Review - Clinical - Presentations VI

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V5.5

[Block 1: The beat drops with crunchy guitars. The singers trade off the hematology and toxicology lines.]
(Soprano) Burton line bluish line in the gingival margin in chronic lead poisoning
(Child) Fanconi anemia “(Shout) DNA crosslink repair defect” (Shout) PRESENTS short stature, café-au-lait spots, thumb/radial defects, aplastic anemia, pancytopenia, (Shout) AML, horseshoe or absent kidney
Next, Para para para para
(Soprano) Paroxysmal nocturnal hemoglobinuria (Shout) PRESENTS Red urine in the morning, pancytopenia, venous thrombosis

[Block 2: The guitars switch to bright, staccato stabs. The flow gets faster, bouncing back and forth.]
(Child) Cryoglobulinemia “Meltzer triad of purpura, arthralgias/myalgia, weakness”. “High (Shout) RF, low C4, normal C3” (Shout) CAUSES “lymphoproliferative (Shout) MM/CLL, rhematic (Shout) SLE/RA, infectious (Shout) HCV/HBV/EBV”
(Soprano) Cold autoimmune hemolytic anemia “commonly primary, mycoplasma, (Shout) EBV, (Shout) CLL” “Painful blue fingers, anemia” “IgM, positive (Shout) DAT due to C3d on RBCs, cold agglutinin titer”
(Child) Erb palsy “waiter’s tip”

[Block 3: A driving drum-and-bass breakdown. The tension builds as they rapid-fire the orthopedics.]
(Soprano) (Shout) ACL injury (Shout) PRESENTS Anterior drawer (90° flexion) and Lachman (20° flexion). “Twisting mechanism, forced shyperextension,”
(Child) (Shout) PCL “dashboard injury”
(Soprano) Meniscal tears “McMurray; (Shout) IR of the tibia + Varus stress = lateral. (Shout) ER of the tibia + Valgus = medial”. “Acute twisting injury”. “swelling, clicking, locking, giving away of the knee”
(Child) Paget “osteoarthritis, spinal stenosis, nerve compression syndromes, deafness, usually conductive rarely osteosarcoma”

[Block 4: Full stadium-rock energy returns. Guitars are soaring and wide as they tackle the rheumatology.]
(Soprano) Reactive arthritis “Urethritis, conjunctivitis, arthritis, asymmetrical oligoarthritis, enthesitis, dactylitis, keratoderma blennorrhagicum”. 1-3 weeks after (Shout) GI/GU infections. NSAIDs, corticosteroids, DMARDs, Antibiotics only for Chlamydia (rifampicin + doxycycline)
(Child) Enteropathic arthritis associated with Crohn or (Shout) UC. B27 in Axial disease not in peripheral arthritis
(Soprano) Psoriatic arthritis “asymmetrical oligo or symmetrical large and small polyarthritis, dactylitis”
(Child) Ankylosing spondylitis “low back pain more than 3 months, sacroiliitis, midthoracic pain, asymmetrical peripheral oligoarthritis, enthesitis, anterior uveitis”
(Soprano) For Axial arthritis “anti-(Shout) TNF” for peripheral “DMARDs”

[Block 5: A bouncy pop-rap bridge pushes the track to its climax. The beat strips back to heavy kicks and clapping as they aggressively chant the vasculitides.]
(Child) Henoch-Schönlein (Shout) PRESENTS nonthrombocytopenic purpura, arthritis, abdominal pain, and glomerulonephritis/hematuria
(Soprano) Polyarteritis nodosa (Shout) PRESENTS “livedo reticularis, neuropathy, intestinal angina/postprandial abdominal pain, renin-mediated hypertension, spares the lungs, fibrinoid necrosis no granuloma”
(Child) Microscopic polyangiitis; P-ANCA-positive, nongranulomatous necrotizing vasculitis, tropism for the kidneys and lungs. No upper respiratory symptoms
(Soprano) Eosinophilic granulomatosis with polyangiitis. “Asthma and eosinophilia”
(Child) Granulomatosis with Polyangiitis “the upper or lower respiratory tract, necrotizing vasculitis affecting arteries or veins, segmental glomerulonephritis, nasal septal perforation, saddle nose”

[Outro: The beat shifts to a rapid, euphoric build-up. The singers deliver the final dermatological lines with maximum energy.]
(Soprano) Kaposi sarcoma, (Shout) HHV-8 (Shout) PRESENTS purplish nodules or plaques in skin and mucosa or rarely (Shout) GI, parenchymal disease in lungs
(Child) Lichen planus (Shout) PRESENTS Pruritic, purple, polygonal planar papules and plaques; flexural aspects of arms and legs, milky-white reticulated papules in mouth. Wickham striae are fine, white lines on top of papular lesions

[Ending: A massive power chord rings out with a final heavy drum crash. Both singers shout one last triumphant harmony before the track cuts to total silence.]

[End]

4474/7500

[Intro: 120 BPM. Palm-muted electric guitars chug a catchy chord progression. A heavy kick drum builds the energy. The Soprano vocalizes a soaring, classical run while the Child hypes up the stadium before the full band explodes into the groove.] [Block 1: The beat drops with crunchy guitars. The singers trade off the hematology and toxicology lines.] (Soprano) Burton line bluish line in the gingival margin in chronic lead poisoning (Child) Fanconi anemia “(Shout) DNA crosslink repair defect” (Shout) PRESENTS short stature, café-au-lait spots, thumb/radial defects, aplastic anemia, pancytopenia, (Shout) AML, horseshoe or absent kidney Next, Para para para para (Soprano) Paroxysmal nocturnal hemoglobinuria (Shout) PRESENTS Red urine in the morning, pancytopenia, venous thrombosis [Block 2: The guitars switch to bright, staccato stabs. The flow gets faster, bouncing back and forth.] (Child) Cryoglobulinemia “Meltzer triad of purpura, arthralgias/myalgia, weakness”. “High (Shout) RF, low C4, normal C3” (Shout) CAUSES “lymphoproliferative (Shout) MM/CLL, rhematic (Shout) SLE/RA, infectious (Shout) HCV/HBV/EBV” (Soprano) Cold autoimmune hemolytic anemia “commonly primary, mycoplasma, (Shout) EBV, (Shout) CLL” “Painful blue fingers, anemia” “IgM, positive (Shout) DAT due to C3d on RBCs, cold agglutinin titer” (Child) Erb palsy “waiter’s tip” [Block 3: A driving drum-and-bass breakdown. The tension builds as they rapid-fire the orthopedics.] (Soprano) (Shout) ACL injury (Shout) PRESENTS Anterior drawer (90° flexion) and Lachman (20° flexion). “Twisting mechanism, forced shyperextension,” (Child) (Shout) PCL “dashboard injury” (Soprano) Meniscal tears “McMurray; (Shout) IR of the tibia + Varus stress = lateral. (Shout) ER of the tibia + Valgus = medial”. “Acute twisting injury”. “swelling, clicking, locking, giving away of the knee” (Child) Paget “osteoarthritis, spinal stenosis, nerve compression syndromes, deafness, usually conductive rarely osteosarcoma” [Block 4: Full stadium-rock energy returns. Guitars are soaring and wide as they tackle the rheumatology.] (Soprano) Reactive arthritis “Urethritis, conjunctivitis, arthritis, asymmetrical oligoarthritis, enthesitis, dactylitis, keratoderma blennorrhagicum”. 1-3 weeks after (Shout) GI/GU infections. NSAIDs, corticosteroids, DMARDs, Antibiotics only for Chlamydia (rifampicin + doxycycline) (Child) Enteropathic arthritis associated with Crohn or (Shout) UC. B27 in Axial disease not in peripheral arthritis (Soprano) Psoriatic arthritis “asymmetrical oligo or symmetrical large and small polyarthritis, dactylitis” (Child) Ankylosing spondylitis “low back pain more than 3 months, sacroiliitis, midthoracic pain, asymmetrical peripheral oligoarthritis, enthesitis, anterior uveitis” (Soprano) For Axial arthritis “anti-(Shout) TNF” for peripheral “DMARDs” [Block 5: A bouncy pop-rap bridge pushes the track to its climax. The beat strips back to heavy kicks and clapping as they aggressively chant the vasculitides.] (Child) Henoch-Schönlein (Shout) PRESENTS nonthrombocytopenic purpura, arthritis, abdominal pain, and glomerulonephritis/hematuria (Soprano) Polyarteritis nodosa (Shout) PRESENTS “livedo reticularis, neuropathy, intestinal angina/postprandial abdominal pain, renin-mediated hypertension, spares the lungs, fibrinoid necrosis no granuloma” (Child) Microscopic polyangiitis; P-ANCA-positive, nongranulomatous necrotizing vasculitis, tropism for the kidneys and lungs. No upper respiratory symptoms (Soprano) Eosinophilic granulomatosis with polyangiitis. “Asthma and eosinophilia” (Child) Granulomatosis with Polyangiitis “the upper or lower respiratory tract, necrotizing vasculitis affecting arteries or veins, segmental glomerulonephritis, nasal septal perforation, saddle nose” [Outro: The beat shifts to a rapid, euphoric build-up. The singers deliver the final dermatological lines with maximum energy.] (Soprano) Kaposi sarcoma, (Shout) HHV-8 (Shout) PRESENTS purplish nodules or plaques in skin and mucosa or rarely (Shout) GI, parenchymal disease in lungs (Child) Lichen planus (Shout) PRESENTS Pruritic, purple, polygonal planar papules and plaques; flexural aspects of arms and legs, milky-white reticulated papules in mouth. Wickham striae are fine, white lines on top of papular lesions [Ending: A massive power chord rings out with a final heavy drum crash. Both singers shout one last triumphant harmony before the track cuts to total silence.] [End]

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