A 32 year-old female with Turner syndrome comes to your primary care clinic with heaviness and swelling in her right lower extremity. She reports that her skin feels ‘like an elephant’s skin’ and is uncomfortable to move her leg. However, she has no pain. On physical examination, you notice thickened, woody skin, nonpitting edema in the right lower extremity, and “ski-jump” upturned toe nails. Of the following, which is the most effective method to relieve her symptoms?
A 60-year-old man with a confirmed diagnosis of polyarteritis nodosa presents with worsening renal function and hypertension. He is hepatitis B surface antigen-positive. Which of the following is the most appropriate initial treatment for this patient?
A 38-year-old woman presents to the emergency department with a 2-week history of fever, fatigue, and severe muscle pain in her legs. She also mentions a new-onset “pins and needles” sensation in her right foot. Physical examination reveals a blood pressure of 170/100 mmHg, tender calf muscles, and a foot drop on the right side. Angiography shows microaneurysms in the renal and mesenteric arteries. What is the most appropriate initial treatment for this patient’s condition?
A 43-year-old woman presents with severe abdominal pain after meals, muscle aches, and fatigue for the past few months. She has also developed hypertension and painful nodules on her lower extremities. Laboratory studies show elevated inflammatory markers (ESR, CRP), negative ANCA, and negative ANA. A mesenteric angiogram reveals multiple microaneurysms in the mesenteric arteries. Which of the following is the best next step in management?
A 45-year-old man presents with fever, weight loss, and severe abdominal pain. He also reports numbness and tingling in his feet. On examination, he has livedo reticularis on his legs and a mononeuritis multiplex. Laboratory tests reveal elevated inflammatory markers (ESR and CRP) and hepatitis B surface antigen positivity. Which of the following is the most appropriate diagnostic test to confirm polyarteritis nodosa in this patient?
A 50-year-old man presents with a 1-month history of recurrent fevers, night sweats, and pain in his hands and legs. He reports a recent episode of severe testicular pain and difficulty walking due to weakness in his left leg. His past medical history includes untreated hepatitis B. Labs reveal an elevated white blood cell count, ESR, and a negative ANCA test. A biopsy of an affected artery shows transmural inflammation and fibrinoid necrosis. Which of the following diagnostic findings is most characteristic of this patient’s condition?
A 39-year-old man presents with progressive weakness in his right foot, severe hypertension, and testicular pain. He has also experienced unexplained weight loss, fever, and skin nodules. Workup shows negative ANCA, elevated ESR, and angiography revealing microaneurysms in the renal and mesenteric arteries. You suspect polyarteritis nodosa. Which of the following best differentiates polyarteritis nodosa from microscopic polyangiitis?
A 45-year-old man presents with a 3-month history of fever, weight loss, and severe abdominal pain that worsens after eating. He also reports numbness and tingling in his feet. His medical history includes hypertension and a recent diagnosis of hepatitis B. On examination, his blood pressure is 160/95 mmHg, and he has livedo reticularis on his legs. Laboratory tests show an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). What is the most likely underlying mechanism of this patient’s condition?
A 50-year-old man presents with fever, unintentional weight loss, muscle pain, and numbness in his right foot for the past few months. He has a history of hypertension and was recently diagnosed with hepatitis B infection. On examination, he has a skin condition characterized by a network-like pattern of reddish-blue discoloration on his lower extremities and asymmetric weakness in the right foot. Laboratory tests reveal elevated ESR and CRP, negative ANCA, and normal complement levels. Angiography shows multiple aneurysms and narrowing in the renal arteries. What is the most likely diagnosis?
A 3-year-old boy is diagnosed with Kawasaki disease. Which of the following is NOT part of the diagnostic criteria for Kawasaki disease?
