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urticaria -
#1
brian

A patient who has experienced recurrent urticaria comes to your office because the lesions have persisted for 48 hours. The patient has individual wheals that are smooth, edematous, and purpuric. They also itch and are painful.

Which one of the following is the most important diagnostic step at this time?

1 A skin biopsy
2 A trial of oral H1 antihistamines
3 A serum C4 complement level
4 A WBC count with differential
5 A placebo-controlled food additive challenge
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#2
bill

3
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#3
mash

2 trial of oral H1 antihistamines
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#4
brian

what is your diagnosis?
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#5
bill

Urticaria Smile)
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#6
bill

"Evaluation of the complement system, including total hemolytic complement (CH50), C3, and C4 should be considered in patients with prominent angioedema and in patients with urticarial lesions lasting more than 24 hours. These tests are of no value in patients with classic chronic urticaria."

www.emedicine.com
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#7
brian

As I know C4 complement level is not Dx test for Urticaria :-) but for angioedema :-)
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#8
brian

Actually this is a typical scenario of urticarial vasculitis, and Dx test is skin biopsy.
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#9
bill

Agree.
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