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سجل عبر فيسبوكحالة سريرية
الوصف الكامل Background
An 18-year-old man is evaluated because of a 2-day history of fever, chills, and migratory arthralgias involving the ankles, knees, elbows, and shoulders. On physical examination there are subcutaneous nodules on the volar surface of both forearms, and a grade 2/6 systolic murmur and an S3 heard at the left ventricular apex. There is no objective evidence of joint disease.
Which of the following additional findings establishes a definite diagnosis of acute rheumatic fever in this patient?
( A ) Arthritis
( B ) Erythema marginatum
( C ) Choreoathetosis
( D ) An elevated erythrocyte sedimentation rate
( E ) A throat culture positive for group A streptococci
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Mon, 2007-09-24 02:40
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Majors: carditis?, poly arthritis, chorea, erythema marginatum, subcutaneous nodules
Minors: previous rheumatic fever, Arthralgias, Fever, Acute phase reactants(HIGH ESR, or WBC), prolonged P-R interval.
2(or 1) majors + 2 minors +
exactly as Dam said....
r they considered carditis?
The patient has two major criteria, carditis and subcutaneous nodules, for the diagnosis of acute rheumatic fever. Although the addition of other major criteria, such as choreoathetosis, erythema marginatum, or arthritis, strengthens the likelihood of the diagnosis, a definite diagnosis cannot be made without a positive throat culture for streptococci or a rise and fall in antistreptolysin-O titer. The presence of two or more of the Jones criteria can also be observed in other systemic diseases not due to streptococcal infection. A high erythrocyte sedimentation rate and first-degree atrioventricular block are findings that are not specific for acute rheumatic fever
many thanx