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USMLE 2CK Practice Question for May 9th

A 56-year-old man comes to the physician because of a dry, hacking cough that has been present for several months. He denies fevers, shortness of breath, or sputum production. His weight has been stable for many years. His current medications are enalapril and lovastatin, which were both started 6 months ago. He has never smoked. A review of systems reveals that his right great toe bothers him occasionally, when it becomes painful, red, and swollen. He usually gets relief with ibuprofen. His blood pressure is 130/80 mm Hg. Examination of the nose and throat shows no abnormalities. There is good air movement, and the lungs are clear to auscultation. Joint and skin examination is normal. Which of the following is the most appropriate next step in management?

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