Author Question: A 9-month-old patient presents with fever and large areas of redness and bullae over the trunk, ... (Read 50 times)

panfilo · **on:** Jun 25, 2018

A 9-month-old patient presents with fever and large areas of redness and bullae over the trunk, palms, legs, and sole of the feet. There is redness and swelling of the conjunctiva and lips. The clinician should recognize this condition as:

A. Giant cell arteritis
B. Stevens-Johnson syndrome
C. Botulism
D. Myasthenia gravis

Question 2

Your patient with Crohn's Disease complains of eye pain and photophobia. This is likely related to:

A. Symptoms of temporal arteritis
B. Altered pupil response due to uveitis
C. Blurry vision due to bilateral cataracts
D. Subconjunctival hemorrhage

lin77x · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
Stevens-Johnson syndrome, also called erythema multiforme, involves inflammation of the mucous membranes and skin. It is often related to an infection or can be due to almost any medication. Often, no specific cause is identified. The condition can be fatal. It is important to immediately recognize and treat. The patient appears acutely ill and has systemic symptoms, including malaise, fever, and arthralgias, so that the eye findings are not isolated. Conjunctival bullae and ulcerations may develop. Patients develop erythematous lesions and bullae over the skin and hemorrhagic lesions of the mucous membranes. In addition to the eye tissue, the palms, soles, anus, vagina, nose, and mouth are commonly affected.

Answer to Question 2

ANS: B
Uveitis involves inflammation of the uveal tract, including the iris. The inflammation may be caused either by infection or as part of a reaction associated with a systemic disorder. For instance, an increased incidence of uveitis is associated with autoimmune disorders, such as Crohn's disease, ankylosing spondylitis, and HIV infection. The vision changes associated with uveitis stem from altered responsiveness of the pupil and lens. Patients commonly experience both photophobia and eye pain. There is a ciliary flush and, usually, a constricted pupil.