Review - Clinical - Presentations III

[Intro: 120 BPM. Palm-muted electric guitars chug a catchy chord progression. A heavy kick drum builds the energy before the full band explodes into the groove.] [Block 1: The beat drops with crunchy guitars and a bouncing bassline. The MC rides the rhythm with high energy.] Scarlet fever “erythrogenic toxin; circumoral pallor, strawberry tongue, and sandpaper rash (from trunk to the extremities, spare palms but palm desquamation seen)” Kawasaki disease “fever, strawberry tongue, cervical LAP, bilateral conjunctivitis, polymorphous (maculopapular, erythroderma, or erythema multiforme-like) exanthem, extremity edema, arthritis, carditis, giant coronary aneurysms” Streptococcus gallolyticus (formerly bovis) “Colon cancer & infective endocarditis” (snare) NEXT [Block 2: The guitars switch to bright, staccato stabs. The flow gets faster and punchier.] Botulinum “floppy baby”, descending paralysis (snare) NEXT Waterhouse-Friderichsen “Acute adrenal insufficiency, fever, bilateral adrenal hemorrhage” (snare) NEXT Secondary Syphilis (Shout) presents Condyloma lata (contagious, the anogenital, medial thighs, or inframammary creases), cervical LAP, maculopapular rash on palms and soles. pharyngitis, tonsillitis, patchy alopecia (snare) NEXT Acuminata is cauliflower-like, dry, bulky BUT Lata is smooth, moist, flat [Block 3: A driving drum-and-bass breakdown. The vocals are crisp and rhythmic.] Tertiary Syphilis (Shout) presents Gummas, Argyll Robertson “no light but accommodate”, aortitis, tabes dorsalis (snare) NEXT Lymphogranuloma venereum, L1–L3 Chlamydia trachomatis; Painless genital ulcer, tender LAP (buboes) (snare) NEXT Chancroid “1-3 soft, painful exudative ulcer AND tender LAP”. Azithromycin or ceftriaxone. Herpes “painful vesicles and ulcers” (snare) NEXT [Block 4: Full stadium-rock energy returns. Guitars are soaring and wide.] Klebsiella granulomatis “Granuloma inguinale, donovanosis”; “nodule or papule turns to non-painful shiny ulcers with raised edges and no LAP. Tropics and subtropics Babesiosis (Shout) presents high fever, hemolytic anemia, sweats, splenomegaly, hepatomegaly, Maltese cross in RBCs (snare) NEXT Measles “cough, coryza, conjunctivitis, Koplik, then cephalad-to-caudal rash- confluent, fades in the same pattern”. petechial rash means black measles. Mild case means modified measles Rubella “retroauricular LAP; discrete, less prominent cephalad-to-caudal rash; Forchheimer, pharyngitis, conjunctivitis” Roseola infantum “herpes 6-7, high fever rose-colored rash with defervescence” Erythema infectiosum “parvo B19, slapped cheek then truncal (central clearing) lacy, reticulated rash” [Block 5: A bouncy pop-rap bridge. The MC emphasizes the rapid-fire symptoms over a clapping beat.] Malaria (Shout) presents malarial paroxysm “chills, high fever, and then sweats” -tertian fever vivax/ovale or quartan in P malariae. Diarrhea, seizure, anemia, jaundice, splenomegaly, hepatomegaly, organ dysfunction, hypoglycemia, cerebral malaria (altered consciousness). No rash or LAP (snare) NEXT Mycoplasma pneumonia “nonproductive cough, macular rash, variable fever” (snare) NEXT [Outro: The final energetic build-up. The beat pushes forward toward the climax.] Sydenham chorea “Emotional lability, incoordination, poor school performance, uncontrollable movements, and facial grimacing exacerbated by stress; insidious”. Erythema marginatum “serpiginous, macular not pruritic” (snare) NEXT Above PLUS Migratory Polyarthritis (large joints) and pancarditis (endo+myo+peri; AR/MR years later AS/MS) [Ending: A massive power chord rings out with a final heavy drum crash. The MC shouts one last hype ad-lib before the track cuts to total silence.]