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 a single 35 yo woman.......  



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Author6 Posts
  #1

A single 35 year-old woman with a history of Raynaud’s phenomenon since 1990 came to the Rheumatology outpatient clinic for evaluation. Her past medical and family history were unremarkable. Physical examination showed that the hands were cold with a bluish appearance and livedo reticularis was present on the lower extremities (figure). Immunological evaluation showed: positive antinuclear antibodies at low titer (1/80), positive anticardiolipin antibodies, both IgG and IgM (280 IU and 150 IU respectively, normal value <100 IU). The rest of the immunological evaluation was negative. What is the differential diagnosis?
1. Systemic lupus erythematosus
2. Progressive systemic sclerosis
3. Primary antiphospholipid syndrome
4. Atrophic blanche

(source: mednet)




  #2

antiphospholipid synd


  #3

in differential i think SLE and aPL syndrome both......


  #4

YESSSSS, THIS IS A CASE OF PRIMARY ANTIPHOSPHOLIPID ANTIBODY SYN., grin which is a distinct entity characterised by venous and arterial thrombosis, due to the presence of APL abs.These abs r directed against negative charged phospholipids(antocardiolipin abs or lupus anticoagulant).the MC clinical findings r livedo reticularis,Thrombophlebitis and raynaud's phenomenon.The diagnosis requires the presence of one clinical and one lab finding(autoabs.)


  #5

"smitha" wrote:
A single 35 year-old woman with a history of Raynaud’s phenomenon since 1990 came to the Rheumatology outpatient clinic for evaluation. Her past medical and family history were unremarkable. Physical examination showed that the hands were cold with a bluish appearance and livedo reticularis was present on the lower extremities (figure). Immunological evaluation showed: positive antinuclear antibodies at low titer (1/80), positive anticardiolipin antibodies, both IgG and IgM (280 IU and 150 IU respectively, normal value <100 IU). The rest of the immunological evaluation was negative. What is the differential diagnosis?
1. Systemic lupus erythematosus
2. Progressive systemic sclerosis
3. Primary antiphospholipid syndrome
4. Atrophic blanche

(source: mednet)



  #6

I took the 5 days course, and it was really worthy. I could practice with more cases, I could improve the pronunciation of words that were tough for me. The method at Ximedus made me succed in this test. I had the knowledge but I was timing wrong during the real test, that's why I failed twice. The preparation at Ximedus is very complete. All the practice with the simulated patients, to be able to recognize all the possible scenarios that could be presented, and to be able to deal with difficult situations made me feel very confident at the moment of the test. One normal day of study at ximedus starts with a breakfast in the hotel, then we go to the center, usually 5 min by car, and we study all morning, with breaks, for coffee or water, and then a lunch, and continue with more study until 6, or 7 pm. The feedback that I got was deep enough for not overwhelming me, and clear to make the right changes. This test is passed with lots of practice, and that's what we get at ximedus, practice. And we learn how to avoid the common mistakes that can jeopardize our performance. Thanks to everybody at Ximedus.





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