Quiz 11
Sorry, I made a mistake in this quiz.
A 34 year old female patient comes to your clinic. Her chief complaint is a rash that appeared all over her body as shown in the picture. The rash is slightly itchy. She feels slightly nauseated as well. She has no shortness of breath. She remembers a few insects biting her the previous day.
She remembers this happening in the past when she did not pay any heed
to it because it was not as bad.
She has a positive family history of such a problem but no diagnosis has been made.
Q1. Which one of the following tests is useful to elicit an underlying cause of this problem
Answer: I thought that this is hereditary angio-edema but actually I realized later that it is not because the condition (hereditary angio-edema) does not have Urticaria whereas this patient did. I had given her Zyrtec and Cimetidine and the next day the lesion was gone. This was plainly a reaction to insect bites. This leads me to accept the answer in Choice 1 as a better answer but the history of the family having the condition pushes the angio-edema option higher therefore in view of my error, I am giving the free membership trials to all the people who attempted the quiz- Good luck for the boards. The second question is not valid because choice 1 - which would have been the correct choice for it - (had the condition been angio-edema) - is not it now.
Hereditary angio-edema has been discussed in the past. Even though it is called giant urticaria, It is actually accompanied by non demarcated subcutaneous and submucosal swelling which are truly evanescent, lasting only 15 - 20 minutes. Urticaria is a rare finding in it. Episodes of angio-edema in hereditary angioedema are preventable using Danazol - an androgen.
Q2. Which of the following is helpful in preventing these attacks?
Sex hormones like androgens
Cholestyramine
Tetracycline
Acupuncture
Psychotherapy