jean robert
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36 y.o. schoolteacher seeks an appointment with her physician because of a 4 day history of swollen, painful hands. Her wrists and metacarpophalangeal joints are boggy and inflamed bilaterally and the pain and stiffness are worse in the morning. By the time her medical appointment occurs, the condition appears to be improving. Which of the following questions should her physician ask?
a) Do you have a family history of autoimmune disease?
b) Do you often eat soft cheeses and/or deli foods?
c) Have any of your students had facial rashes?
d) Have you had potential exposure to ticks?
e) Have you had a recent urinary tract or eye infection?
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| pr20
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A. RA---->chronic,inflammatory disease thought to be caused by an autoimmune reaction triggered by an infectious agent in a genetically susceptible individual(HLA-DR4 and DR1)
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| Tiff
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A
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| new_n_lost
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a) Do you have a family history of autoimmune disease?
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| jean robert
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| new_n_lost
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e) Have you had a recent urinary tract or eye infection?
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| nerve09
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d) Have you had potential exposure to ticks?
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| Tiff
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C. Have any of your students had facial rashes?
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| angel23
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C.coz it is a parvovirus infection....B19 virus...
it causes arthritis in adults....
slapped cheek appearance in children
aplastic crisis in sickle cell ds patients
and hydrops foetalis risk in a pregnant lady
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| jean robert
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Correct Answer is C
Parvovirus B19 causes erythema infectiosum, or fifth disease. Adults typically do not get the facial rash ("slapped cheek") typical of children, but have arthralgias and arthritis. The symmetrical distribution of involved joints is similar to that in Rheumatoid Arthritis. The onset in adults is typically 3 to 4 weeks after exposure. Parvovirus infections may persist in immunosuppressed patients, resulting in red blood cell aplasia.
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| jean robert
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(Choice A) Asking about familial history of autoimmune disease is appropriate if RA is suspected.
(Choice B) Asking about eating cheeses and /or deli foods) is correct if you suspect Listeriosis
(Choice D) Asking about potential exposure to ticks) is appropriate if you suspect Lyme disease.
(Choice E) Asking about recent urinary tract or eye infection) is correct if Reiter syndrome is suspected.
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| macintosh
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I still think the correct answer choice is "A". because (1). the wrists and metacarpophalengeal joints are bilaterally involved and (2). the symptoms improve as the day passes.
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| Dr_Cosme
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If it wasn't for the fact that in the history says she is a school teacher, I would choose p/b autoinmune disorder. However, you also noticed that the illness is self limited in this question.
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| icarus
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Thank you a lot for this great information ... will write it down on my HY IMMEDIATELY ...
Kind regards,
icarusmd
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