What treatment should be administered?

A 25 year old male patient farmer by profession with no known comorbids presents with complain of on and off fever and joint pain for the last 5 years. fever is high grade and is associated with rigors, headache and joint pain. previously it used to get relieved from paracetamol but this time it has shown no response to medications. joint pain is gradual in onset started from left knee joint and involved right knee and ankle joint after a few days. It is associated with stiffness that remains throughout the day. No swelling and discoloration of skin present over joints. he has difficulty in walking. significant history of weight loss.

2 positive diagnosis of Lyme, one at 4 and one at 14...now joint pain, UTI, gynecological issues and infection. Headaches, nausea, diarrhea, vomiting. Also severe chronic urticaria.

Young woman in her thirties presents with a case of body aches (primarily in her legs, knees, and back), headache, cough, fatigue, and this rash which presented on bilateral knees, bilateral elbows, bilateral tops of feet and is itchy. She had a low grade temp of 99.9 but says she had the flu. She did vomit once earlier in the day but wasn’t sure if it was related to this or her vitamin that she takes. Vitals stable at office but she does appear to be fatigued and pale. Recommendations on any labs I should run? I was thinking maybe Ana due to the placement of the rash along with joint pain complaint. She has no medical hx and no hx of allergies or asthma.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

70 yo WF with 20y hx HTN lost 21 lbs on a semaglutide but still BMI over 30, shows drop in BP when standing, stabilizing at 102-116 systolic, 65-75 diastolic. Discontinued all HTN meds x 30 days and no episodes of HTN. Could a small weight loss like this cause a drop to normal BP? Has anyone heard of a side effect of lowering BP?