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A 44 yr old Caucasian lady presented with pain in rt wrist & right knee. She has multiple palpable rashes over skin which are erythematous & doesnt blanch on pressure. On examination there is enlarged liver & spleen. Lab results shows U/A - plenty of RBC, Raised protein, Blood picture- reduced complement, Positive rheumatoid factor.
What is most possible disease we r dealing with?
a. Lupus nephritis
b. Rheumatoid Arthitis
c. Essential mixed cryoglobulinemia
d. HS purpura
e. Reactive Arthritis
Please explain the pathology..this q appears as clinical one for CK but concept is tested in step 1 so explain the pathology pls.
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those who r answering dont just put ur ans pls ..explain the pathology u r thinking & y
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White lady with palpable purpura-vasculatis and glomerulonephritis with C3 is most consistent with lupus nephritis.
Essebtial mixed does produce vasculitis and nephritis ,but do not produce hepatosplenomegaly.RA do not produce nephritis or nothing to do with complements..
Reactive is a negative spondyloarthropathy ,so do not fit the baove picture,,...
Definetelly A Lupus Nephritis..AAAA
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well i believe the pt has lupus,,,so its aaa
why?
as rf is an immunecomplex.....so it will deposite or stop in the small cappilaries...where no further can go....producing type 3 hypersensitivity...
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its ddddd
Typical symptoms include palpable purpura (small hemorrhages in the skin), joint pains and abdominal pain
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This is Essential mixed cryoglobulinemia.
There will be joint pains (multi-joint) and swelling (arthritis- as in this pt), enlargement of the spleen, skin vasculitis with purplish patch and kidney disease (plenty of RBC - as in this patient). May be nerve involvement. There will be to recurrent pain in the abdomen, heart attack, and bleeding in the lungs. Weight loss can occur as well as poor appetite.
there will be rheumatoid factor.
It might be a mixed type of cryoglobulinemia.
Great question.
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in lupus neph. there ie hematuria but no proteinuria...........???????
