Pimp question--help!

[bpayh]

So I'm on a family medicine rotation, and I'm trying to make as good an impression as possible.

The attending asked me a really weird pimp question the other day and said, "see if you can figure it out." Basically he said there's a weird disease that you'll never ever diagnose if you're not thinking about it. The patient suffers from aches and pains; cortisone shots make the patient feel better for about 3 days, then they revert back to aches/pains. The treatment is daily prednisone.

It's a lame question, I know, and I can't seem to figure out what he's getting at but I'd really like to come back on Monday with the answer. Does anyone have a CLUE what the answer could be??

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[Flobber]

polymyalgia rheumatica.

 

[random-dude]

yeah sounds like he is going for polymyalgia rheumatica....If he gets frisky and asks about associated diseases say

Temporal Arteritis which can lead to blindness. The treatment for that is a much higher dose of steroids (like 60mg daily).

Then smack him and say thats right b****......although that last part may not make a good impression.

 

[deleted87716]

polymyalgia rheumatica.

Sounds like it. If he asks how to confirm the diagnosis, the answer is an elevated ESR ("sed rate.") If he doesn't ask, volunteer it. Bonus points! 😉

 

[LurkNoMore]

Make sure the person is pretty advanced in age, otherwise you may get frowned at for suggesting PR (saw someone do that a couple of weeks ago on IM rounds when the attending asked one of those "introspective" questions).

 

[deleted109597]

Be sure to mention that it ranks up there with fibromyalgia and chronic fatigue in the "diseases that exist but are so overdiagnosed that half of the FM patients have it".

 

[bpayh]

Thanks guys,

I was thinking of chronic fatigue or fibromyalgia though the treatment didn't sound right. This looks much better!