Select the ONE best lettered option that is most closely associated with it. Each lettered option may be selected once, more than once, or not at all.A 70-year-old female with headaches and fevers notices visual changes. Her erythrocyte sedimentation rate (ESR) is 125. Most likely she is the victim of
Answer(s): H
Giant cell arteritis (aka temporal arteritis) occurs almost exclusively in patients over 55 years of age. The classic clinical findings are fever, anemia, high ESR, and headache. Other anifestations may include malaise, fatigue, anorexia, weight loss, sweat, and arthralgias. Headache may be associated with a tender, thickened, or nodular temporal artery. Diagnosis often is made clinically and can be confirmed by a temporal artery biopsy. Patients respond well to glucocorticoid therapy.
Select the ONE best lettered option that is most closely associated with the question below. A40-year- old male with purulent, bloody sinus drainage, hemoptysis, and rising creatinine
Answer(s): C
Wegener granulomatosis affects males and females equally, can occur at any age, and is extremely rare in African Americans. Patients typically present with severe upper respiratory tract symptoms. Nasal perforation and saddle nose deformity may occur. Pulmonary involvement (cough, hemoptysis, or dyspnea are common presenting symptoms/signs) is present in 8590% of patients, renal disease in 7080% of patients, eye involvement in 5055%, and skin lesions in 4050%. Antineutrophil cytoplasmic antibodies (C- ANCA) is positive in 90% of patients. ESR typically is high.
Select the ONE best lettered option that is most closely associated with the question below. A 32-year-old White female with anemia, arthralgia, alopecia, and RBC casts on urinalysis.
Answer(s): B
SLE is characterized by tissue and cell damage from pathogenic autoantibodies and immune complexes.Ninety percent of patients are women in childbearing years and the disease is more common in African Americans. Multiple organ system manifestations can occur, including musculoskeletal (arthralgias, myalgias), cutaneous (malar rash, photosensitivity, hair loss), renal (nephritis, nephritic syndrome), nervous (seizures, headaches), cardiopulmonary (pericarditis, pleuritis), hematologic (anemia, leukopenia)
Select the ONE best lettered option that is most closely associated with the question below. A 38-year-old African American female with shortness of breath and bilateral hilar adenopathy on CXR.
Answer(s): I
Sarcoidosis is a relatively common disease. In the United States, most patients are African American (ratio ranges from 10:1 to 17:1). The disease is systemic, and the lung is almost always affected (primarily an ILD). Seventyfive to ninety percent of patients have enlarged intrathoracic lymph nodes, usually the hilar nodes
Select the ONE best lettered option that is most closely associated with the question below.A 45-year-old female with pain and visible swelling in her metacarpal-phalangeal joints bilaterally. Her distal interphalangeal joints (DIPs) appear normal.
Answer(s): A
Rheumatoid arthritis affects approximately 0.8% of the population. Women are affected three times more often than men. Synovial inflammation causes tenderness, swelling, and limitation of motion. Most often the arthritis is symmetric and characteristically involves joints such as the wrist and the proximal interphalangeal and metacarpophalangeal joints.
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