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 EMQ 22



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EMQ: 22

a)      Sarcoidosis

b)      Malaria

c)      Dressler’s syndrome

d)      Whipple’s disease

e)      Lymphoma

f)        Polymyalgia rheumatica

g)      Infective endocarditis

h)     Retroperitoneal fibrosis

i)        Typhoid fever

j)        Tuberculosis

1) A 45-year-old homeless male, who drinks 50 units of alcohol a week and smokes heavily, is admitted with a history of fever, cough and loss of weight.

On examination he looks emaciated, his trachea is deviated to the left, there is flattening of the upper part of his chest on the left hand side, chest movements are decreased on the left hand side, upper zone, breath sounds are vesicular and there are fine crepitations in the left upper zone

2) A 26-year-old male who has been on a holiday to Kenya presents with fever accompanied by chills and rigors. On examination of his abdomen his spleen is just palpable below the left costal margin

3) A 32-year-old male presents with a history of fever with night sweats and loss of weight. On examination he has cervical, axillary and inguinal lymphadenopathy and hepatosplenomegaly.

4) A 40-year-old businessman presents with fever and loss of weight of a few weeks duration. He gives a history of having had a dental extraction 2 months prior to presentation.

On examination he is febrile, there is clubbing and erythematous macules on his palms. His pulse rate is 110 beats per minute; regular, jugular venous pressure is not raised. The apex beat is at the 5th left intercostal space in the mid-clavicular line and there is a pan systolic murmur at the apex and this radiates to his axilla.

5) A 26-year-old male presents with a history of fever.  He has been on a backpacking holiday in India. On examination he is febrile, there is an erythematous rash on his trunk, his spleen is palpable. His pulse rate is 60 beats per minute.


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