 |  78 yo lady
|
|
| Author | 5 Posts |
keepgoing
Forum Fanatic
Topics: 115
Posts: 2,336
|
A 78 year old female presents with a two month history of progressive weakness. She complains of marked weakness, particularly when she gets out of a chair, brushes her hair and hangs clothes out to dry. She indicated that if she is to squat to pick up an object that she has extreme difficulty trying to stand again. She complains also of some pain and tenderness in her proximal muscles although weakness is her major complaint. Over the past six weeks she describes the onset of a skin rash. She has joint stiffness of wrists and fingers in the morning lasting about 20 minutes but no red hot or swollen joints. She has been unable to stop smoking over the past 40 years. Last week for the first, she coughed up blood streaked, otherwise clear sputum. She has had no fevers, chills or night sweats. Her appetite has remained fairly good, but she has lost over 6 lbs. in weight over the past 3 months. Physical examination reveals a prominent erythematous/ purplish, slightly elevated rash over extensor surfaces of PIP and DIP joints and over the extensor surfaces of the elbows and knees. Obvious periorbital heliotrope sign with rash on face in malar distribution extending onto neck and over shoulders. There is marked weakness of shoulder and hip girdle muscles, ESR is 64 mm/hr. and CPK is markedly elevated.
a. bilateral inspiratory rates
b. diastolic murmur
c. digital clubbing
d. temporal artery and scalp tenderness
e. temporal mandibular joint tenderness
___________________
God,be my strength.
|
| LG
Forum Newbie
Topics: 2
Posts: 52
|
it looks like she has dermatomiositis in the context of pulmonary malignancy.....so she must have some digital clubbing
for some reason i don't see the question for this case
|
| GoodGirl
.
Topics: 124
Posts: 1,787
|
KG, the question is missing .
___________________
Prioritize & simplify
|
| vaibhavbora
Forum Elite
Topics: 20
Posts: 389
|
please post qs last line .. stem suggest s dermatomyostitis,, heliotrope ras h
___________________
VB
|
| sigh
Forum Guru
Topics: 36
Posts: 461
|
It can be mixed connective tissue disorder...
|
|
| |
| | | | | |
You don't have permission to post.
|
