caldje Posted December 2, 2005 Share Posted December 2, 2005 we're doing rheum and musculoskeletal in clin med so I figured id ask one tonight... what 4 out of seven things have to be present to diagnose RA? and what joints are not affected in solitary RA? Quote Link to comment Share on other sites More sharing options...
andersenpa Posted December 5, 2005 Share Posted December 5, 2005 Define and differentiate specificity, sensitivity, positive predictive value, and negative predicitive value. Quote Link to comment Share on other sites More sharing options...
caldje Posted December 5, 2005 Share Posted December 5, 2005 we're doing rheum and musculoskeletal in clin med so I figured id ask one tonight... what 4 out of seven things have to be present to diagnose RA? and what joints are not affected in solitary RA? -hand involvement (the PIP joints are spared in RA alone but are involved with secondary OA.) -you must have symmetrical polyarticular arthritis -of at least 3 joints -RF factor or anti-CCP positive. -morning stiffness lasting great than 1 hour that improves throughout the day -radiographic findings (degeneration) -rheumatoid nodules. just thought id answer it real quick since i posted it. how about this.. in the same line of questioning. describe boutteniere's deformity and swan-neck deformity. Quote Link to comment Share on other sites More sharing options...
caldje Posted December 5, 2005 Share Posted December 5, 2005 specificity is whether or not the test is positive only in a certain condition you are looking for. sensitivity is the probability that a person with the disease has a positive test. the others i dunno. Quote Link to comment Share on other sites More sharing options...
merseur Posted December 6, 2005 Share Posted December 6, 2005 bouttenieres deformity-rapture extenson tendon at PIP causis PIP to flexed and DIP extended, Swan Neck-DIP flexed, PIP extended. Usually due to raptured or dislocated tendon Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted February 16, 2006 Share Posted February 16, 2006 Time to revive this thread :) I got an interesting question from a surgical PA when we were looking at a CT of a pt with a massive inguinal hernia. He said it was Throckmorton negative - then asked what "Throckmorton negative" meant and the significance of the finding. Quote Link to comment Share on other sites More sharing options...
Guest ChadDC Posted February 16, 2006 Share Posted February 16, 2006 Also known as the "Peter Pointer Principle", the penis points to the side of pathology on imaging (well, 50% of the time at least). Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted February 16, 2006 Share Posted February 16, 2006 Time to revive this thread :) I got an interesting question from a surgical PA when we were looking at a CT of a pt with a massive inguinal hernia. He said it was Throckmorton negative - then asked what "Throckmorton negative" meant and the significance of the finding. Thats actually the oldest joke in radiology LA. Although everyone knows what throckmortons sign is, you should never use the eponym in dictations or written notes. Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted February 16, 2006 Share Posted February 16, 2006 Thats actually the oldest joke in radiology LA. Although everyone knows what throckmortons sign is, you should never use the eponym in dictations or written notes. It might be old but it was new to me. He asked in the middle of some more serious pimping, so I thought it was real. I'll take your advice and not use it in any documentation. :p Just passing on info to any of my cohorts who may be as naive to that one as I was. Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted February 16, 2006 Share Posted February 16, 2006 im not getting onto you i just dont want you making the same mistakes i made!!!! I also got called to medical records and fussed out for writting: the area was prepped and draped in the usual standard sterie manner, 5 cc 1% lidocain was infiltrated into the area. A 3 cm insicion was made down to the subcutaneaous tissue and approx 5 cc of PUSSEY material was removed. Moral of the story is always use purulent!!!!! Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted February 16, 2006 Share Posted February 16, 2006 I didn't take it that way... you are direct but you've never been unkind! "Purulent" is a great word to have in our professional vocab, no? I learn so much here! Quote Link to comment Share on other sites More sharing options...
rcdavis Posted February 17, 2006 Share Posted February 17, 2006 too bad the crash of 3/05 occurred: else you could have referred to LA and my several page give and take on the "p" word Quote Link to comment Share on other sites More sharing options...
pahopeful Posted February 17, 2006 Author Share Posted February 17, 2006 Thanks for reviving the thread, LA! Haven't seen any pimping around here in quite a while. I'm on pediatrics right now so here's some Peds pimping for you all. Fifth's disease is a common pediatric disease causing a pink maculopapular rash. Some sources say it is so named because it was the 5th disease discovered to cause such a rash. The question is: What are the 4 diseases that cause a pink maculopapular rash that came before Fifth's?? pahopeful Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted February 17, 2006 Share Posted February 17, 2006 I know I knew all five (in order) at one point in my career... but rubella & roseola are the only two coming to mind right now.... someone else know the other two? Davis, davis... will I never live that down? At least something great came of it! Quote Link to comment Share on other sites More sharing options...
ajnelson Posted February 17, 2006 Share Posted February 17, 2006 Is one of the others scarlet fever? Quote Link to comment Share on other sites More sharing options...
merseur Posted February 17, 2006 Share Posted February 17, 2006 Are you referring to viral syndome? Fifth dz plus the following: Roseola, varicela, herpes stomatitis, herpangina-(?) All of them shows maculopapular rash at some point. Quote Link to comment Share on other sites More sharing options...
pahopeful Posted February 18, 2006 Author Share Posted February 18, 2006 Nope, not talking about the viral syndrome thing... You guys have almost got all of them: rubella, roseola, scarlet fever Anybody like to guess the last one?? pahopeful Quote Link to comment Share on other sites More sharing options...
Guest thinePA Posted February 19, 2006 Share Posted February 19, 2006 I'm new to this, but I'll give it a shot... 1. rubella 2. roseola 3. scarlet fever 4. rubeola 5. Lyme's (big guess...) Quote Link to comment Share on other sites More sharing options...
Guest thinePA Posted February 19, 2006 Share Posted February 19, 2006 I've got another question for yall... What blood test can be ordered specifically to diagnose Sarcoidosis? Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted February 19, 2006 Share Posted February 19, 2006 ACE level, but is very nonspecific Quote Link to comment Share on other sites More sharing options...
Guest thinePA Posted February 20, 2006 Share Posted February 20, 2006 Nice one PA-C. Anyone know the skin test that you can order to confirm? Quote Link to comment Share on other sites More sharing options...
Monica Posted February 20, 2006 Share Posted February 20, 2006 Nice one PA-C. Anyone know the skin test that you can order to confirm? Anergy testing I believe. Quote Link to comment Share on other sites More sharing options...
pahopeful Posted February 20, 2006 Author Share Posted February 20, 2006 I'm new to this, but I'll give it a shot...1. rubella 2. roseola 3. scarlet fever 4. rubeola 5. Lyme's (big guess...) Good guesses...glad you joined in thinePA! Ok, the answer that I was given for the one rash no has named yet is MEASLES! So the 4 rashes before Fifth's disease include: 1. measles 2. rubella 3. roseola 4. scarlet fever Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted February 20, 2006 Share Posted February 20, 2006 measles and rubeola are one in the same Quote Link to comment Share on other sites More sharing options...
Melodie Posted February 20, 2006 Share Posted February 20, 2006 Comment in: Am J Epidemiol. 1992 Jun 15;135(12):1427-9. The "fourth disease" of childhood: reevaluation of a nonexistent disease. Morens DM, Katz AR. Section of Epidemiology, School of Public Health, University of Hawaii, Honolulu. Observed and described between 1884 and 1900, "fourth disease" (Dukes disease) followed measles, scarlet fever, and rubella as the fourth clinically characterized childhood exanthem. Like rubella ("third disease") and erythema infectiosum ("fifth disease"), accepted by the medical community at about the same time, the existence of fourth disease was initially controversial. Over the following decades descriptions of hundreds of cases, outbreaks, and laboratory studies were published in the indexed medical literature. Unlike rubella and fifth disease, however, fourth disease was not subsequently proven to exist by either epidemiologic criteria or isolation of an etiologic agent. By the 1930s, it was infrequently recognized and by the 1960s had been dropped from textbooks. In this study, the authors use epidemiologic methods to reevaluate published data on English schoolchildren from 1892 to 1900 upon which the original fourth disease claim of Dukes was based. The authors conclude that fourth disease never existed. Reinterpretation of the original data suggests that cases can be completely explained as misdiagnosed rubella and scarlet fever. Misidentification of fourth disease is attributed to failures in the critical abilities of the medical and scientific communities at the time. The implications of erroneously identifying a nonexistent disease suggest that modern scientific approaches to disease identification are sound. Quote Link to comment Share on other sites More sharing options...
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