3. tx {{Correct Ans- 1. progressive muscle weakness + constitutional, periorbital violaceous heliotrope
rash (sun exposed), gottrons papules, proximal
... [Show More] muscle weakness (gowers), neck flexor weakness,
calcinosis (in muscle,, nail telangiectasias,
2. clinical pres + EMG abnormal, muscle biopsy abnormal, inc. CK/AST/ALT/LDH/aldolase
3. corticosteroids, MTX, cyclophosphamide, cyclosporine, vitamin D/calcium supplementation
dermatomyositis complications {{Correct Ans- aspiration pneumonia (dec. gag reflex), intestinal
perforation (GI vascultis), osteopenia(secondary to intestinal perforation)
rheumatic fever
- children 5-15 year of age
1. pathogenesis
2. clinical dx/presentation {{Correct Ans- 1. autoimmune complication of GABHS URI.pharyngitis (NOT
IMPETIGO)
2. Jones criteria, 2 major or 1 major + 2 minor
Major: migratory polyarthritis,
carditis(transmural, left sided endocarditis, tachycardia)
syndhams chorea (basal ganglia autoimmune
erythema marginatum (non-pruritic pink/red macules that spread with centrpitally), subcutaneous
nodules
Minor: fever, arthralgia, leukocytosis, CRP/ESR, prolonged PR on ECG
1. rheumatic fever lab findings
2. treatment
- eventually cardiac damage/valvular insufficiency may require valve replacement {{Correct Ans- 1.
ESR/CRP elevated, leukocytoisis, ASO titers/anti-DNase,anti-hyaluronidase elevated,
echocardiography shows decreased ventricular function,2. benzathine penicillin, or oral penicillin
NSAIDS (after DX)
corticosteroids for severe cardiac involvement
diuretics,digoxin, salt restriction for CHF
haloperidol for syndenhams chorea
what must a patient who has rhuematic fever prophylax against {{Correct Ans- antimicrobial prophylaxis
especially before minor dental procedures
lyme disease
1. pathogenesis
2. clinical presentation early/early disseminated/late {{Correct Ans- 1. New england US borellia
burgdorferi tick bite via ixodes tick
2. early = erythema chronicum migrans (target like annular rash), constitutional symptoms (headache,
myaligias, fatigue, arthralgias,lymphadenopathy)
early disseminated = multiple secondary erythema migrans, constitutional symptoms, FACIAL NERVE
PALSY (UNI/BILATERAL), encephalitis, heart block/carditis (arrythmias), aseptic meningitis
Late: arthritis
lyme disease
1. diagnosis
2. treatmnet {{Correct Ans- 1. clinical pres + ELISA (sensitive), then western blot (sens + specific),
2. early doxycycline or amoxicillin
ceftriaxone or penicillin for carditis/meningitis
reactive reiters disease1. clinical presentation {{Correct Ans- 1. chlamydia trachomatis--> arthritis, urethritis, conjunctivitis (cant
see cant pee cant climb a tree - TF) [Show Less]