USMLE Forum Archives - USMLE Step 3 - Rheum- salmon-colored maculopapular rash
Rheum- salmon-colored maculopapular rash
harry206 - 05-10-09 10:37
A 22-year-old male presents with a ten day history of spiking fevers in the evening. He says that the fever usually resolves without any medication. The fever is characteristically associated with an evanescent, salmon-colored maculopapular rash on his trunk and extremities. His other symptoms include arthralgias and severe myalgias for the last two weeks. He denies any recent episode of sore throat. His past medical history is insignificant. His temperature is 40 C (105 F), pulse is 90/min, and blood pressure is 120/76 mmHg. Examination shows tender cervical lymphadenopathy. His chest is clear to auscultation, and cardiac examination is normal without any murmurs. Labs show:
WBC counts:
23,000/micro-L
ESR:
70
Hemoglobin:
11.4g/dl
ANA:
Negative
Rheumatoid factor:
Negative
The appropriate treatment is given to the patient. Which of the following should be monitored to prevent any complications?
harry206 - 05-10-09 10:37
A 22-year-old male presents with a ten day history of spiking fevers in the evening. He says that the fever usually resolves without any medication. The fever is characteristically associated with an evanescent, salmon-colored maculopapular rash on his trunk and extremities. His other symptoms include arthralgias and severe myalgias for the last two weeks. He denies any recent episode of sore throat. His past medical history is insignificant. His temperature is 40 C (105 F), pulse is 90/min, and blood pressure is 120/76 mmHg. Examination shows tender cervical lymphadenopathy. His chest is clear to auscultation, and cardiac examination is normal without any murmurs. Labs show:
WBC counts:
23,000/micro-L
ESR:
70
Hemoglobin:
11.4g/dl
ANA:
Negative
Rheumatoid factor:
Negative
The appropriate treatment is given to the patient. Which of the following should be monitored to prevent any complications?
The correct answer and explanation will be available after you answer.
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#3
Re: Rheum- salmon-colored maculopapular zkadhem - 05-10-09 13:58 this is typical presentation of Adult-onset Still's disease. Typically ANA and RF are NEGEATIVE.
Always keep an eye on the immune status of the patient while he is on long term steroids therapy.
So do serial CBC with differentials.
#15
Re: Rheum- salmon-colored maculopapular babbu5508 - 07-13-10 10:15 My answer is: b.
Still's Disease is a form of arthritis that is characterized by high spiking fevers and evanescent (transient) salmon-colored rash.
#21
Re: Rheum- salmon-colored maculopapular babbu5508 - 09-30-10 00:35 Treatment for Adult-Onset Still's disease is with anti-inflammatory drugs. Cortisone medications (steroids) such as prednisone are used to treat severe symptoms of Still's. Other medications include Plaquenil, Cuprimine, Imuran, Methotrexate
#24
Re: Rheum- salmon-colored maculopapular drnoor50 - 10-21-10 22:25 My answer is: d.
To evaluate AGN
#45
Re: Rheum- salmon-colored maculopapular babbu5508 - 03-31-11 11:58 When only a small number of joints are involved, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms.
Corticosteroids may be used for more severe flare-ups to help control symptoms.
#49
Re: Rheum- salmon-colored maculopapular sudha2015 - 04-16-11 07:48 My answer is: a.
The appropriate treatment is given to the patient. Which of the following should be monitored to prevent any complications
#59
Re: Rheum- salmon-colored maculopapular josmiley1502 - 11-20-11 02:37 My answer is: d.
coz streptococcus also affects kidney function
#60
Re: Rheum- salmon-colored maculopapular emc900 - 12-19-11 15:49 My answer is: d.
Post streptococcus glomerulonephritis would be of concern.
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