42 yr old dude comes to the ER complains of 2 week of weakness, low grade fever, and exertional shortness of breath. He also notes fingertip pain and urine that has been dark and cloudy recently. ON physical exam, several of his proximal interphalangeal joints are swollen. Which of the following diagnosis is most consistent with presentation:
A) infective endocarditis
B) RA
C) Post strep glomerulonephritis
answer A
He does not meet the diagnostic criteria.
For dx we need 2 major, 1 major and 3 minor, or 5 minor criteria.
He's got no major criteria: no + blood cultures and no abnormal echo
IN terms of minor criteria he's got 3 and that's it!!!???:
1) fever
2) glomerulonephritis
3) painful fingertips (osler's nodes)
he's also got arthritis in his PIP and the explanation says that his arthritis may be due to immune complex deposition, however that's not one of the criteria.
Also he's got exertional shortness of Breath for two weeks but again that's not one of the criteria.
So he's got 3 minor criteria and that's it!! he doesn't have the 5 required for diagnosis.
Am I missing something here???
A) infective endocarditis
B) RA
C) Post strep glomerulonephritis
answer A
He does not meet the diagnostic criteria.
For dx we need 2 major, 1 major and 3 minor, or 5 minor criteria.
He's got no major criteria: no + blood cultures and no abnormal echo
IN terms of minor criteria he's got 3 and that's it!!!???:
1) fever
2) glomerulonephritis
3) painful fingertips (osler's nodes)
he's also got arthritis in his PIP and the explanation says that his arthritis may be due to immune complex deposition, however that's not one of the criteria.
Also he's got exertional shortness of Breath for two weeks but again that's not one of the criteria.
So he's got 3 minor criteria and that's it!! he doesn't have the 5 required for diagnosis.
Am I missing something here???
