I hope everyone enjoy and get benefit from my questions
big thanx for the knight , mobic , and a very big one for ali al kafaji[COLOR=green]

HII



A PREVIOUSLY healthy 3 year old boy is brought to the emergency department by his mother because of 2-day hx of ahigh fever ,rash and red eyes, his temperture is 39.5C
physical exam shows bilateral conjuctival injection ,an enlarged left sided cervical lymphnode(1.7)cm ,fissured lips, ared tongue with red papillae , pharyngeal hyperemia , erythematous palms and soles , and aconfluent ,blanching erythematous rash on the trunk
LAB FINDING :ESR 28mm/h
platelet count 490,000/mm


DUE TO THIS CONDITION , THE P IS AT INCREASED RISK FOR WHICH OF THE FOLLOWING COMLICATION ?


A-BLINDNESS

B-CORONARY ANEURYSM

C-GLOMERULONEPHRITIS

D-HEPATITIS

E-SPLENIC RUPTURE






GOOD LUCK

i know this is scarlet fever but i don't know the complication.

NO ITS NOT , ITS MUCH COMLICATED


THINK AGAIN

Blindness

Glonerulonephritis??

i think Coronary aneurysm (as the Dx is Kawasaki dis-MucoCutaneousLymphnode synd-)

i thought of scarlet fever coz of the red tongue and blanching rash on trunk, anyway, let us know what is this.

hmmm i have no idea........

HII
THE ANSWER IS B- CORONARY ANEURYSM
THE DISEASE IS CALLED KAWASAKI(MUCOCUTANEOUS LYMPHNODE SYNDROM):
IT OCCURE IN INFFANTS AND YOUNG CHILDREN (LESS THAN 4 Y)
clinical features include: acute febrile illness,conjuctivitis,generalised maculopapular rash , lyphadenopathy
this disease affect the medium and large size arteries but the coronary artery is the most affected ( 70%)


well done DR. SARMAD



GOOD LUCK

But the clinical features resemble the scarlet fever , mo?

what's the characteristics features of kawasaki in your example????

HII

Kawasaki disease is a systemic vasculitis predominantly affecting children under the age of 5 years. It has a number of classic clinical features required for diagnosis.

In 1990 the American Heart Association committee on rheumatic fever, endocarditis, and Kawasaki disease2 gave the case definition that has been generally accepted—ie, a febrile illness of at least five days with at least four of the five following signs and no other reasonable cause for the findings:


Bilateral conjunctival injection – (there is no corneal ulceration but there may be a concomitant anterior uveitis on slit lamp examination)

Oral changes (erythema of lips or oropharynx, strawberry tongue due to prominent papillae, or fissuring of the lips)
Peripheral extremity changes (oedema, erythema, or generalised or periungal desquamation); erythema is seen in the first week whereas desquamation begins about 14–21 days after the onset of the illness

Rash – this starts in the first few days; it is often diffuse and polymorphic and lasts a week before fading. Vesicles are rarely seen; however, the rash can appear macular, maculopapular, urticarial, scarlettina or even morbilliform
Cervical lymphadenopathy is found in about 50% of cases; most often there is a painful solitary enlarged lymph gland, > 1.5 cm in diameter


AS FOR THE DIFFERENCE BETWEEN IT AND SCARLET FEVER:
1- IN KAWASAKI THE LYMPHADENOPATHY IS MORE EXTENSIVE
2- IN SCARLET FEVER YOU DONT SEE CONJUCTIVITES, ALSO THERE IS RAPID RESPONSE TO ANTIBIOTIC

hii


A 77-year-old man has developed increasing dyspnea for the past 3 years. On physical examination he has a diastolic murmur. A chest radiograph shows an enlarged heart and prominent aorta. He dies from complications of pneumonia. At autopsy, the thoracic aorta is aneurysmally dilated. A microscopic section of the aorta shows chronic inflammation and luminal narrowing of vasa vasora. There is disruption of the aortic medial elastic fibers. Which of the following conditions is most likely to cause these findings?

A Hypercholesterolemia

B Marfan syndrome

C Polyarteritis nodosa

D Takayasu arteritis

E Tertiary syphilis

F Wegener granulomatosis




good luck

i think the answe is tertiary syphlis

either polyarteritis nodosa or tertiary syphilis