Sunday4-fow Showman,Easy one! - sammy08

[ArchivalUser]

An 18 year old female presents to your office with headaches, joint pains and nausea soon after returning from her trip. She says that the illness started with fever and joint pains,especially in the toes, ankles and fingers. Her headaches and nausea then developed over the next few hours. She also tells you that she went hiking twice, and had many outdoors activities while on the trip. Her past medical history is insignificant. Her temperature is 102F, blood pressure is 110/66mm, pulse is 102/min and respirations are 18/min. Physical examination reveals a stiff neck. Careful inspection reveals a few purpuric lesions on both legs. Examination for CSF shows :

Glucose 20mg/dl
Proteins 155mg/dl
WBC 200/mm3

What is the most likely cuase of this patient's condition?

A. Secondary syphilis
B. Pneumococcal meningitis
C. Reiter's syndrome
D. Lyme disease
E. Rocky Mountain spotted fever
F. Infective endocarditis
G.Arbovirus infection
H. Acute rheumatic fever
I. Meningococal infection

[ArchivalUser]

iii?

[ArchivalUser]

ee

[ArchivalUser]

E..

[ArchivalUser]

eee

[ArchivalUser]

eeee i suppose.

i guess the reason y im not going for gonococcal is that it usually affects the knee, and secondly no sexual history in the story, and thirdly when it does cause petechiae, the patient tends to be much much sicker.

[ArchivalUser]

The correct answer is II..it's meningococcal meningitis.The outdoor activities are just a distractor. see the timing of the symptoms and the csf findings

[ArchivalUser]

watch for purpura ,cardinal sign for dxing meningococcal infn!

[ArchivalUser]

hi sammy.thnxs for questions.it was nt easy 1.