Wednesday, April 3, 2013

CLINICAL SCENARIO.......Answers.

CORRECT ANSWERS to the posted questions are as follows:


1.    The answers is INFECTIOUS MONONUCLESOSIS.

       Best CLUES to the diagnosis are:

               *** Protracted duration of the illness.
               *** Kehr's Sign. left shoulder pain.
                      (due to splenomegaly).
               *** Early Satiety (due to splenomegaly).


     
       Viral Pharyngitis....,,,,,, does not present with above symptoms/signs.
   
       Exudative Tonsillitis....is very unlikely due to lack of exudates.
                                             Also does not produce splenomegaly.

       Vincent's Angina..........is a necrotizing ulcerative gingivitis,
                                             (Trench Mouth), which this pt. does not have.

       Acute Herpangina........is a group A coxsackie viral infection.
                                             Findings of many palate ulcerations.





2.   The answer is PSITTACOSIS.


       Best CLUES to the diagnosis are:

               ***Household  pet bird.
               ***Abrupt onset with high fevers.


      Chlamydia Pneumonia.....typically is preceeded by a recent sore throat
                                                or upper respiratory infection.

     Mycoplasma Pneumonia...typically occurs in younger patients.
                                                Such are college dormitory or military
                                                barrack residents.

     Legionnaire's Disease........Pt. must  have had history of exposure to
                                                water vapors/condensation. Such as air-
                                                coditioning, humidifiers, etc.

    Lofren's Syndrome..............Is triad of:  * Hilar adenopathy
                                                                   * Erythema Nodosum
                                                                   * Arthritis

                                                 It is also called Sarcoid Arthritis.
              



Vincent's Angina was named after a French physician:
                JEAN HYACYNTHE VINCENT.

Lofren's Syndrome was named after a Swedish clinician:
                SVEN HALVAR LOFGREN.
              



      
                                                               

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