som
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6yr old african american brought to your office with painful episodes of righ knee and intermittent episodes of fever with chills frm 6 wks.
VS: temp 103^oF
pulse=90/min
on/e : multiple red macules with central pallor on the trunk
cervical LA
rt knee jt is swollen, erythematous, with nml ROM
labs: leukocytosis, thrombicytosis, incerased esr
x ray: nml hip and knee
Gm stain and culture of rt knee syn. fluid is negative
what is the most appropritae treatment for this child now:
A. bed rest with acetaminophen
B. bed rest with ten day Pn
C. bed rest with knee in a comfy position
D. NSAIDS with LFT monitoring
E. IV naficillin
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| tolito
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what is Pn?
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| som
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Pn is penicillin
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| robin082006
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D?
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| nadiabarati
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E?
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| cbenitesch
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Could be a prodromal phase of viral hepatitis? can go for D!. Not enough Jones Criteria for Rheumatic fever!
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| tolito
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hey som, spare us the agony. what is the answer.
the fever with CHILLS lasting 6 wks is bothersome. cos of the CHILLS. very few conditions give rise to chills. in a 6yr old??
then the skin lesions could be from typhoid, meningitis, any septicemia, drug related...
painful swollen knee with normal xrays ( at 6wks, rules out ch osteomyelitis). the aspirate may be sterile cos of antibiotiics but 6wks of fever with CHILLS means antibiotics aren't working so there should be growth.
help!!
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| som
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this is a case of juvenile RA
D is th ans
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| tolito
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i am sorry i believe there are a few things wrong with this q. it is not giving classic sympt and signs. this would be unfair in the exam.
first. chronic high grade fever with chills
second, monoarticular arthritis
third, fever should be intermittent.
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| tolito
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oops! missed the intermittent fever
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| fox
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Is it the same as still's disease?
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| tolito
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oops i goofed again.
i was stressing CHILLS when i was thinking RIGOR!!!
i want to formulate an anxiom.. 'YOU PROBABLY DONT KNOW ENOUGH OF A TOPIC WHENEVER YOU THINK ANY QUESTION IS UNFAIR'  :
GOOD QUESTION.
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| tolito
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juvenile rh arthritis is a group of diseases. still's is one of them.
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| study_ing
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good discussion ppl 
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