Alright so let's do a quick quiz to try and
highlight some of the information we've discussed.
What I'm gonna do is present
four very tight little vignettes
and see if you can come up with a
diagnosis just from these limited information.
Headache, fever, recent
camping trip and that rash.
Okay, hopefully you recognized that
rash as erythema chronicum migrans.
This is a classic picture for Acute Lyme.
Moving on to the second case:
A 29 year-old woman who's
experiencing migratory polyarthralgias
and you see some vesicles
and pustules on her palms.
Great, this is a classic illness script for gonococcal
infection, so called Disseminated Gonococcal Infection.
Okay, let's move on to the third one:
A 25 year-old man with
a recent diarrheal illness
and what looks like either
conjunctivitis or potentially even scleritis.
Okay, that kind of constellation of antecedent
diarrheal illness or antecedent genitourinary infection,
along with scleritis and presumably some joint
disease, should make you think about Reactive Arthritis
And the last case:
An obese older man with a history
of CKD shows you this painful thumb.
Okay, so that is a classic picture
of Chronic Tophaceous Gout.
Those tophi in the DIP are essentially pure uric
acid crystals with some inflammatory debris as well.
This is somebody who
clearly has chronic gout.
And I think that's all for today.